HL7 ORM Service Order Control Operation Mapping

Owned by David Davies
Mar 08, 2018

Reference: IHE Technical Frameworks Vol 1

…actions (operations) based on the value of the field ORC-1 Order Control Code:

CA – Procedure has been cancelled, usually due to the cancellation of the underlying order; the
Image Manager and the Report Manager shall inactivate corresponding procedure information using Study Instance UID as a unique key of the Requested Procedure in question. Information from PID and PV1 segments shall not be used to update patient or visit information. If the Department System Scheduler/Order Filler has been notified that a Performed Procedure Step is in progress for a Requested Procedure, the order control code DC shall be used.

XO – Procedure-related information (including scheduled date/time and/or resource) has been changed. The Image Manager and Report Manager shall modify corresponding procedure information using the Study Instance UID as a unique key of the procedure in question. Information from PID and PV1 segments shall not be used to update patient or visit information.

DC – Order to which the particular procedure is related has been discontinued after at least one
Performed Procedure Step for this procedure has started. The Image Manager and the Report Manager shall consider all remaining SPS known for that procedure (if any) cancelled. The Image Manager shall use the Study Instance UID as a unique key of the procedure in question. Information from PID and PV1 segments shall not be used to update patient information.

DCM4CHEE ORM Service OrderControlOperationMap

The OrderControlOperationMap maps operation requests and order status from the received HL7 ORC segment to an operation supported by the DCM4CHEE order processing service i.e. service=HL7Service,type=ORM. This controls what happens to worklist items.

The following DCM4CHEE operations can be requested:

  • NW - create a new MWL item without an initial status 
  • XO - change an existing item or create a new item without an initial status if an existing one is not found.
  • CA - remove the item from the MWL.
  • SC - update the status of an item 
     

In addition a MWL items status can be updated by supplying a status value for XO and SC operations. The format is DC4CHEE-OP(DICOM-STATUS) e.g.

  • XO(SCHEDULED)
  • SC(ARRIVED)

Valid DICOM status values are:

  • SCHEDULED
  • COMPLETED
  • STARTED
  • ARRIVED
  • DISCONTINUED

On the HL7 side the operation and status are requested in the ORC segment of the order message (ORM^O001).

  • ORC-1 (field 1) is the requested operation (HL7-OP)
  • ORC-5 (field 5) is the requested status (HL7-STATUS)
     

Standard operation (HL7-OP) codes are:

  • NW - new order
  • XO - change an order
  • CA - cancel an order
  • SC - scheduling status change

…and standard status (HL7-STATUS) codes are:

  • SC - SCHEDULED
  • CM - COMPLETED
  • CA - CANCELLED
  • IP - IN PROGRESS
  • AR - ARRIVED
  • DC - DISCONTINUED

The OrderControlOperationMap format is:

HL7-OP(HL7-STATUS):DC4CHEE-OP(DICOM-STATUS)

Below is the default mapping table for DCM4CHEE.


NW:NW
XO:XO
XO(SC):XO(SCHEDULED)
XO(CM):XO(COMPLETED)
CA:CA
OC:CA
DC:SC(DISCONTINUED)
OD:SC(DISCONTINUED)
SC(IP):SC(STARTED)
SC(AR):SC(ARRIVED)
SC(CM):SC(COMPLETED)
SC(DC):SC(DISCONTINUED)
SC(CA):CA
SC:NOOP

Following sample HL7 ORM is provided with the DCM4CHE 5 toolkit:

MSH|^~\&|MESA_OF|XYZ_RADIOLOGY|MESA_IM|XYZ_IMAGE_MANAGER|||ORM^O01|103106|P|2.3.1|||||| ||
PID|||583295^^^ADT1||DOE^J1|||M||WH||||||||20983295|||||||||||||||||||||
PV1||E||||||5101^NELL^FREDERICK^P^^DR|||||||||||V103-1^^^ADT1|||||||||||||||||||||||||200007010800|||||||V|
ORC|NW|A103Z^MESA_ORDPLC|B103Z^MESA_ORDFIL||||1^once^^^^S||200007010900|^ROSEWOOD^RANDOLPH||7101^ESTRADA^JAIME^P^^DR||(314)555-1212|200007010900||922229-10^IHE-RAD^IHE-CODE-231||
OBR|1|A103Z^MESA_ORDC|B103Z^MESA_ORDFIL|P1^Procedure 1^ERL_MESA^X1_A1^SP Action Item X1_A1^DSS_MESA|||||||||xxx||Radiology^^^^R|7101^ESTRADA^JAIME^P^^DR||MOF5026|RP1026|SPS2032||||MR|||1^once^^^^S|||WALK|||||||||||A|||P1^Procedure 1^ERL_MESA
ZDS|1.113654.3.13.1026^100^Application^DICOM

Examples of how this works:
1. Sending this to DCM4CHEE configured with the default orm2dcm.xsl and the default
mapping i.e NW:NW will create a new MWL item with an empty status value:

2. To create a new MWL item with a status of SCHEDULED either:
change the mapping from NW:NW to NW:XO(SCHEDULED) e.g
ORC|NW|A103Z^MESA_ORDPLC|B103Z^MESA_ORDFIL||||1^once^^^^S|
or use XO(SC) i.e.
ORC|XO|A103Z^MESA_ORDPLC|B103Z^MESA_ORDFIL|||SC|1^once^^^^S|

3. When I cancel an already scheduled item, instead of removing the item from the MWL (default behavior) I want to set the status to DISCONTINUED:
change the mapping from CA:CA to CA:SC(DISCONTINUED) e.g.

ORC|CA|A103Z^MESA_ORDPLC|B103Z^MESA_ORDFIL||SC||1^once^^^^S|