Procedure Updated [RAD-13]

AdvaPACS implements the Procedure Updated [RAD-13] transaction. The source documentation from IHE can be found here.

Supported Versions

AdvaPACS supports HL7 version 2.3.1 and 2.5.1.

Supported Trigger Events

• ORM^O01

note

This shall be used after the first time a particular Study Instance UID is sent. If it has not been sent previously, then Procedure Scheduled [RAD-4] should be used.

Expected Actions

The Patient will either be created or updated based on matching with the Patient ID(s).

The Order will be located by Study Instance UID and updated.

Message Semantics

Required segments for ORM^* messages.

ADT	Description
MSH	Message Header
PID	Patient Identification
PV1	Patient Visit
{ORC	Common Order
OBR}	Order Detail
ZDS	Additional identification information (custom for IHE)

MSH

SEQ	LEN	DT	OPT	TBL#	ITEM #	ELEMENT NAME	Used by AdvaPACS
1	1	ST	R		00001	Field Separator	✅
2	4	ST	R		00002	Encoding Characters	✅
3	180	HD	R+		00003	Sending Application	✅
4	180	HD	R+		00004	Sending Facility	✅
5	180	HD	R+		00005	Receiving Application	✅
6	180	HD	R+1		00006	Receiving Facility	✅
7	26	TS	R		00007	Date/Time Of Message	✅
8	40	ST	O		00008	Security
9	13	CM	R	0076/0003	00009	Message Type	✅
10	20	ST	R		00010	Message Control ID	✅
11	3	PT	R		00011	Processing ID	✅
12	60	VID	R		00012	Version ID
13	15	NM	O		00013	Sequence Number
14	180	ST	O		00014	Continuation Pointer
15	2	ID	O		00015	Accept Acknowledgment Type	✅
16	2	ID	O		00016	Application Acknowledgment Type	✅
17	3	ID	O		00017	Country Code
18	16	ID	O		00692	Character Set
19	250	CE	O		00693	Principal Language Of Message
20	20	ID	O		01317	Alternate Character Set Handling Scheme

PID

All the fields are optional, except those listed below.

SEQ	LEN	DT	OPT	TBL#	ITEM #	ELEMENT NAME	Used by AdvaPACS
1	4	SI	O		00104	Set ID - Patient ID	✅
3	20	CX	R		00106	Patient Identifier List	✅
5	48	XPN	R		00108	Patient Name	✅
7	26	TS	R2		00110	Date/Time of Birth	✅
8	1	IS	R	0001	00111	Sex	✅
13	40	XTN	O			Phone Number - Home	✅
29	26	TS	O		00740	Patient Death Date and Time	✅
30	1	ID	O	0136	00741	Patient Death Indicator	✅

If the Assigning Authorities feature of AdvaPACS is enabled, Patient IDs must include Assigning Authority. The first subcomponent (namespace ID) of Assigning Authority shall be populated. If the second and third subcomponents (universal ID and universal ID type) are also populated, they shall reference the same entity as is referenced in the first subcomponent.

PV1

All the fields are optional, except those listed below.

SEQ	LEN	DT	OPT	TBL#	ITEM #	ELEMENT NAME	Used by AdvaPACS
1	4	SI	O		00131	Set ID - PV1	✅
2	1	IS	R	0004	00132	Patient Class	✅
8	60	XCN	C	0010	00138	Referring Doctor	✅
19	20	CX	C		00149	Visit Number	✅

ORC

All the fields are optional, except those listed below.

SEQ	LEN	DT	OPT	TBL#	ITEM #	ELEMENT NAME	Used by AdvaPACS
1	2	ID	R	0119	00215	Order Control	✅
2	22	EI	R2		00216	Placer Order Number	✅
3	22	EI	R		00217	Filler Order Number	✅
4	22	EI	O		00218	Placer Group Number	✅
5	2	ID	R	0038	00219	Order Status	✅
7	200	TQ	R		00221	Quantity/Timing	✅
10	120	XCN	R2		00224	Entered By
12	120	XCN	R2		00226	Ordering Provider
13	80	PL	R2		00227	Enterer's Location	✅
14	40	XTN	R2		00228	Callback Phone Number
17	60	CE	R2		00231	Entering Organization	✅

The following Order Control Codes and Order Statuses are applicable for use in the ORC-1 and ORC-5 fields respectively.

ORC-1 Value	ORC-1 Description	ORC-5 Value
CA	Cancel order request	CA
DC	Discontinue order request	CA
XO	Change order request, order is still scheduled or in progress	SC
XO	Change order request, order has been completed	CM

All (ORC, OBR) segment pairs sent in the Procedure Scheduled message shall be present in the Procedure Update message, not only the pairs introducing a change.

Quantity/Timing shall be the date and time of the Scheduled Procedure Step (in the fourth component)

OBR

All the fields are optional, except those listed below.

SEQ	LEN	DT	OPT	TBL#	ITEM #	ELEMENT NAME	Used by AdvaPACS
1	4	SI	R		00237	Set ID – OBR	✅
2	22	EI	R2		00216	Placer Order Number	✅
3	22	EI	R		00217	Filler Order Number	✅
4	200	CE	R		00238	Universal Service ID	✅
5	2	ID	R2		00239	Priority
12	60	CE	R2		00246	Danger Code
13	300	ST	R2		00247	Relevant Clinical Info
15	300	CM	C	0070	00249	Specimen Source
16	120	XCN	R2		00226	Ordering Provider
17	40	XTN	R2		00250	Order Callback Phone Number
18	60	ST	R		00251	Placer Field 1	✅
19	60	ST	R		00252	Placer Field 2	✅
20	60	ST	R		00253	Filler Field 1	✅
24	10	ID	R	0074	00257	Diagnostic Serv Sect ID	✅
27	200	TQ	R		00221	Quantity/Timing	✅
30	20	ID	R2	0124	00262	Transportation Mode
31	300	CE	R2		00263	Reason for Study
34	200	NDL	O		00266	Technician	✅
44	80	CE	O	0088	00393	Procedure Code

Field OBR-15 Specimen Source holds the laterality (Left/Right) indicator (when used) in the component. This element shall be present if the procedure has laterality and the Universal Service ID code in OBR-4 does not encode laterality. This element shall not be present otherwise.

Required fields in the OBR segment that are not identical to those from the ORC segment shall be filled by the Department System Scheduler as defined in the following table.

Element Name	Seq	Shall Contain:	Notes
Placer Field 1	OBR-18	Accession Number	Length of the value in this field shall not exceed 16 characters
Placer Field 2	OBR-19	Requested Procedure ID	All OBR segments within a singe ORM message shall have the same value in this field
Filler Field 1	OBR-20	Scheduled Procedure Step ID	If a Scheduled Procedure Step has multiple Protocol Codes associated with it, several ORC segments within a single ORM message may have the same value in this field
Universal Service ID	OBR-4	Both the Universal Service ID of the Order and a Scheduled Protocol Code of the Scheduled Procedure Step	Components 1-3 of OBR-4 shall be copied by the Order Filler from the components 1-3 of OBR-4 it obtains from the ORM message. Components 1-3 of OBR-4 in all OBR segments of an ORM message shall have the same value. Components 4-6 shall be filled with the Scheduled Protocol Code.
Specimen Source	OBR-15	Laterality of the procedure. The value shall be appended to the Requested Procedure Description	Only if not already encoded within the Universal Service ID
Diagnostic Service Section ID	OBR-24	DICOM Modality
Procedure Code	OBR-44	Requested Procedure Code and Requested Procedure Code Description	Components 1-3 shall contain the Requested Procedure Code for this ORM message. Optionally, component 5 may contain the Requested Procedure Description.

ZDS

SEQ	LEN	DT	OPT	TBL#	ITEM #	ELEMENT NAME	Used by AdvaPACS
1	200	RP	R		Z0001	Study Instance UID	✅

Study Instance UID

ZDS-1-1 shall be a DICOM compliant Study Instance UID value.

ZDS-1-3 shall be "Application"

ZDS-1-4 shall be "DICOM"