Procedure Update
AdvaPACS supports the IHE Procedure Scheduled [RAD-13] transaction for updating existing imaging orders and scheduled procedures via HL7 ORM messages.
Supported Trigger Events
The following trigger events are supported by AdvaPACS:
| Trigger Event | Action |
|---|---|
ORM^O01 | Imaging order / scheduled procedure. |
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 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 | - |
The following Order Control and Order Status combinations are supported when updating or cancelling an existing order. The Order Control value is provided in ORC-1, while the corresponding Order Status is provided in ORC-5.
| ORDER CONTROL | DESCRIPTION | ORDER STATUS |
|---|---|---|
CA | Cancels the existing order. | CA |
DC | Discontinues the existing order. | CA |
XO | Updates an order that is still scheduled or in progress. | SC |
XO | Updates an order that 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
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 Message
The following example uses an ORM^O01 message to update an existing scheduled procedure. The order is identified using the existing order and procedure identifiers provided in the ORC and OBR segments.
MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706113000+1200||ORM^O01|MSG000002|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|XO|ORD123456^^HOSPITAL|ORD123456^^HOSPITAL||CM
OBR|1|ORD123456^^HOSPITAL|ORD123456^^HOSPITAL|CTCHESTCON^CT Chest with Contrast^L||||||||||||1234^SMITH^JANE||ACC123456^^HOSPITAL|RP123456|SPS123456||||CT|||^^^20260706140000
In this example, the following fields contain the key information used to update the procedure:
| Field | Description |
|---|---|
ORC-1 | Indicates the Order Control action to perform. XO updates an existing order. |
ORC-5 | Contains the Order Status. CM indicates the procedure is now complete. |
ORC-2 | Contains the Placer Order Number used to identify the existing order. |
ORC-3 | Contains the Filler Order Number used to identify the existing order. |
OBR-4 | Contains the updated procedure code and description. |
OBR-18 | Contains the Accession Number. |
OBR-19 | Contains the Requested Procedure ID. |
OBR-20 | Contains the Scheduled Procedure Step ID. |
OBR-27 | Contains the updated scheduled date and time. |
The patient is matched using the Patient ID(s) in PID-3, while the existing order and procedure are updated using the identifiers provided in the message.
OLD
AdvaPACS implements the Patient Registration [RAD-1] 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
- ADT^A01
- ADT^A04
- ADT^A05
- ADT^A08
- ADT^A11
- ADT^A38
Expected Actions
A01, A04, A05 - will create a new Patient record if a Patient matching the provided Patient ID(s) can not be located. Ignored if there is an existing record.
A11, A38 - will attempt to delete a Patient record if found. The Patient will only be deleted if there are no resources associated with it.
A08 - will update an existing Patient. If no Patient is found by the provided Patient ID(s) then the message will be ignored.
Message Semantics
Required segments for ADT^* messages.
| ADT | Description |
|---|---|
| MSH | Message Header |
| EVN | Event Type |
| PID | Patient Identification |
| PV1 | Patient Visit |