FAQs - Pathology Feed (HL7)

1) Can I put two different results for the same test in one HL7 message?

(e.g., Can I send two different creatinine results in one HL7 message?)

No. An ORU^R01 test result message can only have one Filler Order Number (FON) associated with it. Each unique FON can only have one value for a single test ID. PKB doesn't accept that two different results for the same test ID can be linked to one FON because if you go on to send another HL7 message to update just one of those results — how would PKB know which to update?

2) If we put a delay on a result, does it mean that PKB won't process it?

PKB still processes the result, but delays displaying it to the patient. Delaying based on the process of reporting is not considered best practice because the disease progresses without waiting for the process of reporting, and the clinical safety risk of the patient not seeing their report goes up every day the report release is delayed. Delays to displaying results do not apply to clinicians.

3) What will PKB do if we resend an unchanged result but with a different (longer) delay in OBR-13?

If you update the delay days for a previously sent result (and nothing else other than MSH), then we'll apply the delay using that changed value as it relates to the Observation timestamp. The UI will also display to the user that a "correction" has been made to the result.

4) Can we send in results so that they are mapped to something other than the General Health privacy label?

Yes, there are two places within the ORU message to set the privacy label associated with the results: PV1-10 (hospital service code) and OBR-4.1 (order service code).

5) How can a result be deleted from a patient record?

To delete a specific result from a patient record, an ORU HL7 message is required that contains the Filler order number (as derived from ORC-3.1 or OBR-3.1) of the Report that the result was sent within, with the Result status (OBR-25.1) set to R. This will delete ALL results sent as part of that report. The report then needs to be re-sent containing only the results you want to have displayed. In summary: Delete the report (where it includes a result that should not be there) and send in the report again, containing the results that should be included.

6) Does PKB support HTML for HL7 lab results?

PKB supports some basic html in the NTE segment only.

• HTML Support: Use <b> for bolding, <p> for paragraphs, and <a> for clickable links.

Additionally, the following is also supported

• Control Characters: Unicode characters below 32 are prohibited, with three specific exceptions: Horizontal Tab (U+0009), Line Feed (U+0010), and Carriage Return (U+0013).

• Layout: Include \n or \r\n

LOINC Mapping & Display

7) If we're sending LOINC-mapped results, are the units we send in the HL7 message important?

Yes, the units sent in with LOINC-mapped results are very important.

• If you tell us the units you are using for each test, we'll make sure we can support those units for that test. We match on LOINC code and unit, but do need to map each possibility.

• Units need to match our expectation exactly.

• If a LOINC has multiple unit possibilities, we need to map each one. Each combination is graphed separately in PKB.

• If we receive a LOINC code and unit combination we don't have mapped, we treat it as a result that's not LOINC mapped.

• Our matching is done on string matching, so units must match exactly (including CAPS use).

8) How can we assure that the LOINC code and units mapping is correct?

All lab panels, when viewed in the UI, will have the Trust's name in brackets after the panel name if they are NOT LOINC mapped. If they are LOINC mapped, the Trust name will not appear and the lab name would match the PKB name rather than the Trust's name for that test. You can view panels in the UI by going to Health > Tests > make sure you click the 'trends' option to see panels. Alongside this, the Lab Tests Online link should only link to the correct page if the test has the correct LOINC code attached.

9) When I send a LOINC coded result, can I change the display name or the panel the result is displayed within in PKB?

No. When sending LOINC coded results, the display name and the panel in which it is displayed are both applied by PKB.

10) Why is sending a reference range important?

The high / low reference range is plotted on the result's graph in PKB alongside the patient's actual result for the test. This allows the patient to know where they sit in the target reference range.

Textual Reports & Identifiers

11) What is a fully (single) textual report in PKB?

A report is considered a fully textual report when all the OBX segments have matching test IDs (OBX-3.1 and OBX-3.3, case sensitive).

12) Why are the values I sent for OBX-3.1 and 3.3 not showing when I send in a textual result?

If your report conforms to the criteria of being a fully (single) textual report, then those values are replaced by the ones supplied in OBR-4.1 and OBR-4.3 respectively.