Inbound Reports
AdvaPACS can receive reports from external reporting systems using HL7 ORU^R01 messages. These messages contain the patient, order, and report information required to associate the incoming report with an existing study. Report content is provided in the OBX segment and can be sent as text, formatted text, or encapsulated data such as HTML or PDF.
Supported Trigger Events
The following trigger events are supported by AdvaPACS.
| Trigger Event | Action |
|---|---|
ORU^R01 | Observation result message used to create or update a report in AdvaPACS. |
Expected Actions
When an ORU^R01 message is received, AdvaPACS processes the patient, order, and report information contained in the message.
| Resource | Action |
|---|---|
| Patient | The patient is created or updated based on matching with the Patient ID(s). |
| Order | The order-related segments are processed according to the supported order creation and update behaviour. |
| Report | The report is created for the associated study. If a report already exists, it is overwritten by the incoming report. |
Message Structure
Inbound Report messages use the standard ORU^R01 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 and identifiers associated with the report. |
OBR | Yes | Identifies the order, procedure, and study associated with the report. |
OBX | Yes | Contains the report content and related observation information. Multiple OBX segments may be included where required. |
ZDS | Optional | Contains the DICOM Study Instance UID used to identify the study associated with the report. |
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 (Patient Identifier) 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 contains visit information associated with the patient and report, including the patient class, referring doctor, and visit number.
| 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 associated with the report. 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.
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 report. It also contains key reporting information, including the reporting and verifying radiologists.
| 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-32 | Principal Result Interpreter | 200 | NDL | O | - |
| OBR-33 | Assistant Result Interpreter | 200 | NDL | O | - |
| 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-27 | Report Date/Time | Contains the date and time associated with the report. |
OBR-32 | Reporting Radiologist | Identifies the radiologist who authored the report. |
OBR-33 | Verifying Radiologist | Identifies the radiologist who verified the report. |
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.
OBX
The OBX (Observation/Result) segment contains the report content and defines how that content is encoded.
The following fields are supported:
| FIELD | NAME | LENGTH | DATA TYPE | OPT. | TABLE |
|---|---|---|---|---|---|
| OBX-1 | Set ID - OBX | 4 | SI | O | - |
| OBX-2 | Value Type | 3 | ID | R | 0125 |
| OBX-5 | Observation Value | 99999 | Varies | R | - |
| OBX-11 | Observation Result Status | 1 | ID | R | 0085 |
| OBX-14 | Date/Time of the Observation | 26 | TS | O | - |
ZDS
The ZDS (Additional Identification Information) segment contains the DICOM Study Instance UID used to identify the study associated with the report.
| 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 sends an HTML report encoded as Base64.
MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ORU^R01^ORU_R01|MSG000001|P|2.5.1
PID|1||123456^^^HOSPITAL^MR||SMITH^JOHN^MICHAEL||19800115|M
ORC|RE||||CM
OBR|1|||CTCHEST^CT Chest^L||||||||||||||ACC123456^HOSPITAL||||||CT|||^^^20260706100000+1200|||||1234^JONES^SARAH|5678^BROWN^DAVID
OBX|1|ED|||^text^html^Base64^PHA+Tm8gYWN1dGUgY2FyZGlvcHVsbW9uYXJ5IGFibm9ybWFsaXR5LjwvcD4=||||||F|||20260706102500+1200
In this example, the following fields provide the key report information:
| Field | Description | Example |
|---|---|---|
OBR-27 | Contains the report date and time. | ^^^20260706100000+1200 |
OBR-32 | Identifies the reporting radiologist who authored the report. | 1234^JONES^SARAH |
OBR-33 | Identifies the verifying radiologist who verified the report. | 5678^BROWN^DAVID |
OBX-5 | Contains the report content as Base64-encoded HTML. | ^text^html^Base64^<Base64 encoded report> |
OBX-11 | Contains the report status. | F |