Procedure Scheduled
AdvaPACS supports the IHE Procedure Scheduled [RAD-4] transaction for receiving new imaging orders and scheduled procedures via HL7 ORM messages. These messages allow an external scheduling system, such as a RIS or HIS, to create new orders and studies in AdvaPACS using the supplied patient, order, procedure, scheduling, and Study Instance UID information.
Supported Trigger Events
The following trigger events are supported by AdvaPACS:
| Trigger Event | Action |
|---|---|
ORM^O01 | New imaging order / scheduled procedure. |
Expected Actions
| Order Control | Action |
|---|---|
NW | Creates a new order and associated study if a matching order cannot be found. Ignored if the order already exists. |
Message Structure
Procedure Scheduled messages use the standard ORM^O01 message structure. The following segments are supported:
| Segment | Required | Description |
|---|---|---|
MSH | Yes | Identifies the message type, sender, receiver, and other message-level information. |
PID | Yes | Contains the patient identifiers and demographics. |
PV1 | Optional | Contains patient visit information, including the patient class and referring doctor where applicable. |
ORC | Yes | Contains common order information, including the order control, order status, and order identifiers. |
OBR | Yes | Contains the requested procedure and scheduled procedure step details, including the accession number, modality, and scheduled date and time. |
ZDS | Optional | Contains the DICOM Study Instance UID associated with the scheduled procedure. |
The following reference provides the supported fields for each HL7 segment used in this workflow. Unless otherwise stated, fields not listed are ignored during processing.
MSH
The MSH (Message Header) segment identifies the message type, sender, receiver, version and other information required to process an HL7 message. All patient registration messages sent to AdvaPACS must include a valid MSH segment.
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| MSH-1 | Field Separator | 1 | ST | R | - |
| MSH-2 | Encoding Characters | 4 | ST | R | - |
| MSH-3 | Sending Application | 227 | HD | R+ | - |
| MSH-4 | Sending Facility | 227 | HD | R+ | - |
| MSH-5 | Receiving Application | 227 | HD | R | - |
| MSH-6 | Receiving Facility | 227 | HD | R+ | - |
| MSH-7 | Date/Time of Message | 26 | TS | R | - |
| MSH-9 | Message Type | 15 | MSG | R | 0076 |
| MSH-10 | Message Control ID | 199 | ST | R | - |
| MSH-11 | Processing ID | 3 | PT | R | 0103 |
| MSH-12 | Version ID | 60 | VID | R | 0104 |
| MSH-15 | Accept Acknowledgment Type | 2 | ID | O | 0155 |
| MSH-16 | Application Acknowledgment Type | 2 | ID | O | 0155 |
PID
The PID segment contains the patient identifiers and demographic information used to identify the patient associated with the report.
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| PID-1 | Set ID - PID | 4 | SI | O | - |
| PID-3 | Patient Identifier List | 20 | CX | R | - |
| PID-5 | Patient Name | 48 | XPN | R | - |
| PID-7 | Date/Time of Birth | 26 | TS | R2 | - |
| PID-8 | Sex | 1 | IS | R | 0001 |
| PID-13 | Phone Number - Home | 40 | XTN | O | - |
| PID-29 | Patient Death Date and Time | 26 | TS | O | - |
| PID-30 | Patient Death Indicator | 1 | ID | O | 0136 |
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
The PV1 (Patient Visit) segment describes the patient's encounter at the requesting facility. While many fields are optional for outpatient imaging, the segment can be used to communicate visit information, patient class, referring provider, and visit identifiers when available.
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| PV1-1 | Set ID - PV1 | 4 | SI | O | - |
| PV1-2 | Patient Class | 1 | IS | R | 0004 |
| PV1-8 | Referring Doctor | 60 | XCN | C | 0010 |
| PV1-19 | Visit Number | 20 | CX | C | - |
ORC
The ORC (Common Order) segment contains common order information used to identify and process the order. This includes the order control, order numbers, order status, scheduled date and time, and organisation information.
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| ORC-1 | Order Control | 2 | ID | R | 0119 |
| ORC-2 | Placer Order Number | 22 | EI | R2 | - |
| ORC-3 | Filler Order Number | 22 | EI | R | - |
| ORC-4 | Placer Group Number | 22 | EI | O | - |
| ORC-5 | Order Status | 2 | ID | R | 0038 |
| ORC-7 | Quantity/Timing | 200 | TQ | R | - |
| ORC-10 | Entered By | 250 | XCN | O | 0010 |
| ORC-13 | Enterer's Location | 80 | PL | R2 | - |
| ORC-17 | Entering Organization | 60 | CE | R2 | - |
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.
The following values are required when creating a new order:
ORC-1— Order Control must be set toNW.ORC-5— Order Status must be set toSC.ORC-7.4— Quantity/Timing must contain the date and time of the Scheduled Procedure Step.
OBR
The OBR (Observation Request) segment contains information about the requested procedure and Scheduled Procedure Step associated with the order.
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| OBR-1 | Set ID - OBR | 4 | SI | R | - |
| OBR-2 | Placer Order Number | 22 | EI | R2 | - |
| OBR-3 | Filler Order Number | 22 | EI | R | - |
| OBR-4 | Universal Service ID | 200 | CE | R | - |
| OBR-18 | Placer Field 1 | 60 | ST | R | - |
| OBR-19 | Placer Field 2 | 60 | ST | R | - |
| OBR-20 | Filler Field 1 | 60 | ST | R | - |
| OBR-24 | Diagnostic Service Section ID | 10 | ID | R | 0074 |
| OBR-27 | Quantity/Timing | 200 | TQ | R | - |
| OBR-34 | Technician | 200 | NDL | O | - |
The following fields have specific uses within AdvaPACS:
| Field | AdvaPACS Value | Notes |
|---|---|---|
OBR-4 | Universal Service ID | Components 1–3 contain the Universal Service ID. Components 4–6 may contain the Scheduled Protocol Code. |
OBR-15 | Laterality | Contains the procedure laterality when it is not already encoded in OBR-4. |
OBR-18 | Accession Number | Must not exceed 16 characters. |
OBR-19 | Requested Procedure ID | All OBR segments within the same message must contain the same Requested Procedure ID. |
OBR-20 | Scheduled Procedure Step ID | Multiple Scheduled Protocol Codes may reference the same Scheduled Procedure Step ID. |
OBR-24 | DICOM Modality | Contains the modality associated with the Scheduled Procedure Step. |
OBR-44 | Requested Procedure Code | Components 1–3 contain the Requested Procedure Code. Component 5 may optionally contain the Requested Procedure Description. |
The Placer Order Number and Filler Order Number provided in OBR-2 and OBR-3 must match the corresponding values in ORC-2 and ORC-3. Laterality may be included in the Universal Service ID in OBR-4. If it is not included, the laterality should be provided separately in OBR-15.
ZDS
The ZDS (Additional Identification Information) segment contains the DICOM Study Instance UID used to identify the study associated with the order.
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| ZDS-1 | Study Instance UID | 200 | RP | R | - |
The Study Instance UID is provided in ZDS-1 using the following structure:
| Component | Value |
|---|---|
ZDS-1.1 | DICOM-compliant Study Instance UID |
ZDS-1.3 | Application |
ZDS-1.4 | DICOM |
Example Messages
The examples below illustrate typical HL7 messages used during order registration. Use them as a reference when building, testing, or troubleshooting your integration with AdvaPACS.
Create an Order
Use an ORM^O01 message to create a new order in AdvaPACS. For a new order, ORC-1 should be set to NW (New Order) and ORC-5 should contain the current order status. When the message is processed, the Patient will either be created or updated based on matching the Patient ID(s) provided in PID-3.
The following example creates a scheduled CT Chest order:
MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ORM^O01|MSG000001|P|2.5.1
PID|1||123456^^^HOSPITAL^MR||SMITH^JOHN^MICHAEL||19800115|M|||123 Example Street^^Auckland^^1010^NZ
PV1|1|O|||||1234^SMITH^JANE
ORC|NW|ORD123456|ORD123456||SC
OBR|1|ORD123456|ORD123456|CTCHEST^CT Chest^L||||||||||||1234^SMITH^JANE||ACC123456|RP123456|SPS123456||||CT|||^^^20260706120000
In this example:
PID-3contains the Patient ID (123456).ORC-1isNW, indicating a new order.ORC-2contains the Placer Order Number (ORD123456).ORC-3contains the Filler Order Number (ORD123456).ORC-5isSC, indicating the order is scheduled.OBR-4contains the Universal Service Identifier, identifying the requested procedure asCTCHEST.OBR-16contains the Ordering Provider.OBR-18contains the Accession Number (ACC123456).OBR-19contains the Requested Procedure ID (RP123456).OBR-20contains the Scheduled Procedure Step ID (SPS123456).OBR-24contains the Diagnostic Service Section ID, in this caseCT.OBR-27.4contains the scheduled date and time of the procedure (20260706120000).
Using Assigning Authorties
When Assigning Authorities are enabled, identifiers in the HL7 message should include the appropriate assigning authority. This allows identifiers from different systems or organisations to be uniquely identified within AdvaPACS. For example:
MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ORM^O01|MSG000001|P|2.5.1
PID|1||123456^^^HOSPITAL^MR||SMITH^JOHN^MICHAEL||19800115|M|||123 Example Street^^Auckland^^1010^NZ
PV1|1|O|||||1234^SMITH^JANE
ORC|NW|ORD123456^^HOSPITAL|ORD123456^^HOSPITAL||SC
OBR|1|ORD123456^^HOSPITAL|ORD123456^^HOSPITAL|CTCHEST^CT Chest^L||||||||||||1234^SMITH^JANE||ACC123456^^HOSPITAL|RP123456|SPS123456||||CT|||^^^20260706120000
The assigning authority provided for each identifier must match an Assigning Authority configured in AdvaPACS for the corresponding identifier type. Patient and order identifiers may use different assigning authorities depending on your configuration.
For more information regarding Assigning Authorities, refer to the Assigning Authority documenation.
Uploading a Document
Documents associated with an order, such as referral forms, consent forms, or other supporting documents, can be included in the HL7 message using an OBX segment. The document is provided using the ED (Encapsulated Data) data type and should be Base64 encoded.
The following example includes a PDF referral form:
MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ORM^O01|MSG000001|P|2.5.1
PID|1||123456^^^HOSPITAL^MR||SMITH^JOHN^MICHAEL||19800115|M|||123 Example Street^^Auckland^^1010^NZ
PV1|1|O|||||1234^SMITH^JANE
ORC|NW|ORD123456|ORD123456||SC
OBR|1|ORD123456|ORD123456|CTCHEST^CT Chest^L||||||||||||1234^SMITH^JANE||ACC123456|RP123456|SPS123456||||CT|||^^^20260706120000
OBX|1|ED|REDOC^Referral Form PDF||^ReferralSystem^application/pdf^PDF^Base64^JVBER...YWxvZw