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Order Entry: Pharmacy/Treatment, Vaccination

Co-Chair:

Hans Buitendijk
Cerner Corporation

Co-Chair:

David Burgess
LabCorp

Co-Chair:

Lorraine Constable
Constable Consulting

Co-Chair:

Robert Hausam
Hausam Consulting

Co-Chair:

Ken McCaslin
Accenture

Co-Chair:

Patrick Loyd
ICode Solutions

Co-Chair:

Riki Merrick
Vernetzt, LLC

Co-Chair:Chapter Chair:

JD Nolen

Children’s Mercy Hospital

Editor

Scott Robertson
Kaiser Permanente

Sponsoring Committee:

Orders & Observations

List Server:

ord@lists.hl7.org



Purpose

This extension of chapter 4 was created because as of version 2.6 it had become too large to edit without great difficulty. Thus, the sections specific to pharmacy and vaccines were excised from that chapter and now comprise the content of this chapter.

Preface (organization of this chapter)

This chapter is organized into two major sections, Pharmacy, and Vaccine. Each section contains the trigger events, message definitions, segments and examples for the specific type of order messages. Each section about a type of order is organized into background and overview, message structure, and message segments (that are specific to the order class in question). Special discussions of the use of fields, segments or messages, and examples are included. Segments are introduced in order of occurrence in a message. A list of allowable values for a field is included in the body of the text, along with the field definition for easier reference.

Section 4A.3 to 4A.6    Covers pharmacy/treatment trigger events & messages, pharmacy/treatment segments, pharmacy/treatment message examples and pharmacy/treatment message flow diagrams.

Sections 4A.7 to 4A.6    Covers vaccine trigger events & message definitions, vaccine segments and vaccine message examples.

Pharmacy/Treatment Trigger Events & Messages

Usage notes for pharmacy/treatment messages

For the RDS (pharmacy/treatment dispense), RGV (pharmacy/treatment give) and RAS (pharmacy/treatment administration) messages, the placer and filler order numbers are those of the parent RDE (pharmacy/treatment encoded order) message. In these messages, the filler order number does not provide a unique identification of the instance of the pharmacy/treatment action (dispense, give or administer). To correct this problem, each of the defining segments (RXD, RXG, and RXA) has an appropriately named sub-ID field (dispense sub-ID counter, give sub-ID counter, and administration sub-ID counter). The combination of the filler order number (including its application ID component) and the appropriate sub-ID counter uniquely identifies the instance of the pharmacy/treatment action(s) present in these messages.

Although the default order control code for the RDE, RDS, RGV and RAS messages is "RE," there are cases in which the pharmacy or treatment system and the receiving system must communicate changes in state. Depending on whether the pharmacy or treatment supplier's relationship to the receiving system is that of placer or filler, the appropriate order control code may be substituted for the default value of RE. The receiving system can also use an appropriate order control code to report status back to the pharmacy or treatment system.

For example, suppose that a pharmacy or treatment system is sending RGV messages to a nursing system which will administer the medication and that the pharmacy or treatment system needs to request that several instances of a give order be discontinued. To implement this request, the RGV message may be sent with a "DC" order control code (discontinue request), and the appropriate RXG segments whose give sub-ID fields identify the instances to be discontinued. If a notification back to the pharmacy or treatment supplier is needed, the nursing system can initiate an RGV message with a "DR" order control code (discontinue as requested), and containing RXG segments whose give sub-ID fields identify the discontinued instances.

IV solution groups

An order for a group of IV solutions to be given sequentially can be supported in two similar ways: Parent/Child and Separate Orders. This HL7 Standard supports both methods of ordering. The method used at a particular site must be negotiated between the site institution and the various application vendors. See Chapter 2, section 2.A.53 OSD Order Sequence Definition, "Use Case 1 Cyclic placer order groups," for further details.

OMP - Pharmacy/Treatment Order Message (Event O09)

OMP^O09^OMP_O09: Pharmacy/treatment Order Message
HL7 MessageStructure Table - OMP_O09
Segment Cardinality Must Implement Status
OMP_O09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
NTE 0..*
ARV 0..* B
GT1 0..1
AL1 0..*
ADDITIONAL_DEMOGRAPHICS 0..1
PD1 1..1 Yes
PRT 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..1
ORDER 1..* Yes
ORC 1..1 Yes
RXO 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
CDO 0..*
FT1 0..*
BLG 0..1
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for OMP^O09^OMP_O09

Send Application Ack: ORP^O10^ORP_O10

Enhanced Mode Acknowledgement Choreography for OMP^O09^OMP_O09

When the MSH-15 value of an OMP^O09^OMP_O09 message is AL or ER or SU, an ACK^O09^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an OMP^O09^OMP_O09 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an OMP^O09^OMP_O09 message is AL or ER or SU, an ORP^O10^ORP_O10 or OSU^O52^OSU_O52 message SHALL be sent as an application ack.

When the MSH-16 value of an OMP^O09^OMP_O09 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O09^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ORP^O10^ORP_O10 or OSU^O52^OSU_O52
NE (none)

ORP - Pharmacy/Treatment Order Acknowledgment (Event O10)

ORP^O10^ORP_O10: Description
HL7 MessageStructure Table - ORP_O10
Segment Cardinality Must Implement Status
ORP_O10
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*

Original Mode Acknowledgement Choreography for ORP^O10^ORP_O10

Send Immediate Ack: ACK^O10^ACK

Enhanced Mode Acknowledgement Choreography for ORP^O10^ORP_O10

When the MSH-15 value of an ORP^O10^ORP_O10 message is AL or ER or SU, an ACK^O10^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ORP^O10^ORP_O10 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O10^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

RDE/RRE - pharmacy/treatment encoded order message (O01/O02)

Attention: The use of RDE with the trigger of O01 and RRE with the trigger O02 is maintained for backward compatibility as of v 2.4 and is withdrawn as of v 2.7. Refer to RDE with trigger O11 and RRE with trigger O12 instead.

RDE - Pharmacy/Treatment Encoded Order Message (Event O11)

This message communicates the pharmacy or treatment application's encoding of the pharmacy/treatment order ,OMP, message. It may be sent as an unsolicited message to report on either a single order or multiple pharmacy/treatment orders for a patient.

The RDE/RRE message pair can also be used to communicate a refill authorization request; however, a specific trigger event has been assigned. See section 4A.3.13 "RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)." As a site-specific variant, the original order segments (RXO, RXRs, associated RXCs, and any NTEs) may be sent optionally (for comparison).

The event O11 represents an encoding of an order. To communicate explicit dispense requests, which are different event types, the RDE^O11/RRE^O12 message pair is also used, but the event O49 is preferred. See section 4A.3.23 "RDE - Pharmacy/Treatment Dispense Request Message (Event O49)." As a site-specific variant, the original order segments (RXO, RXRs, associated RXCs, and any NTEs) may be sent optionally (for comparison).

RDE^O11^RDE_O11: Pharmacy/Treatment Encoded Order Message
HL7 MessageStructure Table - RDE_O11
Segment Cardinality Must Implement Status
RDE_O11
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PD1 0..1
PRT 0..*
NTE 0..*
ARV 0..* B
GT1 0..1
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..1
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
CDO 0..*
FT1 0..*
BLG 0..1
CTI 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
PHARMACY_TREATMENT_INFUSION_ORDER 0..*
RXV 1..1 Yes
PRT 0..*
NTE 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RDE^O11^RDE_O11

Send Application Ack: RRE^O12^RRE_O12

Enhanced Mode Acknowledgement Choreography for RDE^O11^RDE_O11

When the MSH-15 value of a RDE^O11^RDE_O11 message is AL or ER or SU, an ACK^O11^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RDE^O11^RDE_O11 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RDE^O11^RDE_O11 message is AL or ER or SU, a RRE^O12^RRE_O12 or OSU^O52^OSU_O52 message SHALL be sent as an application ack.

When the MSH-16 value of a RDE^O11^RDE_O11 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O11^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRE^O12^RRE_O12 or OSU^O52^OSU_O52
NE (none)

Note:     The RXCs which follow the RXO may not be fully encoded, but those that follow the RXE must be fully encoded.

The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.

The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.

The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXV segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).

The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.


RRE - Pharmacy/Treatment Encoded Order Acknowledgment (Event O12)

RRE^O12^RRE_O12: Pharmacy/Treatment Encoded Order Acknowledgment Message
HL7 MessageStructure Table - RRE_O12
Segment Cardinality Must Implement Status
RRE_O12
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*

Original Mode Acknowledgement Choreography for RRE^O12^RRE_O12

Send Immediate Ack: ACK^O12^ACK

Enhanced Mode Acknowledgement Choreography for RRE^O12^RRE_O12

When the MSH-15 value of a RRE^O12^RRE_O12 message is AL or ER or SU, an ACK^O12^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RRE^O12^RRE_O12 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O12^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

RDS - Pharmacy/Treatment Dispense Message (Event O13)

The RDS message may be created by the pharmacy/treatment application for each instance of dispensing a drug or treatment to fill an existing order or orders. In the most common case, the RDS messages would be routed to a Nursing application or to some clinical application, which needs the data about drugs dispensed or treatments given. As a site-specific variant, the original order segments (RXO, RXE and their associated RXR/RXCs) may be sent optionally (for comparison).

The ORC must have the filler order number and the order control code RE. The RXE and associated RXCs may be present if the receiving application needs any of their data. The RXD carries the dispense data for a given issuance of medication: thus it may describe a single dose, a half-day dose, a daily dose, a refill of a prescription, etc. The RXD is not a complete record of an order. Use the RXO and RXE segments if a complete order is needed. It is a record from the pharmacy or treatment supplier to the Nursing application (or other) with drug/treatment dispense and administration instructions.

The FT1 segment is optional and repeating in order to accommodate multiple charge, benefit and pricing situations. Example use cases demonstrating zero, one and two FT1 segments follow:

In the case where the RDS message represents a dispense event that is in process (i.e., has not been received by the patient), the financial transactions associated with the dispense do not yet exist. Until the financial transactions associated with the dispense event have been completed, no FT1 segment may exist in the message.

In the case where the RDS message represents a dispense event that has been received by the patient, and thus all financial transactions have been completed, the RDS message may contain one or more FT1 segments. Examples of single and multiple FT1 segments follow.

Payment for the dispense event completed by a single payor:

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006082911150700||RDS^O13^RDS_O13|...<cr>

PID|...<cr>

ORC|RE|...<cr>

RXD|1|00310-0131-10^LISINOPRIL 10MG TABLET^NDC|200607150830|100|TAB|...<cr>

FT1|1|||200607151035||PY|00310-0131-10^LISINOPRIL 10MG TABLET^NDC|||100|125.43&USD|...<cr>

Payment for the dispense event involves multiple payment sources:

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006082213000700||RDS^O13^RDS_O13|...<cr>

PID|...<cr>

ORC|RE|...<cr>

RXD|1|00340-0241-10^VERAPAMIL 120MG TABLET^NDC|200607200940|100|TAB|...<cr>

FT1|1|||200607211055||CD|00340024110^VERAPAMIL 120MG TABLET ^NDC|||100|55.43&USD|...<cr> (amount paid by insurance)

FT1|2|||200607211055||CP|00340024110^VERAPAMIL 120MG TABLET ^NDC|||100|5.00&USD|...<cr> (copay paid by patient)

Note: The use of RDS with the trigger of O01 and RRD with the trigger O02 is maintained for backward compatibility as of v 2.4 and is withdrawn as of v 2.7.

RDS^O13^RDS_O13: Pharmacy/Treatment Dispense Message
HL7 MessageStructure Table - RDS_O13
Segment Cardinality Must Implement Status
RDS_O13
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PD1 1..1 Yes
PRT 0..*
ARV 0..* B
NTE 0..*
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
RXD 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
CDO 0..*
FT1 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
ORDER_DETAIL_SUPPLEMENT 0..1
NTE 1..* Yes
RXR 1..* Yes
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RDS^O13^RDS_O13

Send Application Ack: RRD^O14^RRD_O14

Enhanced Mode Acknowledgement Choreography for RDS^O13^RDS_O13

When the MSH-15 value of a RDS^O13^RDS_O13 message is AL or ER or SU, an ACK^O13^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RDS^O13^RDS_O13 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RDS^O13^RDS_O13 message is AL or ER or SU, a RRD^O14^RRD_O14 message SHALL be sent as an application ack.

When the MSH-16 value of a RDS^O13^RDS_O13 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O13^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRD^O14^RRD_O14
NE (none)

Note:    The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.

The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.

The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXD segment are intended to communicate notes and comments relative to the dispense event.

The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).

The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.


RRD - Pharmacy/Treatment Dispense Acknowledgement Message (Event O14)

RRD^O14^RRD_O14: Pharmacy/Treatment Dispense Acknowledgment Message
HL7 MessageStructure Table - RRD_O14
Segment Cardinality Must Implement Status
RRD_O14
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
DISPENSE 0..1
RXD 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*

Original Mode Acknowledgement Choreography for RRD^O14^RRD_O14

Send Immediate Ack: ACK^O14^ACK

Enhanced Mode Acknowledgement Choreography for RRD^O14^RRD_O14

When the MSH-15 value of a RRD^O14^RRD_O14 message is AL or ER or SU, an ACK^O14^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RRD^O14^RRD_O14 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O14^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

RGV/RRG - pharmacy/treatment give message (O01/O02)

Attention: The use of RGV with the trigger of O01 and RRG with the trigger O02 is maintained for backward compatibility as of v 2.4 and is withdrawn as of v 2.7. Refer to RGV with trigger O15 and RRG with trigger O16 instead.

RGV - Pharmacy/Treatment Give Message (Event O15)

When the "give" (i.e., administration) information needs to be transmitted from the pharmacy or treatment application to another application, it is done with the RGV message. The RGV message uses the RXG segment to record drug or treatment administration instructions, which is not contained in an RDS, dispense message. The RGV message may carry information about a single scheduled administration on a drug or treatment, or it may carry information about multiple administrations. If the pharmacy or treatment application (or some other application) needs to create an unambiguous MAR report where each administration is matched to a particular give date/time instruction, it may use the RGV message as described in the following way:

For each scheduled administration of the medication, the pharmacy/treatment issues either a single RGV message or a single RGV message with multiple RXG segments, one for each scheduled administration. The actual administrations (transmitted by one or more RAS messages) are matched against the scheduled ones by recording in each RXA segment the Give Sub-ID of the corresponding RXG segment. If more than one administration needs to be matched (as in the case of recording a change or rate of an IV solution) the administering application issues additional RXA segment(s) (corresponding to the same RXG segment). If no matching is needed, the Give Sub-ID of the RXA segments has the value zero (0).

When used for a scheduled administration or for the start of a continuous administration such as an IV fluid, the ORC must have the filler order number and the order control code RE.

When used for an update to a continuous administration which is currently in progress (e.g. change of rate of an IV fluid), the ORC must have the filler order number and the order control code XO. For these updates the value of RXG-1 Give Sub-ID Counter may be used to provide a unique reference (see section 4A.4.6.1).

The RXE and associated RXCs may be present if the receiving application needs any of their data. The RXG carries the scheduled administration data for either a single "give instruction" (single dose) of medication or for multiple "give instructions." The RXG is not a complete record of an order. Use the RXO and RXE segments if a complete order is needed. It is a record from the pharmacy or treatment application to the Nursing application (or other) with drug/treatment administration instructions.

RGV^O15^RGV_O15: Pharmacy/Treatment Give
HL7 MessageStructure Table - RGV_O15
Segment Cardinality Must Implement Status
RGV_O15
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
AL1 0..*
ARV 0..* B
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
ORDER_DETAIL_SUPPLEMENT 0..1
NTE 1..* Yes
RXR 1..* Yes
COMPONENTS 0..*
RXC 1..1 Yes
NTE 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
GIVE 1..* Yes
RXG 1..1 Yes
PRT 0..*
RXR 1..* Yes
RXC 0..*
CDO 0..*
TIMING_GIVE 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RGV^O15^RGV_O15

Send Application Ack: RRG^O16^RRG_O16

Enhanced Mode Acknowledgement Choreography for RGV^O15^RGV_O15

When the MSH-15 value of a RGV^O15^RGV_O15 message is AL or ER or SU, an ACK^O15^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RGV^O15^RGV_O15 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RGV^O15^RGV_O15 message is AL or ER or SU, a RRG^O16^RRG_O16 message SHALL be sent as an application ack.

When the MSH-16 value of a RGV^O15^RGV_O15 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O15^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRG^O16^RRG_O16
NE (none)

RRG - Pharmacy/Treatment Give Acknowledgment Message (Event O16)

RRG^O16^RRG_O16: Pharmacy/Treatment Give Acknowledgment Message
HL7 MessageStructure Table - RRG_O16
Segment Cardinality Must Implement Status
RRG_O16
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
GIVE 0..1
RXG 1..1 Yes
PRT 0..*
RXR 1..* Yes
RXC 0..*
TIMING_GIVE 1..* Yes
TQ1 1..1 Yes
TQ2 0..*

Original Mode Acknowledgement Choreography for RRG^O16^RRG_O16

Send Immediate Ack: ACK^O16^ACK

Enhanced Mode Acknowledgement Choreography for RRG^O16^RRG_O16

When the MSH-15 value of a RRG^O16^RRG_O16 message is AL or ER or SU, an ACK^O16^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RRG^O16^RRG_O16 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O16^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

RAS/RRA - pharmacy/treatment administration message (O01/O02)

Note: The use of RAS with the trigger of O01 and RRA with the trigger O02 is maintained for backward compatibility as of v2.4 and is withdrawn as of v2.7. Refer to RAS with trigger O17 and RRA with trigger O18 instead.

RAS - Pharmacy/Treatment Administration Message (Event O17)

The RAS message may be created by the administering application (e.g., nursing application) for each instance of administration for an existing order. If the administering application wants to report several administrations of medication/treatment for a given order with a single RAS message, each instance is reported by a separate (repeating) RXA segment. In addition, the administration records for a group of orders may be sent in a single message by creating repeating groups of segments at the ORC level.

In the most common case, the RAS messages would be sent from a nursing application to the pharmacy or treatment application (or to the ordering application or another clinical application), which could use the data to generate the medication administration reports. Multiple RXA segments, each corresponding to a separate administration instance for a given order, may be sent with a single ORC.

RAS^O17^RAS_O17: Pharmacy/Treatment Administration
HL7 MessageStructure Table - RAS_O17
Segment Cardinality Must Implement Status
RAS_O17
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PD1 1..1 Yes
PRT 0..*
NTE 0..*
ARV 0..* B
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
CTI 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
ORDER_DETAIL_SUPPLEMENT 0..1
NTE 1..* Yes
RXR 1..* Yes
COMPONENTS 0..*
RXC 1..1 Yes
NTE 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
CDO 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
ADMINISTRATION 1..* Yes
RXA 1..* Yes
PRT 0..*
RXR 1..1 Yes
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RAS^O17^RAS_O17

Send Application Ack: RRA^O18^RRA_O18

Enhanced Mode Acknowledgement Choreography for RAS^O17^RAS_O17

When the MSH-15 value of a RAS^O17^RAS_O17 message is AL or ER or SU, an ACK^O17^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RAS^O17^RAS_O17 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RAS^O17^RAS_O17 message is AL or ER or SU, a RRA^O18^RRA_O18 message SHALL be sent as an application ack.

When the MSH-16 value of a RAS^O17^RAS_O17 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O17^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRA^O18^RRA_O18
NE (none)

RRA - Pharmacy/Treatment Administration Acknowledgment Message (Event O18)

RRA^O18^RRA_O18: Pharmacy/Treatment Administration Acknowledgment Message
HL7 MessageStructure Table - RRA_O18
Segment Cardinality Must Implement Status
RRA_O18
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ADMINISTRATION 0..1
RXR 1..1 Yes
TREATMENT 1..* Yes
RXA 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for RRA^O18^RRA_O18

Send Immediate Ack: ACK^O18^ACK

Enhanced Mode Acknowledgement Choreography for RRA^O18^RRA_O18

When the MSH-15 value of a RRA^O18^RRA_O18 message is AL or ER or SU, an ACK^O18^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RRA^O18^RRA_O18 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O18^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)

The RDE/RRE is used to communicate a refill authorization request originating with the pharmacy. This message replicates the standard RDE message with a different trigger event code to indicate the specific use case of a refill authorization request.

RDE^O25^RDE_O11: Pharmacy/Treatment Refill Authorization Request
HL7 MessageStructure Table - RDE_O11
Segment Cardinality Must Implement Status
RDE_O11
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PD1 0..1
PRT 0..*
NTE 0..*
ARV 0..* B
GT1 0..1
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..1
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
CDO 0..*
FT1 0..*
BLG 0..1
CTI 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
PHARMACY_TREATMENT_INFUSION_ORDER 0..*
RXV 1..1 Yes
PRT 0..*
NTE 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RDE^O25^RDE_O11

Send Application Ack: RRE^O26^RRE_O12

Enhanced Mode Acknowledgement Choreography for RDE^O25^RDE_O11

When the MSH-15 value of a RDE^O25^RDE_O11 message is AL or ER or SU, an ACK^O25^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RDE^O25^RDE_O11 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RDE^O25^RDE_O11 message is AL or ER or SU, a RRE^O26^RRE_O12 message SHALL be sent as an application ack.

When the MSH-16 value of a RDE^O25^RDE_O11 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O25^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRE^O26^RRE_O12
NE (none)

RRE - Pharmacy/Treatment Refill Authorization Request Acknowledgment (Event O26)

RRE^O26^RRE_O12: Pharmacy/Treatment Refill Authorization Request Acknowledgment Message
HL7 MessageStructure Table - RRE_O12
Segment Cardinality Must Implement Status
RRE_O12
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*

Original Mode Acknowledgement Choreography for RRE^O26^RRE_O12

Send Immediate Ack: ACK^O26^ACK

Enhanced Mode Acknowledgement Choreography for RRE^O26^RRE_O12

When the MSH-15 value of a RRE^O26^RRE_O12 message is AL or ER or SU, an ACK^O26^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RRE^O26^RRE_O12 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O26^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

ROR - Pharmacy/Treatment Order Response

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

RAR - Pharmacy/Treatment Administration Information

Attention:This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

RDR - Pharmacy/Treatment Dispense Information

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

RER - Pharmacy/Treatment Encoded Order

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

RGR - Pharmacy/Treatment Dose Information

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

Pharmacy Query/Response Message Pair

Conformance Statement

Query Statement ID (Query ID=Q31):

Q31

Type:

Query

Query Name:

Dispense History

Query Trigger (= MSH-9):

QBP^Q31^QBP_Q11

Query Mode:

Both

Response Trigger (= MSH-9):

RSP^K31^RSP_K31

Query Characteristics:

May specify patient, medication, a date range, and how the response is to be sorted.

Purpose:

To retrieve patient pharmacy dispense history information from the Server.

Response Characteristics:

Sorted by Medication Dispensed unless otherwise specified in SortControl.

Based on Segment Pattern:

RDS_O01

QBP^Q31^QBP_Q11: Query Grammar: QBP Message
HL7 MessageStructure Table - QBP_Q11
Segment Cardinality Must Implement Status
QBP_Q11
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
QPD 1..1 Yes
QBP 0..1
... 0..1
RCP 1..1 Yes
DSC 0..1

Original Mode Acknowledgement Choreography for QBP^Q31^QBP_Q11

Send Application Ack: RSP^K31^RSP_K31

Enhanced Mode Acknowledgement Choreography for QBP^Q31^QBP_Q11

When the MSH-15 value of a QBP^Q31^QBP_Q11 message is AL or ER or SU, an ACK^Q31^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a QBP^Q31^QBP_Q11 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a QBP^Q31^QBP_Q11 message is AL or ER or SU, a RSP^K31^RSP_K31 message SHALL be sent as an application ack.

When the MSH-16 value of a QBP^Q31^QBP_Q11 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^Q31^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RSP^K31^RSP_K31
NE (none)

RSP^K31^RSP_K31: Response Grammar: Pharmacy Dispense Message
HL7 MessageStructure Table - RSP_K31
Segment Cardinality Must Implement Status
RSP_K31
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
QAK 1..1 Yes
QPD 1..1 Yes
RCP 1..1 Yes
RESPONSE 1..* Yes
PATIENT 0..1
PID 1..1 Yes
PD1 0..1
PRT 0..*
NTE 0..*
ARV 0..* B
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
RXD 1..1 Yes
PRT 0..*
RXR 1..* Yes
RXC 0..*
CDO 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
COMPONENTS 0..*
RXC 1..1 Yes
NTE 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*
DSC 0..1

Original Mode Acknowledgement Choreography for RSP^K31^RSP_K31

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for RSP^K31^RSP_K31

When the MSH-15 value of a RSP^K31^RSP_K31 message is AL or ER or SU, an ACK^K31^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RSP^K31^RSP_K31 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^K31^ACK
NE (none)
MSH-16 NE (none)

QPD Input Parameter Specification

Field Seq (Query ID=Q31)

Name

Key/

Search

Sort

LEN

TYPE

Opt

Rep

Match Op

TBL

Segment Field Name

Service Identifier Code

Element Name

1

MessageQueryName

60

CWE

R

2

QueryTag

32

ST

R

PatientList

S

Y

20

CX

O

PID.3

PID-3: Patient Identifier List

MedicationDispensed

S

Y

100

CWE

O

=

RXD.2

RXD-2: Dispense/Give Code

DispenseDate.LL

S

Y

24

DTM

O

>
=

RXD.3

RXD-3: Date/Time Dispensed

DispenseDate.UL

S

Y

24

DTM

O

<
=

RXD.3

RXD-3: Date/Time Dispensed

QPD Input Parameter Field Description and Commentary

Input Parameter (Query ID=Q31)

Comp. Name

DT

Description

MessageQueryName

CWE

Must be valued Q31^Dispense History^HL7nnnn.

QueryTag

ST

Unique to each query message instance.

PatientList

CX

The combination of values for PatientList.ID, and PatientList.AssigningAuthority, are intended to identify a unique entry on the PATIENT_MASTER table. The PatientList.IdentifierTypeCode is useful for further filtering or to supply uniqueness in the event that the assigning authority may have more than one coding system. (The PATIENT_MASTER table contains a constraint that prevents multiple patients from being identified by the same combination of field values.) This PATIENT_MASTER entry will be searched against on the PHARMACY_DISPENSE_TRANSACTION table to retrieve the rows fulfilling the query conditions.

If this field is not valued, all values for this field are considered to be a match.

If one PID.3 is specified, only 1 segment pattern will be returned.

ID

ID

If this field, PID.3.1, is not valued, all values for this field are considered to be a match.

Assigning Authority

HD

If this field, PID.3.4, is not valued, all values for this field are considered to be a match.

Identifier type code

IS

If this field, PID.3.5, is not valued, all values for this field are considered to be a match.

MedicationDispensed

CWE

If this field is not valued, all values for this field are considered to be a match.

DispenseDate.LL

DTM

This is the earliest value to be returned for Date/Time Dispensed. If this field is not valued, all values for this field are considered to be a match.

DispenseDate.UL

DTM

This is the latest value to be returned for Date/Time Dispensed. If this field is not valued, all values for this field are considered to be a match.

Example

Example: The user wishes to know all the medications dispensed for the patient whose medical record number is "555444222111" for the period beginning 5/31/2005 and ending 5/31/2006. The following QBP message is generated.

MSH|^&~\|PCR|Gen Hosp|Pharm||200611201400-0800||QBP^Q31^QBP_Q11|ACK9901|P|2.8|

QPD|Q31^Dispense History^HL70471|Q001|555444222111^^^MPI^MR||20050531|20060531|

RCP|I|999^RD|

The pharmacy system identifies medical record number "555444222111" as belonging to Adam Everyman and locates 4 prescription dispenses for the period beginning 5/31/2005 and ending 5/31/2006 and returns the following RSP message:

MSH|^&~\|Pharm|Gen hosp|PCR||200611201400-0800||RSP^K31^RSP_K31|8858|P|2.8|

MSA|AA|ACK9901|

QAK|Q001|OK|Q31^Dispense History^HL70471|4|

QPD|Q31^Dispense History^HL70471|Q001|444-33-3333^^^MPI^MR||20050531|20060531|

PID|||444-33-3333^^^MPI^MR||Everyman^Adam||19600614|M||C|2222 Home Street ^^Anytown^US^12345||^^^^^555^5552004|

ORC|RE||89968665||||||200505121345-0700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^5551003|

RXE|1^BID^^20050529|00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |120||mgm|

RXD|1|00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |200505291115-0700|100|||1331665|3|

RXR|PO|

ORC|RE||89968665||||||200505291030-0700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^5551003|

RXE|1^^D100^^20070731^^^TAKE 1 TABLET DAILY --GENERIC FOR CALAN SR|00182196901^VERAPAMIL HCL ER TAB 180MG ER^NDC |100||180MG|TABLET SA|||G|||0|BC3126631^CHU^Y^L||213220929|0|0|19980821|

RXD|1|00182196901^VERAPAMIL HCL ER TAB 180MG ER^NDC |20050821|100|||213220929|0|TAKE 1 TABLET DAILY --GENERIC FOR CALAN SR|

RXR|PO|

ORC|RE||235134037||||||200509221330-0700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^5551003|

RXD|1|00172409660^BACLOFEN 10MG TABS^NDC|200509221415-0700|10|||235134037|5|AS DIRECTED|

RXR|PO|

ORC|RE||235134030||||||200510121030-0700|||222-33-4444^PUMP^PATRICK^^^^MD ||^^^^^555^5551027|

RXD|1|00054384163^THEOPHYLLINE 80MG/15ML SOLN^NDC|200510121145-0700|10|||235134030|5|AS DIRECTED|

RXR|PO|

RDE - Pharmacy/Treatment Dispense Request Message (Event O49)

This message communicates the request to dispense items. It may be sent as a consequence of an existing order. It may not follow the order immediately: The pharmacist receives clinical orders continuously, but may decide that the orders for dispense are sent periodically. This illustrates that there is a new event.

This message is also not required to contain the order in its entirety: for example if one RDE^O11 contains 3 medications order there are 3 dispensing locations, the pharmacist issues one RDE^O49 for each medication. Any supply aspects are handled through these new types of message, while the clinical order can be segregated from such supply constraints.

The order to dispense refers to the “clinical” order, the original RDE^O25 (or OMP^O09) by means of a parent-child hierarchy, where ORC-8 of the OXX message refers to the ORC-2 of the RDE^025 order.

RDE^O49^RDE_O49: Pharmacy/Treatment Dispense Request Message
HL7 MessageStructure Table - RDE_O49
Segment Cardinality Must Implement Status
RDE_O49
MSH 1..1 Yes
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PD1 0..1
PRT 0..*
NTE 0..*
GT1 0..1
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..1
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
PRT 0..* Deprecated
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
FT1 0..*
BLG 0..1
CTI 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RDE^O49^RDE_O49

Send Application Ack: RRE^O50^RRE_O50

Enhanced Mode Acknowledgement Choreography for RDE^O49^RDE_O49

When the MSH-15 value of a RDE^O49^RDE_O49 message is AL or ER or SU, an ACK^O49^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RDE^O49^RDE_O49 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RDE^O49^RDE_O49 message is AL or ER or SU, a RRE^O50^RRE_O50 message SHALL be sent as an application ack.

When the MSH-16 value of a RDE^O49^RDE_O49 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O49^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRE^O50^RRE_O50
NE (none)

Note:

The RXCs which follow the RXO may not be fully encoded, but those that follow the RXE must be fully encoded.

The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.

The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.

The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).

The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.


RRE - Pharmacy/Treatment Encoded Order Acknowledgment (Event O50)

RRE^O50^RRE_O50: Pharmacy/Treatment Encoded Order Acknowledgment Message
HL7 MessageStructure Table - RRE_O50
Segment Cardinality Must Implement Status
RRE_O50
MSH 1..1 Yes
MSA 1..1 Yes
ERR 0..*
SFT 0..*
UAC 0..1
NTE 0..*
RESPONSE 0..1
PATIENT 0..1
PID 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
PRT 0..* Deprecated
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*

Original Mode Acknowledgement Choreography for RRE^O50^RRE_O50

Send Immediate Ack: ACK^O50^ACK

Enhanced Mode Acknowledgement Choreography for RRE^O50^RRE_O50

When the MSH-15 value of a RRE^O50^RRE_O50 message is AL or ER or SU, an ACK^O50^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RRE^O50^RRE_O50 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O50^ACK
NE (none)
MSH-16 NE (none)

There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).

RCV - Pharmacy/Treatment Dispense Message (Event O59)

The RCV message may be created to communicate the reception of items. This message supports reception of items to fill an existing order or orders, or to stock refills. In the most common case, the RCV messages would be routed to the dispensing system that issued the RDS message. The RDS message informs of the items that have been sent, while the RCV informs about the effectively received items (thus supporting any change in quantities, status,e tc., derived from transport or from a mismatch between the actually sent items and the content of the RDS).

In typical cases, the RCV^O59 message is an “echo” of one RDS^O13, but this is not forcibly so: Since the shipment and reception are asynchronous events, and considering variants in delivery, it is expected that one RCV^OYY message is issued for each confirmation of a reception, independently of whether there was one shipment or several shipments.

The RXD segment carries the dispense data for a given reception of the received items.

The FT1 segment is optional and repeating in order to accommodate multiple charge, benefit and pricing situations. When a message of type RCV is used, the FT1 may be included in the RCV message. If the RCV^O59 message is not used by the implementation, then the RDS may contain the FT1 segment.

RCV^O59^RCV_O59: Pharmacy/Treatment Dispense Message
HL7 MessageStructure Table - RCV_O59
Segment Cardinality Must Implement Status
RCV_O59
MSH 1..1 Yes
SFT 0..*
UAC 0..1
NTE 0..*
PATIENT 0..1
PID 1..1 Yes
PD1 0..1
PRT 0..*
NTE 0..*
AL1 0..*
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ORDER 1..* Yes
ORC 1..1 Yes
PRT 0..*
RXD 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
FT1 0..*
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
ORDER_DETAIL 0..1
RXO 1..1 Yes
ORDER_DETAIL_SUPPLEMENT 0..1
NTE 1..* Yes
RXR 1..* Yes
COMPONENT 0..*
RXC 1..1 Yes
NTE 0..*
ENCODING 0..1
RXE 1..1 Yes
PRT 0..*
NTE 0..*
RXR 1..* Yes
RXC 0..*
TIMING_ENCODED 1..* Yes
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for RCV^O59^RCV_O59

Send Application Ack: RRD^O14^RRD_O14

Enhanced Mode Acknowledgement Choreography for RCV^O59^RCV_O59

When the MSH-15 value of a RCV^O59^RCV_O59 message is AL or ER or SU, an ACK^O59^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RCV^O59^RCV_O59 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a RCV^O59^RCV_O59 message is AL or ER or SU, a RRD^O14^RRD_O14 message SHALL be sent as an application ack.

When the MSH-16 value of a RCV^O59^RCV_O59 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^O59^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RRD^O14^RRD_O14
NE (none)

Note:    The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.

The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.

The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXD segment are intended to communicate notes and comments relative to the dispense event.

The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).

The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.


Pharmacy/Treatment Segments

RXO - Pharmacy/Treatment Order Segment

This is the "master" pharmacy/treatment order segment. It contains order data not specific to components or additives. Unlike the OBR, it does not contain status fields or other data that are results-only.

It can be used for any type of pharmacy order, including inpatient (unit dose and compound unit dose), outpatient, IVs, and hyperalimentation IVs (nutritional IVs), as well as other non-pharmacy treatments, e.g., respiratory therapy, oxygen, and many nursing treatments.

In addition to the pharmaceutical/treatment information, this segment contains additional data such as provider and text comments.

A quantity/timing field is not needed in the RXO segment. The ORC segment contains the requested ORC-7-quantity/timing of the original order which does not change as the order is encoded, dispensed, or administered.

HL7 Attribute Table - RXO - Pharmacy/Treatment Order Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXO
1

00292 Requested Give Code MAY
True:
False: 		C
[1..1]
[0..1]
0747
CWE
2

00293 Requested Give Amount - Minimum MAY
True:
False: 		C
[1..1]
[0..1]
NM
3 00294 Requested Give Amount - Maximum [0..1]
NM
4

00295 Requested Give Units MAY
True:
False: 		C
[1..1]
[0..1]
0748
CWE
5

00296 Requested Dosage Form MAY
True:
False: 		C
[1..1]
[0..1]
0750
CWE
6 00297 Provider's Pharmacy/Treatment Instructions [0..*]
0751
CWE
7 00298 Provider's Administration Instructions [0..*]
0752
CWE
8 00299 Deliver-To Location SHALL NOT W [0..0]
9 00300 Allow Substitutions [0..1] [1..1]
0161 Allow Substitution
ID
10 00301 Requested Dispense Code [0..1]
0753
CWE
11 00302 Requested Dispense Amount [0..1]
NM
12 00303 Requested Dispense Units [0..1]
0754
CWE
13 00304 Number Of Refills = [0..1] 3
NM
14 00305 Ordering Provider's DEA Number SHALL NOT W [0..0]
XCN
15

00306 Pharmacist/Treatment Supplier's Verifier ID MAY
True:
False: 		C
[1..1]
[0..1]
XCN
16 00307 Needs Human Review [0..1] [1..1]
0136 Yes/no Indicator
ID
17

00308 Requested Give Per MAY
True:
False: 		C=
[1..1]
[0..1] 		20
ST
18 01121 Requested Give Strength [0..1]
NM
19 01122 Requested Give Strength Units [0..1]
0756
CWE
20 01123 Indication [0..*]
0758
CWE
21 01218 Requested Give Rate Amount = [0..1] 6
ST
22 01219 Requested Give Rate Units [0..1]
0760
CWE
23 00329 Total Daily Dose [0..1]
CQ
24 01476 Supplementary Code [0..*]
0762
CWE
25 01666 Requested Drug Strength Volume # [0..1] 5
NM
26 01667 Requested Drug Strength Volume Units [0..1]
0764
CWE
27 01668 Pharmacy Order Type [0..1] [1..1]
0480 Pharmacy Order Types
ID
28 01669 Dispensing Interval [0..1]
NM
29 02149 Medication Instance Identifier [0..1]
EI
30 02150 Segment Instance Identifier [0..1]
EI
31

02151 Mood Code MAY
True:
False: 		C
[1..1]
[0..1]
0725 Mood Codes
CNE
32 01681 Dispensing Pharmacy B [0..1]
0765
CWE
33 01682 Dispensing Pharmacy Address B [0..1]
XAD
34 01683 Deliver-to Patient Location [0..1]
PL
35 01684 Deliver-to Address [0..1]
XAD
36 02309 Pharmacy Phone Number [0..*]
XTN

RXO-1: Requested Give Code (CWE) 00292

Definition: This field identifies the treatment product or treatment ordered to be given to the patient; it is analogous to OBR-4-universal service ID in function. Examples of treatments products include medications and certain devices or supplies, e.g., inhaler spacers, blood glucose monitors, syringes, infusion sets, which might require prescription. Refer to Table 0747 - Requested Give Code in Chapter 2C for valid values.

Often the coded entry implies dosage form and a dosage form is required in addition to the product name. When the give code does not include the dosage form, use RXO-5-requested dosage form. When the give code does not include the strength, use RXO-18-requested give strength and the RXO-19-requested give units. Realize that strengths do not apply to some such orders.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription/treatment is transmitted as free text using RXO-6; then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Use of the RXO-6.2 versus the RXO-1.2 for a free text order is dependent on whether or not the free text describes a product or if it is more commentary in nature.

Please refer to the request –to-dispense fields RXO-10, RXO-11, and RXO-12 for a discussion of the interrelationship with the request-to-give fields.

RXO-2: Requested Give Amount - Minimum (NM) 00293

Definition: This field is the ordered amount. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription/treatment is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the Requested Give Amount field).


RXO-3: Requested Give Amount - Maximum (NM) 00294

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose order, this field is not used.

RXO-4: Requested Give Units (CWE) 00295

Definition: This field indicates the units for the give amount. Refer to Table 0748 - Requested Give Units in Chapter 2C for valid values.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight). See Chapter 7 for full definition of ISO+ units.

A table of standard units is needed to define standard abbreviations for compound units. Until such a table is agreed on, a user-defined table is needed for each site. If the interpretation of a compound unit requires knowledge of some observation results (such as body weight or height), these results can be sent in the same order message using the optional OBX segments.

RXO-5: Requested Dosage Form (CWE) 00296

Definition: This field indicates the manner in which the treatment is aggregated for dispensing, e.g., tablets, capsules suppositories. In some cases, this information is implied by the dispense/give code in RXO-1-requested give code or RXO-10-Requested dispense code. Required when both RXO-1-Requested give code and RXO-10-Requested dispense code do not specify the drug/treatment form; optionally included otherwise. Refer to Table 0750 - Requested Dosage Form in Chapter 2C for valid values.

RXO-6: Provider's Pharmacy/Treatment Instructions (CWE) 00297

Definition: This field identifies the ordering provider's instructions to the pharmacy or the non-pharmacy treatment provider (e.g., respiratory therapy). If coded, a user-defined table must be used. If transmitted as a free text field, place a null in the first component and the text in the second, e.g., |^this is a free text treatment instruction|.Refer to Table 0751 - Provider's Pharmacy/Treatment Instructions in Chapter 2C for valid values.

If the prescription is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank. Otherwise, RXO-1, RXO-2 and RXO-4 are mandatory.

RXO-7: Provider's Administration Instructions (CWE) 00298

(Definition from RXO.7 in Ch. 4A)

Definition: This field identifies the ordering provider's instructions to the patient or to the provider administering the drug or treatment. If coded, a user-defined table must be used. If transmitted as free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration instruction|.Refer to Table 0752 - Provider's Administration Instructions in Chapter 2C for valid values.

(Definition from RXE.7 in Ch. 4A)

Definition: This field contains the ordering provider's instructions to the patient or the provider administering the drug or treatment. If coded, a user-defined table must be used; if free text (describing a custom IV, mixture, or salve, for example), place the text in the second component, e.g., |^this is a free text administration instruction|.Refer to Table 0718 - Provider's Administration Instructions in Chapter 2C for valid values.

RXO-8: Deliver-To Location

(Definition from RXO.8 in Ch. 4A)

Attention: The RXO-8 field was retained for backward compatibilty only as of v 2.6 and the detail was withdrawn and removed from the standard as of v 2.8.

(Definition from RXE.8 in Ch. 4A)

Attention: The RXE-8 field was retained for backward compatibilty only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

RXO-9: Allow Substitutions (ID) 00300

Definition: Coded values indicate whether substitutions are allowed, and, if yes, what type of substitutions. Refer to HL7 Table 0161 – Allow Substitution in Chapter 2C, Code Tables, for valid codes.

RXO-10: Requested Dispense Code (CWE) 00301

Definition: This field indicates what is to be/was dispensed; it is analogous to OBR-4-universal service ID in function. It may be present in the order or not, depending on the application. If not present, and values are given for RXO-11-requested dispense amount and RXO-12-requested dispense units, the RXO-1-requested give code is assumed. If the requested dispense code does not include the dosage form, then RXO-5-requested dosage form is required. Refer to Table 0753 - Requested Dispense Code in Chapter 2C for valid values.

Note on request-to-dispense fields:    

Sometimes an order will be written in which the total amount of the drug or treatment requested to be dispensed has no direct relationship with the give amounts and schedule. For example, an outpatient pharmacy/treatment order might be take four tablets a day of <drug name, value>, Q6H (every 6 hours) -- dispense 30 tablets. An inpatient order might be NS/D5W (normal saline with 5% dextrose) at 1000cc/hour—dispense 3 1-liter bottles of NSD5W solution. The request-to-dispense fields support this common style of ordering.


RXO-11: Requested Dispense Amount (NM) 00302

Definition: This field specifies the amount to be dispensed. See above note.

RXO-12: Requested Dispense Units (CWE) 00303

Definition: This field identifies the units for the dispense amount. This must be in simple units that reflect the actual quantity of the substance to be dispensed. It does not include compound units. See above note. Refer to Table 0754 - Requested Dispense Units in Chapter 2C for valid values.

RXO-13: Number Of Refills (NM) 00304

(Definition from RXO.13 in Ch. 4A)

Definition: This field defines the number of times the requested dispense amount can be given to the patient, subject to local regulation. Refers to outpatient only.

(Definition from RXE.12 in Ch. 4A)

Definition: This field contains the total original number of refills. Outpatient only.

RXO-14: Ordering Provider's DEA Number

(Definition from RXO.14 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

(Definition from RXE.13 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The reader is referred to the PRT segment described in Chapter 7.

This field is defined as conditional because it is required when the substance requested is a controlled substance (e.g., a narcotic). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

RXO-15: Pharmacist/Treatment Supplier's Verifier ID (XCN) 00306

(Definition from RXO.15 in Ch. 4A)

Definition: This field is the provider ID of the pharmacist/treatment supplier verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders), in addition to ORC-11-verified by.

Example:    

The site requires a "verified by" provider (such as a nurse) and a "verifying pharmacist/treatment supplier" on the order. In this case the first field, ORC-11-verified by, is already present; but the second field, RXO-15-pharmacist/treatment supplier's verifier ID, is needed.

(Definition from RXE.14 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The reader is referred to the PRT segment described in chapter 7.

This field contains the provider ID of Pharmacist/treatment supplier's verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

RXO-16: Needs Human Review (ID) 00307

(Definition from RXO.16 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that the pharmacist or non-pharmacist treatment supplier filling the order needs to pay special attention to the text in the RXO-6-provider's pharmacy/treatment instructions. A warning is present.

N    No - No warning is present. This is the equivalent default (null) value.

An example of the use of this field is given by the following case:

A smart Order Entry application knows of a possible drug or treatment interaction on a certain order, but the provider issuing the order wants to override the condition. In this case, the pharmacy or treatment application receiving the order will want to have a staff pharmacist or non-pharmacist treatment supplier review the interaction and contact the ordering physician.

(Definition from RXE.20 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the encoded order needs to warn the person administering the drug or treatment to pay attention to the text in RXE-21-pharmacy/treatment special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXD.14 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/no indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXD-15-Special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXG.12 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/No Indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXG-13-Special administration instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

RXO-17: Requested Give Per (ST) 00308

Definition: This field identifies the time unit to use to calculate the rate at which the pharmaceutical is to be administered.

Format:

S<integer>

=

<integer> seconds

M<integer>

=

<integer> minutes

H<integer>

=

<integer> hours

D<integer>

=

<integer> days

W<integer>

=

<integer> weeks

L<integer>

=

<integer> months

Note: This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.


This field is defined as conditional because it is required when the ordered substance is to be administered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" are 300 ml and the "give per" time unit is H1, the rate is 300ml/hr and the duration of this dose is 1 hour. Thus the give amount and give per time unit define the duration of the service.

This field is distinct from the "interval" component of the quantity/timing field, but it could be used in conjunction with it, as in give 300ml of NS per hr for 1 hour, repeat twice a day.

RXO-18: Requested Give Strength (NM) 01121

Definition: Required when RXO-1-requested give code does not specify the strength; optionally included otherwise. This is the numeric part of the strength, used in combination with RXO-19-requested give strength units.

The need for strength and strength unit fields in addition to the amount and amount units fields included in various RX_ segments requires explanation. Physicians can write a prescription for a drug such as Ampicillin in two ways. One way would be: "Ampicillin 250 mg capsules, 2 capsules four times a day." In this case the give amount would be 2, the give units would be capsules, the strength would be 250 and the strength units would milligrams.

However, the provider could also write the pharmaceutical treatment as "Ampicillin 500 mg four times a day." In this case the give amount would be 500 and the give units would be milligrams. The strength would not be reported in the RXO segment because it is not specified; the drug could be given in two 250 mg caps or one 500 mg cap. But the pharmacist would dispense a specific capsule size and would record the strength in the RXE segment as 250 or 500, depending upon which capsule size was dispensed.

Some coding systems imply the strength, units, route of administration, and manufacturer of substances within a single instructional code. NDC codes, for example, usually imply not only the medical substance, but also the strength, the units, and the form, e.g., 0047-0402-30^Ampicillin 250 MG CAPS^NDC. So all of this information can also be completely specified in RXO-1-requested give code and in the analogous CWE/CNE fields in other pharmacy/treatment segments. In this case, it is not necessary to use the strength and strength units fields to specify this information.

RXO-19: Requested Give Strength Units (CWE) 01122

Definition: Required when both RXO-1-requested give code and RXO-10-requested dispense code do not specify the strength; optionally included otherwise. This is the unit of the strength, used in combination with RXO-18-requested give strength. Refer to Table 0756 - Requested Give Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


RXO-20: Indication (CWE) 01123

(Definition from RXO.20 in Ch. 4A)

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0758 - Indication in Chapter 2C for valid values.

(Definition from RXD.21 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0708 - Indication in Chapter 2C for valid values.

(Definition from RXG.22 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0743 - Indication in Chapter 2C for valid values.

(Definition from RXA.19 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0694 - Indication in Chapter 2C for valid values.

RXO-21: Requested Give Rate Amount (ST) 01218

Definition: This field contains the rate at which to administer a treatment, e.g., 150 ml/hr (for an IV) or 4 liters/min for nasal oxygen.

RXO-22: Requested Give Rate Units (CWE) 01219

Definition: This field contains the units in which RXO-21-requested give rate amount is denominated. Refer to Table 0760 - Requested Give Rate Units in Chapter 2C for valid values.

RXO-23: Total Daily Dose (CQ) 00329

(Definition from RXO.23 in Ch. 4A)

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

(Definition from RXE.19 in Ch. 4A)

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

(Definition from RXD.12 in Ch. 4A)

Definition: This field contains the total daily dose being dispensed as expressed in terms of the actual dispense units.

Note:    The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXD so that it may "stand alone" as a dispense result instruction segment.


RXO-24: Supplementary Code (CWE) 01476

(Definition from RXO.24 in Ch. 4A)

This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0762 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXC.7 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical or other treatment substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0700 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXE.31 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0727 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXD.25 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0710 - Supplementary Code in Chapter 2C for valid values.

RXO-25: Requested Drug Strength Volume (NM) 01666

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXO-18, RXO-19, RXO-25 and RXO-26 as:

RXO||||||||||||||||||120|mg^^ISO||||||5|ml^^ISO ...<cr>

RXO-26: Requested Drug Strength Volume Units (CWE) 01667

Description: This field indicates the volumetric unit associated with RXO-25 Requested Drug Strength Volume. See example in RXO-25. Refer to Table 0764 - Requested Drug Strength Volume Units in Chapter 2C for valid values.

RXO-27: Pharmacy Order Type (ID) 01668

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 — Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

RXO-28: Dispensing Interval (NM) 01669

Definition: This field specifies the minimum number of days that must occur between dispensing events

RXO-29: Medication Instance Identifier (EI) 02149

Definition: This field contains a value that uniquely identifies the medication associated with this segment. Rather than identifying the product to be given, as in RXO-1 Requested Give Code, this field serves to identify the medication in association with the order represented by the segment instance. This identifier is persistent within and across message instances.

Note: RXO-29 Medication Instance Identifier was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-29 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established.


RXO-30: Segment Instance Identifier (EI) 02150

Definition: This field contains a value that uniquely identifies this segment across time and messages. This is not intended as a "Set ID", but as a unique identifier allowing references not only to segments of the same message, but also to segments of other messages and indirectly to the entities described in those segments if the necessary persistence was manageable by the applications. This identifier is persistent within and across message instances.

Note: RXO-30 Segment Instance Identifier was introduced in v 2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-30 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established.


RXO-31: Mood Code (CNE) 02151

Definition: This field represents the functional state of the order represented by this segment instance. Refer to HL7 Table 0725 – Mood Codes in Chapter 2C, Code Tables, for valid values. This field may only be used with new trigger events and new messages from v2.6 onward. When this field is not valued in a message that qualifies, then the value is assumed to be 'EVN'.

There may appear to be overlap between this field and ORC-5 Order Status. However, the intent of Mood Code is to support the description and documentation of historical events. In this context, Mood codes may clash with Order Status codes, a Mood code may apply for different Order Status values, or this segment may be being used outside of the order paradigm (e.g., in a patient care plan). Moods are meant to change the semantics of clinical data in a message when it is not inferable from the trigger event: when the data can represent a past medication, a future medication (e.g., in a patient care plan), or in a request (e.g., as a reason for referral). The reader is referred to Chapter 12, Patient Care, for further discussion of patient care plans and referrals.

Note: RXO-31 Mood Code was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-31 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established. While a similar note exists for RXO-29 Medication Instance Identifier and RXO-30 Segment Instance Identifier, particular care should be taken with RXO-31 as this could modify the intent of the segment/message and create backward compatibility problems.


RXO-32: Dispensing Pharmacy (CWE) 01681

(Definition from RXO.32 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7. Refer to Table 0765 - Dispensing Pharmacy in Chapter 2C for valid values.

ense the prescription.

(Definition from RXE.40 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment. Refer to Table 0733 - Dispensing Pharmacy in Chapter 2C for valid values.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

RXO-33: Dispensing Pharmacy Address (XAD) 01682

(Definition from RXO.33 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

(Definition from RXE.41 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility.

RXO-34: Deliver-to Patient Location (PL) 01683

(Definition from RXO.34 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

(Definition from RXE.42 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

(Definition from RXG.29 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

RXO-35: Deliver-to Address (XAD) 01684

(Definition from RXO.35 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

(Definition from RXE.43 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

(Definition from RXG.30 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

RXO-36: Pharmacy Phone Number (XTN) 02309

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXE-45 and RXD-34 to support pharmacy contact information in the context of the order, the encoded order and the dispense.

RXR - Pharmacy/Treatment Route Segment

The Pharmacy/Treatment Route segment contains the alternative combination of route, site, administration device, and administration method that are prescribed as they apply to a particular order. The pharmacy, treatment staff and/or nursing staff has a choice between the routes based on either their professional judgment or administration instructions provided by the physician.

HL7 Attribute Table - RXR - Pharmacy/Treatment Route Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXR
1 00309 Route SHALL [1..1]
0162 Route of Administration
CWE
2 00310 Administration Site [0..1]
0550 Body Parts
CWE
3 00311 Administration Device [0..1]
0164 Administration Device
CWE
4 00312 Administration Method [0..1]
0165 Administration Method
CWE
5 01315 Routing Instruction [0..1]
0766
CWE
6 01670 Administration Site Modifier [0..1]
0495 Body Site Modifier
CWE

RXR-1: Route (CWE) 00309

Definition: This field is the route of administration.

Some current "route codes," such as some of the NDC-derived codes include the site already. In such cases, the entire code can be included in this field as a "locally-defined code" for the CWE data type. Refer to User-Defined Table 0162 - Route of Administration in Chapter 2C, Code Tables, for valid values.

RXR-2: Administration Site (CWE) 00310

Definition: This field contains the site of the administration route. When using a post-coordinated code table in this field, RXR-6 Administration Site may be used to modify the meaning of this field.

Refer to HL7 Table 0550 – Body Parts in Chapter 2C, Code Tables, for valid values. Other appropriate external code sets (e.g., SNOMED) may also be employed.

RXR-3: Administration Device (CWE) 00311

Definition: This field contains the mechanical device used to aid in the administration of the drug or other treatment. Common examples are IV-sets of different types. Refer to User-defined Table 0164 - Administration device in Chapter 2C, Code Tables, for valid entries.

RXR-4: Administration Method (CWE) 00312

Definition: This field identifies the specific method requested for the administration of the drug or treatment to the patient. Refer To User-defined Table 0165 – Administration Method in Chapter 2C, Code Tables, for valid values.

RXR-5: Routing Instruction (CWE) 01315

Definition: This field provides instruction on administration routing, especially in cases where more than one route of administration is possible. A typical case would be designating which IV line should be used when more than one IV line is a possible route for injection. Refer to Table 0766 - Routing Instruction in Chapter 2C for valid values.

RXR-6: Administration Site Modifier (CWE) 01670

Definition: This field contains a modifier which modifies the meaning of RXR-2 Administration Site.

The code table used in this field is dependent upon the code table used in RXR-2 Administration site. If RXR-2 employs HL7 Table 0550 – Body Parts, then this field may only be populated with values from HL7 Table 0495 – Body Parts Modifier. In the case of other code sets (e.g., SNOMED) in RXR-2, RXR-6 may only be populated if modifiers are defined within, or related to, that code set.

Condition Rule: This field may only be populated if RXR-2 Administration Site is populated. This field is not required if RXR-2 is populated.

RXC - Pharmacy/Treatment Component Order Segment

If the drug or treatment ordered with the RXO segment is a compound drug OR an IV solution, AND there is not a coded value for OBR-4-universal service ID, which specifies the components (base and all additives), then the components (the base and additives) are specified by two or more RXC segments. The policy of the pharmacy or treatment application on substitutions at the RXC level is identical to that for the RXO level.

HL7 Attribute Table - RXC - Pharmacy/Treatment Component Order Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXC
1 00313 RX Component Type SHALL [1..1] [1..1]
0166 RX Component Type
ID
2 00314 Component Code SHALL [1..1]
0697
CWE
3 00315 Component Amount SHALL [1..1]
NM
4 00316 Component Units SHALL [1..1]
0698
CWE
5 01124 Component Strength [0..1]
NM
6 01125 Component Strength Units [0..1]
0699
CWE
7 01476 Supplementary Code [0..*]
0762
CWE
8 01671 Component Drug Strength Volume # [0..1] 5
NM
9 01672 Component Drug Strength Volume Units [0..1]
0701
CWE
10

03314 Dispense Amount MAY
True:
False: 		C
[1..1]
[0..1]
NM
11 03315 Dispense Units MAY
True:
False: 		C
[1..1]
[0..1]
0703
CWE

RXC-1: RX Component Type (ID) 00313

Definition: Refer to HL7 Table 0166 – RX Component Type in Chapter 2C, Code Tables for valide values.

For the non-IV case, the "B" value may still apply. For example, if a custom dermatologic salve is being prepared, the "B" item might be a standard base ointment into which other components are mixed.

The amount of the "base" specified in the "B" segment(s) is defined to be the quantity into which amounts specified in the "A" components are mixed. Thus the RXC segments as a group define the "recipe" for a particular amount (defined by the base segment(s)). The give amount, as defined in the RXO, does not need to correspond to this base amount. For example, the RXC segments may specify a recipe for a liter of a standard type of saline with 1 gram of a particular antimicrobial, while the give amount (from the RXO) may specify the administration of 2 liters of this IV-solution every 24 hours.

The amount specified in each "A" segment is defined to be the quantity to be added to the amount of the base as specified in its RXC segment.

If any "base" components are present then these should be transmitted first. The first "base" component in the transmission should be considered the "primary base" if such a distinction is necessary. Similarly, the first "additive" in the transmission should be considered the "primary additive" if such a distinction is necessary.

RXC-2: Component Code (CWE) 00314

Definition: This field is equivalent to OBR-4-universal service ID. It defines the base or component in the same manner as the give and dispense codes. As with the give and dispense codes, it may contain text only, code only, text + code, or text + code + units (implied or explicit). As with the give and dispense codes, if RXC-4-component units is present, this overrides the units implied by the code. If only text is present, the pharmacy or treatment application must include a manual review or reentering of the component drug or treatment. Refer to Table 0697 - Component Code in Chapter 2C for valid values.

RXC-3: Component Amount (NM) 00315

Definition: This field identifies the amount of this component to be added to the specified amount of the base.

RXC-4: Component Units (CWE) 00316

Definition: This field identifies the units for the component amount. If present, this overrides the units implied by RXC-2-component code. This must be in simple units that reflect the actual quantity of the component being added. It does not include compound units. Refer to Table 0698 - Component Units in Chapter 2C for valid values.

RXC-5: Component Strength (NM) 01124

Definition: Use when RXC-2-component code does not specify the strength. This is the numeric part of the strength, used in combination with RXC-6-component strength units.

RXC-6: Component Strength Units (CWE) 01125

Definition: Use when RXC-2-component code does not specify the strength. This is the unit of the strength, used in combination with RXC-5-component strength. Refer to Table 0699 - Component Strength Units in Chapter 2C for valid values.Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

RXC-7: Supplementary Code (CWE) 01476

(Definition from RXO.24 in Ch. 4A)

This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0762 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXC.7 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical or other treatment substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0700 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXE.31 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0727 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXD.25 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0710 - Supplementary Code in Chapter 2C for valid values.

RXC-8: Component Drug Strength Volume (NM) 01671

Definition: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5, which would be encoded in RXC-5, RXC-6, RXC-8 and RXC-9 as

RXC|||||120|mg^^ISO||5|ml^^ISO ...<cr>

RXC-9: Component Drug Strength Volume Units (CWE) 01672

Definition: This field indicates the volumetric unit associated with RXC-8 Component Drug Strength Volume. See example in RXC-8. Refer to Table 0701 - Component Drug Strength Volume Units in Chapter 2C for valid values.

RXC-10: Dispense Amount (NM) 03314

Definition: This field contains the amount to be dispensed as encoded by the pharmacy or treatment supplier.

RXC-11: Dispense Units (CWE) 03315

Definition: This field contains the units for the dispense amount as encoded by the pharmacy or treatment supplier. This field is required if the units are not implied by the actual dispense code. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units. Refer to Table 0703 - Dispense Units in Chapter 2C for valid values.

RXE - Pharmacy/Treatment Encoded Order Segment

The RXE segment details the pharmacy or treatment application's encoding of the order. It also contains several pharmacy-specific order status fields, such as RXE-16-number of refills remaining, RXE-17-number of refills/doses dispensed, RXE-18-D/T of most recent refill or dose dispensed, and RXE-19-total daily dose.

Note that ORC-7-quantity/timing has a different meaning from RXE-1-quantity/timing and RXG-3-quantity/timing. The pharmacy or treatment department has the "authority" (and/or necessity) to schedule dispense/give events. Hence, the pharmacy or treatment department has the responsibility to encode this scheduling information in RXE-1-quantity/timing and RXG-3-quantity/timing. ORC-7-quantity/timing does not change: it always specifies the requested give/dispense schedule of the original order.

HL7 Attribute Table - RXE - Pharmacy/Treatment Encoded Order Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXE
1 00221 Quantity/Timing SHALL NOT W [0..0]
2 00317 Give Code SHALL [1..1]
0292 Vaccines Administered
CWE
3 00318 Give Amount - Minimum SHALL [1..1]
NM
4 00319 Give Amount - Maximum [0..1]
NM
5 00320 Give Units SHALL [1..1]
0715
CWE
6 00321 Give Dosage Form [0..1]
0716
CWE
7 00298 Provider's Administration Instructions [0..*]
0752
CWE
8 00299 Deliver-To Location SHALL NOT W [0..0]
9 00322 Substitution Status [0..1] [1..1]
0167 Substitution Status
ID
10

00323 Dispense Amount MAY
True:
False: 		C
[1..1]
[0..1]
NM
11

00324 Dispense Units MAY
True:
False: 		C
[1..1]
[0..1]
0720
CWE
12 00304 Number Of Refills = [0..1] 3
NM
13 00305 Ordering Provider's DEA Number B [0..*]
XCN
14 00306 Pharmacist/Treatment Supplier's Verifier ID B [0..*]
XCN
15

00325 Prescription Number MAY
True:
False: 		C=
[1..1]
[0..1] 		20
ST
16

00326 Number of Refills Remaining MAY
True:
False: 		C
[1..1]
[0..1]
NM
17

00327 Number of Refills/Doses Dispensed MAY
True:
False: 		C
[1..1]
[0..1]
NM
18

00328 D/T of Most Recent Refill or Dose Dispensed MAY
True:
False: 		C
[1..1]
[0..1]
DTM
19

00329 Total Daily Dose MAY
True:
False: 		C
[1..1]
[0..1]
CQ
20 00307 Needs Human Review [0..1] [1..1]
0136 Yes/no Indicator
ID
21 00330 Special Dispensing Instructions [0..*]
0721
CWE
22

00331 Give Per MAY
True:
False: 		C=
[1..1]
[0..1] 		20
ST
23 00332 Give Rate Amount = [0..1] 6
ST
24 00333 Give Rate Units [0..1]
0722
CWE
25 01126 Give Strength [0..1]
NM
26 01127 Give Strength Units [0..1]
0723
CWE
27 01128 Give Indication [0..*]
0724
CWE
28 01220 Dispense Package Size [0..1]
NM
29 01221 Dispense Package Size Unit [0..1]
0726
CWE
30 01222 Dispense Package Method [0..1] [1..2]
0321 Dispense Method
ID
31 01476 Supplementary Code [0..*]
0762
CWE
32 01673 Original Order Date/Time [0..1]
DTM
33 01674 Give Drug Strength Volume # [0..1] 5
NM
34 01675 Give Drug Strength Volume Units [0..1]
0729
CWE
35 01676 Controlled Substance Schedule [0..1]
0477 Controlled Substance Schedule
CWE
36 01677 Formulary Status [0..1] [1..1]
0478 Formulary Status
ID
37 01678 Pharmaceutical Substance Alternative [0..*]
0730
CWE
38 01679 Pharmacy of Most Recent Fill [0..1]
0732
CWE
39 01680 Initial Dispense Amount [0..1]
NM
40 01681 Dispensing Pharmacy B [0..1]
0765
CWE
41 01682 Dispensing Pharmacy Address B [0..1]
XAD
42 01683 Deliver-to Patient Location [0..1]
PL
43 01684 Deliver-to Address [0..1]
XAD
44 01685 Pharmacy Order Type [0..1] [1..1]
0480 Pharmacy Order Types
ID
45 02310 Pharmacy Phone Number [0..*]
XTN

RXE-1: Quantity/Timing

(Definition from ORC.7 in Ch. 4)

Attention: The ORC-7 field was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7. The reader is referred to the TQ1 and TQ2 segments described in sections 4.5.4 and 4.5.5, respectively.

(Definition from OBR.27 in Ch. 4)

Attention: The OBR-27 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

(Definition from RXE.1 in Ch. 4A)

Attention: The RXE-1 field was retained for backward compatibilty only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

(Definition from RXG.3 in Ch. 4A)

Attention: The RXG-3 field was retained for backward compatibilty only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

Note: The contents of fields 3-8 should be identical to the comparable fields in the RXE (RXE-2 thru 5).


(Definition from OBR.27 in Ch. 7)

Attention: The OBR-27 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

RXE-2: Give Code (CWE) 00317

(Definition from RXE.2 in Ch. 4A)

Definition: This field identifies the medical substance or treatment that has been ordered to be given to the patient, as encoded by the pharmacy or treatment supplier; it is equivalent to OBR-4-universal service ID in function. In the RXE segment, this give code must be fully encoded. The dispense fields, which define the units and amount of what is to be issued to the patient (see RXE-10-dispense amount and RXE-11-dispense units below) do not necessarily correlate with the instructions of what amount is to be "given" or administered with each dose, and may or may not be specified with the order. For example, the "give" part of the order may convey the field-representation of give 250 mg of Ampicillin, while the request to dispense part of the order may convey issue 30 tablets of generic equivalent for this outpatient prescription.

The coding system used is conditional on both the nature of the medical substance or treatment ordered and site-specific implementation considerations. For vaccines, HL7 Table 0292 – Vaccines Administered is the preferred coding system. For non-vaccine products, the coding system may be a local implementation of User-defined Table 0479 – Pharmaceutical Substances or an external coding system. Examples of external coding systems include, but are not limited to, National Drug Codes (NDC), Medispan Generic Product Identifier (MGPI), Drug Descriptor Identifier (DDID), and other drug codes listed in HL7 Table 0396 – Coding Systems. The following examples illustrate some code tables other than User-defined Table 0479:

NDC:                0006915404^Norvasc 10mg Tabs^NDC

DDID:                015189^Norvasc 10mg Tabs^DDID

CVX (HL70292):            30^HBIG^CVX

(Definition from RXG.4 in Ch. 4A)

Definition: This field is the identifier of the medical substance/treatment ordered to be given to the patient; it is equivalent to OBR-4-Universal service ID in function. See the RXE segment for a complete definition of the RXE-2-Give code. If the substance given is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines administered in Chapter 2C, Code Tables).

RXE-3: Give Amount - Minimum (NM) 00318

(Definition from RXE.3 in Ch. 4A)

Definition: This field contains the ordered amount as encoded by the pharmacy or treatment supplier. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

Note:    This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).


(Definition from RXG.5 in Ch. 4A)

Definition: This field contains the ordered amount as encoded by the pharmacy/treatment supplier. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; and thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).


RXE-4: Give Amount - Maximum (NM) 00319

(Definition from RXE.4 in Ch. 4A)

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose, this field is not used.

(Definition from RXG.6 in Ch. 4A)

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose order, this field is not used.

RXE-5: Give Units (CWE) 00320

(Definition from RXE.5 in Ch. 4A)

Definition: This field contains the units for the give amount as encoded by the pharmacy or treatment (e.g., respiratory therapy) application. Refer to Table 0715 - Give Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).


A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

(Definition from RXG.7 in Ch. 4A)

Definition: This field contains the units for the give amount. Refer to Table 0735 - Give Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).


A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

RXE-6: Give Dosage Form (CWE) 00321

(Definition from RXE.6 in Ch. 4A)

Definition: The dosage form indicates the manner in which the medication or treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXE-2-Give Code. Use the RXE-6-Give Dosage Form when the give code does not specify the dosage form. Refer to Table 0716 - Give Dosage Form in Chapter 2C for valid values.

(Definition from RXG.8 in Ch. 4A)

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXG-4-Give Code. Use this field when the give code does not specify the dosage form. Refer to Table 0736 - Give Dosage Form in Chapter 2C for valid values.

RXE-7: Provider's Administration Instructions (CWE) 00298

(Definition from RXO.7 in Ch. 4A)

Definition: This field identifies the ordering provider's instructions to the patient or to the provider administering the drug or treatment. If coded, a user-defined table must be used. If transmitted as free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration instruction|.Refer to Table 0752 - Provider's Administration Instructions in Chapter 2C for valid values.

(Definition from RXE.7 in Ch. 4A)

Definition: This field contains the ordering provider's instructions to the patient or the provider administering the drug or treatment. If coded, a user-defined table must be used; if free text (describing a custom IV, mixture, or salve, for example), place the text in the second component, e.g., |^this is a free text administration instruction|.Refer to Table 0718 - Provider's Administration Instructions in Chapter 2C for valid values.

RXE-8: Deliver-To Location

(Definition from RXO.8 in Ch. 4A)

Attention: The RXO-8 field was retained for backward compatibilty only as of v 2.6 and the detail was withdrawn and removed from the standard as of v 2.8.

(Definition from RXE.8 in Ch. 4A)

Attention: The RXE-8 field was retained for backward compatibilty only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

RXE-9: Substitution Status (ID) 00322

(Definition from RXE.9 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for valid values. If a substitution has been made, and a record of the original requested give code (RXO-1-requested give code) is needed, the optional RXO segment can be included in the RDE message.

(Definition from RXD.11 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for suggested values.

(Definition from RXG.10 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for valid values.

Note: The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXG so that it may "stand alone" as a "give" instruction segment.


RXE-10: Dispense Amount (NM) 00323

Definition: This field contains the amount to be dispensed as encoded by the pharmacy or treatment supplier.

RXE-11: Dispense Units (CWE) 00324

Definition: This field contains the units for the dispense amount as encoded by the pharmacy or treatment supplier. This field is required if the units are not implied by the actual dispense code. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units. Refer to Table 0720 - Dispense Units in Chapter 2C for valid values.

RXE-12: Number Of Refills (NM) 00304

(Definition from RXO.13 in Ch. 4A)

Definition: This field defines the number of times the requested dispense amount can be given to the patient, subject to local regulation. Refers to outpatient only.

(Definition from RXE.12 in Ch. 4A)

Definition: This field contains the total original number of refills. Outpatient only.

RXE-13: Ordering Provider's DEA Number (XCN) 00305

(Definition from RXO.14 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

(Definition from RXE.13 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The reader is referred to the PRT segment described in Chapter 7.

This field is defined as conditional because it is required when the substance requested is a controlled substance (e.g., a narcotic). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

RXE-14: Pharmacist/Treatment Supplier's Verifier ID (XCN) 00306

(Definition from RXO.15 in Ch. 4A)

Definition: This field is the provider ID of the pharmacist/treatment supplier verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders), in addition to ORC-11-verified by.

Example:    

The site requires a "verified by" provider (such as a nurse) and a "verifying pharmacist/treatment supplier" on the order. In this case the first field, ORC-11-verified by, is already present; but the second field, RXO-15-pharmacist/treatment supplier's verifier ID, is needed.

(Definition from RXE.14 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The reader is referred to the PRT segment described in chapter 7.

This field contains the provider ID of Pharmacist/treatment supplier's verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

RXE-15: Prescription Number (ST) 00325

(Definition from RXE.15 in Ch. 4A)

Definition: This field contains the prescription number as assigned by the pharmacy or treatment application. Equivalent in uniqueness to the pharmacy/treatment filler order number. At some sites, this may be the pharmacy or treatment system (internal) sequential form. At other sites, this may be an external form. This is a required field in RXE when used in pharmacy/treatment messages, but it is not required when used in product experience messages (see Chapter 7).

(Definition from RXD.7 in Ch. 4A)

Definition: This field is equivalent in uniqueness to the pharmacy/treatment supplier filler order number. At some sites, this may be the pharmacy/treatment supplier (internal) sequential form. At other sites, this may be an external number.

(Definition from FT1.42 in Ch. 6)

Definition: This field contains the prescription number as assigned by the pharmacy or treatment application. Equivalent in uniqueness to the pharmacy/treatment filler order number. At some sites, this may be the pharmacy or treatment system (internal) sequential form. At other sites, this may be an external form.

RXE-16: Number of Refills Remaining (NM) 00326

(Definition from RXE.16 in Ch. 4A)

Definition: Number of refills remaining. This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

(Definition from RXD.8 in Ch. 4A)

Definition: This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

RXE-17: Number of Refills/Doses Dispensed (NM) 00327

Definition: Number of refills remaining. This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

RXE-18: D/T of Most Recent Refill or Dose Dispensed (DTM) 00328

Definition: Date/time of the most recent refill or dose dispensed.

RXE-19: Total Daily Dose (CQ) 00329

(Definition from RXO.23 in Ch. 4A)

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

(Definition from RXE.19 in Ch. 4A)

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

(Definition from RXD.12 in Ch. 4A)

Definition: This field contains the total daily dose being dispensed as expressed in terms of the actual dispense units.

Note:    The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXD so that it may "stand alone" as a dispense result instruction segment.


RXE-20: Needs Human Review (ID) 00307

(Definition from RXO.16 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that the pharmacist or non-pharmacist treatment supplier filling the order needs to pay special attention to the text in the RXO-6-provider's pharmacy/treatment instructions. A warning is present.

N    No - No warning is present. This is the equivalent default (null) value.

An example of the use of this field is given by the following case:

A smart Order Entry application knows of a possible drug or treatment interaction on a certain order, but the provider issuing the order wants to override the condition. In this case, the pharmacy or treatment application receiving the order will want to have a staff pharmacist or non-pharmacist treatment supplier review the interaction and contact the ordering physician.

(Definition from RXE.20 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the encoded order needs to warn the person administering the drug or treatment to pay attention to the text in RXE-21-pharmacy/treatment special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXD.14 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/no indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXD-15-Special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXG.12 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/No Indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXG-13-Special administration instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

RXE-21: Special Dispensing Instructions (CWE) 00330

(Definition from RXE.21 in Ch. 4A)

Definition: This field contains the pharmacy or treatment supplier's provider-generated special instructions to the provider dispensing/administering the order. Refer to Table 0721 - Special Dispensing Instructions in Chapter 2C for valid values.

(Definition from RXD.15 in Ch. 4A)

Definition: This field contains pharmacy or treatment supplier-generated special instructions to the provider dispensing/administering the order. Refer to Table 0706 - Special Dispensing Instructions in Chapter 2C for valid values.

RXE-22: Give Per (ST) 00331

(Definition from RXE.22 in Ch. 4A)

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical is to be administered.

Format:

S<integer>

=

<integer> seconds

M<integer>

=

<integer> minutes

H<integer>

=

<integer> hours

D<integer>

=

<integer> days

W<integer>

=

<integer> weeks

L<integer>

=

<integer> months

T<integer>

=

at the interval and amount stated until a total of <integer> "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.

INDEF

=

do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

This field is defined as conditional because it is required when the ordered substance is to be administered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

(Definition from RXG.14 in Ch. 4A)

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical/treatment is to be administered.

Format:

S<integer>

=

<integer> seconds

M<integer>

=

<integer> minutes

H<integer>

=

<integer> hours

D<integer>

=

<integer> days

W<integer>

=

<integer> weeks

L<integer>

=

<integer> months

T<integer>

=

at the interval and amount stated until a total of <integer> "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.

INDEF

=

do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

Required when relevant (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

RXE-23: Give Rate Amount (ST) 00332

(Definition from RXE.23 in Ch. 4A)

Definition: This field contains the rate at which the substance should be administered.

(Definition from RXG.15 in Ch. 4A)

Definition: This field contains the amount (number) of substance/treatment to be administered.

RXE-24: Give Rate Units (CWE) 00333

(Definition from RXE.24 in Ch. 4A)

Definition: This field contains the units for RXE-23-give rate amount. May be composite. The ratio of the RXE-23-give rate amount and RXE-24-give rate units defines the actual rate of administration. Thus, if RXE-23-give rate amount = 100 and RXE-24-give rate units = ml/hr, the requested rate of administration is 100 ml/hr. (See ISO+ figure 7-9 in Chapter 7 for possible compound units codes.) Refer to Table 0722 - Give Rate Units in Chapter 2C for valid values.

(Definition from RXG.16 in Ch. 4A)

Definition: This field contains the units for RXG-15-give rate amount. May be composite. The ratio of the RXG-15-give rate amount and RXG-16-give rate units fields define the actual rate of administration. Thus, if RXG-15-give rate amount = 100 and RXG-16-give rate units = ml/hr, the requested rate of administration is 100 ml/hr. Refer to Table 0740 - Give Rate Units in Chapter 2C for valid values.

RXE-25: Give Strength (NM) 01126

(Definition from RXE.25 in Ch. 4A)

Definition: Use when RXE-2-give code does not specify the strength. This is the numeric part of the strength, used in combination with RXE-26-give strength units.

(Definition from RXG.17 in Ch. 4A)

Definition: Use when RXG-4-Give code does not specify the strength. This is the numeric part of the strength, used in combination with RXG-18-Give strength units.

RXE-26: Give Strength Units (CWE) 01127

(Definition from RXE.26 in Ch. 4A)

Definition: Use when RXE-2-Give Code does not specify the strength. This is the unit of the strength, used in combination with RXE-25-Give Strength. Refer to Table 0723 - Give Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity"; i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


(Definition from RXG.18 in Ch. 4A)

Definition: Use when RXG-4-Give Code does not specify the strength. This is the unit of the strength, used in combination with RXG-17-Give Strength. Refer to Table 0741 - Give Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity"; i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


RXE-27: Give Indication (CWE) 01128

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0724 - Give Indication in Chapter 2C for valid values.

RXE-28: Dispense Package Size (NM) 01220

(Definition from RXE.28 in Ch. 4A)

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXE-29-dispense package size unit.

(Definition from RXD.22 in Ch. 4A)

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXD-23-dispense package size unit.

RXE-29: Dispense Package Size Unit (CWE) 01221

(Definition from RXE.29 in Ch. 4A)

Definition: This field contains the units in which RXE-28-dispense package size is denominated. Refer to Table 0726 - Dispense Package Size Unit in Chapter 2C for valid values.

(Definition from RXD.23 in Ch. 4A)

Definition: This field contains the units in which RXE-28-dispense package size is denominated. The advertised number of units in the manufacturer's package, i.e., the package as it comes from the supplier. Refer to Table 0709 - Dispense Package Size Unit in Chapter 2C for valid values.

RXE-30: Dispense Package Method (ID) 01222

(Definition from RXE.30 in Ch. 4A)

Definition: This field contains the method by which treatment is dispensed. Refer to HL7 Table 0321 - Dispense Method in Chapter 2C, Code Tables, for valid values.

(Definition from RXD.24 in Ch. 4A)

Definition: This field contains the method by which treatment is dispensed. Refer To HL7 Table 0321 - Dispense Method in Chapter 2C, Code Tables, for valid values.

RXE-31: Supplementary Code (CWE) 01476

(Definition from RXO.24 in Ch. 4A)

This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0762 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXC.7 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical or other treatment substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0700 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXE.31 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0727 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXD.25 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0710 - Supplementary Code in Chapter 2C for valid values.

RXE-32: Original Order Date/Time (DTM) 01673

Definition: This field contains the date/time of the original order (ORC-9) when a refill authorization is being requested. This was represented in the ORC-9 of the original order transaction.

RXE-33: Give Drug Strength Volume (NM) 01674

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXE-25, RXE-26, RXE-33 and RXE-34 as:

RXE|||||||||||||||||||||||||120|mg^^ISO|||||||5|ml^^ISO ...<cr>

RXE-34: Give Drug Strength Volume Units (CWE) 01675

Description: This field indicates the volumetric unit associated with RXE-33 Give Drug Strength Volume. See example in RXE-33. Refer to Table 0729 - Give Drug Strength Volume Units in Chapter 2C for valid values.

RXE-35: Controlled Substance Schedule (CWE) 01676

Definition: This field specifies the class of the drug or other substance if its usage is controlled by legislation. In the USA, such legislation includes the federal Controlled Substance Act (CSA) or a State Uniform Controlled Substance Act. Refer to User-defined table 0477 – Controlled Substance Schedule in Chapter 2C, Code Tables, for valid values for USA usage. Other countries should create their own versions of this table.

Because some jurisdictions may extend the list of drugs in a particular class and may create an additional schedule, table 0477 is user-defined.

RXE-36: Formulary Status (ID) 01677

Definition: This field specifies whether or not the pharmaceutical substance is part of the local formulary. Refer to HL7 table 0478 - Formulary Status in Chapter 2C, Code Tables, for valid values.

RXE-37: Pharmaceutical Substance Alternative (CWE) 01678

Definition: This field specifies a pharmaceutical substance that is in the formulary that could be prescribed in lieu of the substance being prescribed. In the case where the specified medication is non-formulary this field would contain therapeutic alternatives that are on the formulary. Refer to Table 0730 - Pharmaceutical Substance Alternative in Chapter 2C for valid values.

RXE-38: Pharmacy of Most Recent Fill (CWE) 01679

Definition: This field specifies the pharmacy that last filled the prescription. Refer to Table 0732 - Pharmacy of Most Recent Fill in Chapter 2C for valid values.

RXE-39: Initial Dispense Amount (NM) 01680

Definition: This field specifies the quantity dispensed on the original fill (first fill) of a prescription when that amount is not the same as the quantity to be used in refills. One use case is when a new medication is being prescribed and the prescriber wants to determine if the patient will tolerate the medication. The prescriber indicates that the medication should be filled for an initial amount of 30 tablets and, if tolerated, refilled using a quantity of 100 tablets. In this case, RXE-39 would contain 30 and RXE-10 would contain 100.

If this field is not populated, then the initial dispense amount is the same as RXE-10.

The units are identified in RXE-11.

RXE-40: Dispensing Pharmacy (CWE) 01681

(Definition from RXO.32 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7. Refer to Table 0765 - Dispensing Pharmacy in Chapter 2C for valid values.

ense the prescription.

(Definition from RXE.40 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment. Refer to Table 0733 - Dispensing Pharmacy in Chapter 2C for valid values.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

RXE-41: Dispensing Pharmacy Address (XAD) 01682

(Definition from RXO.33 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

(Definition from RXE.41 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility.

RXE-42: Deliver-to Patient Location (PL) 01683

(Definition from RXO.34 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

(Definition from RXE.42 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

(Definition from RXG.29 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

RXE-43: Deliver-to Address (XAD) 01684

(Definition from RXO.35 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

(Definition from RXE.43 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

(Definition from RXG.30 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

RXE-44: Pharmacy Order Type (ID) 01685

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

RXE-45: Pharmacy Phone Number (XTN) 02310

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXO-36 and RXD-34 to support pharmacy contact information in the context of the order, the encoded order and the dispense.

RXD - Pharmacy/Treatment Dispense Segment

HL7 Attribute Table - RXD - Pharmacy/Treatment Dispense Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXD
1 00334 Dispense Sub-ID Counter SHALL = [1..1] 4
NM
2 00335 Dispense/Give Code SHALL [1..1]
0292 Vaccines Administered
CWE
3 00336 Date/Time Dispensed SHALL [1..1]
DTM
4 00337 Actual Dispense Amount SHALL [1..1]
NM
5

00338 Actual Dispense Units MAY
True:
False: 		C
[1..1]
[0..1]
0704
CWE
6 00339 Actual Dosage Form [0..1]
0705
CWE
7 00325 Prescription Number SHALL = [1..1] 20
ST
8

00326 Number of Refills Remaining MAY
True:
False: 		C
[1..1]
[0..1]
NM
9 00340 Dispense Notes = [0..*] 200
ST
10 00341 Dispensing Provider B [0..*]
XCN
11 00322 Substitution Status [0..1] [1..1]
0167 Substitution Status
ID
12 00329 Total Daily Dose [0..1]
CQ
13 01303 Dispense-to Location SHALL NOT W [0..0]
14 00307 Needs Human Review [0..1] [1..1]
0136 Yes/no Indicator
ID
15 00330 Special Dispensing Instructions [0..*]
0721
CWE
16 01132 Actual Strength [0..1]
NM
17 01133 Actual Strength Unit [0..1]
0707
CWE
18 01129 Substance Lot Number = [0..*] 20
ST
19 01130 Substance Expiration Date [0..*]
DTM
20 01131 Substance Manufacturer Name [0..*]
CWE
21 01123 Indication [0..*]
0758
CWE
22 01220 Dispense Package Size [0..1]
NM
23 01221 Dispense Package Size Unit [0..1]
0726
CWE
24 01222 Dispense Package Method [0..1] [1..2]
0321 Dispense Method
ID
25 01476 Supplementary Code [0..*]
0762
CWE
26 01477 Initiating Location [0..1]
0711
CWE
27 01478 Packaging/Assembly Location [0..1]
0712
CWE
28 01686 Actual Drug Strength Volume = [0..1] 5
NM
29 01687 Actual Drug Strength Volume Units [0..1]
0713
CWE
30 01688 Dispense to Pharmacy B [0..1]
0714
CWE
31 01689 Dispense to Pharmacy Address B [0..1]
XAD
32 01690 Pharmacy Order Type [0..1] [1..1]
0480 Pharmacy Order Types
ID
33 01691 Dispense Type [0..1]
0484 Dispense Type
CWE
34 02311 Pharmacy Phone Number [0..*]
XTN
35 03392 Dispense Tag Identifier [0..*]
EI

RXD-1: Dispense Sub-ID Counter (NM) 00334

(Definition from RXD.1 in Ch. 4A)

Definition: This field starts with 1 the first time that medication/treatment is delivered/dispensed for this order. Increments by one with each additional issuance.

(Definition from RXG.2 in Ch. 4A)

Definition: This is the dispense sub-ID to which this give message is related.

RXD-2: Dispense/Give Code (CWE) 00335

Definition: This field identifies the medical substance or treatment ordered to be given to the patient; it is equivalent to OBR-4-Universal Service ID. See the RXE segment for a complete definition of the RXE-2-give code. If the substance dispensed is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines Administered in Chapter 2C, Code Tables).

Note: The contents of RXD-2-dispense/give code should be compatible with the comparable field in the RXE (RXE-2-give code). The RDS message refers ONLY to the dispensing of the drug or treatment by the pharmacy or treatment supplier.


RXD-3: Date/Time Dispensed (DTM) 00336

Definition: This field indicates when the pharmaceutical/treatment is dispensed from the pharmacy or treatment supplier. Use the time stamp format.

RXD-4: Actual Dispense Amount (NM) 00337

Definition: This field indicates the amount dispensed.

RXD-5: Actual Dispense Units (CWE) 00338

Definition: This field indicates the units dispensed. Site-defined table. This field is required if the units are not implied by the actual dispense code. If present, it overrides units implied by the actual dispense code. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units. Refer to Table 0704 - Actual Dispense Units in Chapter 2C for valid values.

RXD-6: Actual Dosage Form (CWE) 00339

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the dispense/give code in RXD-2-dispense/give code. Use this field when the give code and the dispense code do not specify the dosage form. Refer to Table 0705 - Actual Dosage Form in Chapter 2C for valid values.

RXD-7: Prescription Number (ST) 00325

(Definition from RXE.15 in Ch. 4A)

Definition: This field contains the prescription number as assigned by the pharmacy or treatment application. Equivalent in uniqueness to the pharmacy/treatment filler order number. At some sites, this may be the pharmacy or treatment system (internal) sequential form. At other sites, this may be an external form. This is a required field in RXE when used in pharmacy/treatment messages, but it is not required when used in product experience messages (see Chapter 7).

(Definition from RXD.7 in Ch. 4A)

Definition: This field is equivalent in uniqueness to the pharmacy/treatment supplier filler order number. At some sites, this may be the pharmacy/treatment supplier (internal) sequential form. At other sites, this may be an external number.

(Definition from FT1.42 in Ch. 6)

Definition: This field contains the prescription number as assigned by the pharmacy or treatment application. Equivalent in uniqueness to the pharmacy/treatment filler order number. At some sites, this may be the pharmacy or treatment system (internal) sequential form. At other sites, this may be an external form.

RXD-8: Number of Refills Remaining (NM) 00326

(Definition from RXE.16 in Ch. 4A)

Definition: Number of refills remaining. This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

(Definition from RXD.8 in Ch. 4A)

Definition: This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

RXD-9: Dispense Notes (ST) 00340

Definition: This field contains free text notes to the person dispensing the medication/treatment (may include the ordering provider's original notes, as well as any notes from the formulary or the pharmacy or treatment supplier). This may contain free text describing a custom IV, mixture, or salve for example.

RXD-10: Dispensing Provider (XCN) 00341

Definition: This field is retained for backward compatibility only as of v 27. The reader is referred to the PRT segment described in Chapter.7.

This field contains the provider ID of the person dispensing the pharmaceutical. If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

RXD-11: Substitution Status (ID) 00322

(Definition from RXE.9 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for valid values. If a substitution has been made, and a record of the original requested give code (RXO-1-requested give code) is needed, the optional RXO segment can be included in the RDE message.

(Definition from RXD.11 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for suggested values.

(Definition from RXG.10 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for valid values.

Note: The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXG so that it may "stand alone" as a "give" instruction segment.


RXD-12: Total Daily Dose (CQ) 00329

(Definition from RXO.23 in Ch. 4A)

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

(Definition from RXE.19 in Ch. 4A)

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

(Definition from RXD.12 in Ch. 4A)

Definition: This field contains the total daily dose being dispensed as expressed in terms of the actual dispense units.

Note:    The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXD so that it may "stand alone" as a dispense result instruction segment.


RXD-13: Dispense-to Location

(Definition from RXD.13 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 2.6 and withdrawn from the standard as of v 2.8. The reader is referred toRXD-30 and RXD-31.

(Definition from RXG.11 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 2.6 and removed from the standard as of v 2.8. The reader is referred to RXG-27 and RXG-28.

RXD-14: Needs Human Review (ID) 00307

(Definition from RXO.16 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that the pharmacist or non-pharmacist treatment supplier filling the order needs to pay special attention to the text in the RXO-6-provider's pharmacy/treatment instructions. A warning is present.

N    No - No warning is present. This is the equivalent default (null) value.

An example of the use of this field is given by the following case:

A smart Order Entry application knows of a possible drug or treatment interaction on a certain order, but the provider issuing the order wants to override the condition. In this case, the pharmacy or treatment application receiving the order will want to have a staff pharmacist or non-pharmacist treatment supplier review the interaction and contact the ordering physician.

(Definition from RXE.20 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the encoded order needs to warn the person administering the drug or treatment to pay attention to the text in RXE-21-pharmacy/treatment special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXD.14 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/no indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXD-15-Special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXG.12 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/No Indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXG-13-Special administration instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

RXD-15: Special Dispensing Instructions (CWE) 00330

(Definition from RXE.21 in Ch. 4A)

Definition: This field contains the pharmacy or treatment supplier's provider-generated special instructions to the provider dispensing/administering the order. Refer to Table 0721 - Special Dispensing Instructions in Chapter 2C for valid values.

(Definition from RXD.15 in Ch. 4A)

Definition: This field contains pharmacy or treatment supplier-generated special instructions to the provider dispensing/administering the order. Refer to Table 0706 - Special Dispensing Instructions in Chapter 2C for valid values.

RXD-16: Actual Strength (NM) 01132

Definition: Use when RXD-2-Dispense/Give Code does not specify the strength. This is the numeric part of the strength, of a single dosage unit of the dispensed product, used in combination with RXD-17-actual strength unit.

RXD-17: Actual Strength Unit (CWE) 01133

Definition: Use when RXD-2-Dispense/Give Code does not specify the strength. This is the unit of the strength, of a single dosage unit of the dispensed product, used in combination with RXD-16-actual strength. Refer to Table 0707 - Actual Strength Unit in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


RXD-18: Substance Lot Number (ST) 01129

(Definition from RXD.18 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXG.19 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXA.15 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from SID.2 in Ch. 13)

Definition: This field specifies the lot number assigned by the manufacturer during production of the substance.

RXD-19: Substance Expiration Date (DTM) 01130

(Definition from RXD.19 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM^L.


(Definition from RXG.20 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


(Definition from RXA.16 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


RXD-20: Substance Manufacturer Name (CWE) 01131

(Definition from RXD.20 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered when it is a manufactured substance.

Note: For vaccines, code system MVX may be used to code this field. See Section 4A.7.1, "Vaccine administration data". This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-Administered code.


(Definition from RXG.21 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field (see section4A.7.1, "Vaccine administration data"). This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-administered code.


(Definition from RXA.17 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field. See section 4A.7.1, "Vaccine administration data." This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5- administered code. When using this code system to identify vaccines, the coding system component of the CWE field should be valued as "MVX", not as "HL70227."


RXD-21: Indication (CWE) 01123

(Definition from RXO.20 in Ch. 4A)

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0758 - Indication in Chapter 2C for valid values.

(Definition from RXD.21 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0708 - Indication in Chapter 2C for valid values.

(Definition from RXG.22 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0743 - Indication in Chapter 2C for valid values.

(Definition from RXA.19 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0694 - Indication in Chapter 2C for valid values.

RXD-22: Dispense Package Size (NM) 01220

(Definition from RXE.28 in Ch. 4A)

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXE-29-dispense package size unit.

(Definition from RXD.22 in Ch. 4A)

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXD-23-dispense package size unit.

RXD-23: Dispense Package Size Unit (CWE) 01221

(Definition from RXE.29 in Ch. 4A)

Definition: This field contains the units in which RXE-28-dispense package size is denominated. Refer to Table 0726 - Dispense Package Size Unit in Chapter 2C for valid values.

(Definition from RXD.23 in Ch. 4A)

Definition: This field contains the units in which RXE-28-dispense package size is denominated. The advertised number of units in the manufacturer's package, i.e., the package as it comes from the supplier. Refer to Table 0709 - Dispense Package Size Unit in Chapter 2C for valid values.

RXD-24: Dispense Package Method (ID) 01222

(Definition from RXE.30 in Ch. 4A)

Definition: This field contains the method by which treatment is dispensed. Refer to HL7 Table 0321 - Dispense Method in Chapter 2C, Code Tables, for valid values.

(Definition from RXD.24 in Ch. 4A)

Definition: This field contains the method by which treatment is dispensed. Refer To HL7 Table 0321 - Dispense Method in Chapter 2C, Code Tables, for valid values.

RXD-25: Supplementary Code (CWE) 01476

(Definition from RXO.24 in Ch. 4A)

This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0762 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXC.7 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical or other treatment substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0700 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXE.31 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0727 - Supplementary Code in Chapter 2C for valid values.

(Definition from RXD.25 in Ch. 4A)

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0710 - Supplementary Code in Chapter 2C for valid values.

RXD-26: Initiating Location (CWE) 01477

Definition: This field identifies the pharmacy or other treatment dispensing service (e.g., respiratory) that received the initial request. Refer to Table 0711 - Initiating Location in Chapter 2C for valid values.

Example: Pharmacy A (the Intake/Receiving) receives a phone call from the patient requesting a medication refill, but stipulates that the prescription will be picked up in pharmacy B. In accordance with the business process the prescription will be packaged/assembled in Pharmacy C.

RXD-27: Packaging/Assembly Location (CWE) 01478

Definition: This field identifies the pharmacy which packaged/assembled request. Refer to Table 0712 - Packaging/Assembly Location in Chapter 2C for valid values.

RXD-28: Actual Drug Strength Volume (NM) 01686

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML , which would be encoded in RXD-16, RXD-17, RXD-28 and RXD-29 as

RXD||||||||||||||||120|mg^^ISO|||||||||||5|ml^^ISO ...<cr>

RXD-29: Actual Drug Strength Volume Units (CWE) 01687

Description: This field indicates the volumetric unit associated with RXD-28 Actual Drug Strength Volume. See example in RXD-28. Refer to Table 0713 - Actual Drug Strength Volume Units in Chapter 2C for valid values.

RXD-30: Dispense to Pharmacy (CWE) 01688

(Definition from RXD.30 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment. Refer to Table 0714 - Dispense to Pharmacy in Chapter 2C for valid values.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

(Definition from RXG.27 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

RXD-31: Dispense to Pharmacy Address (XAD) 01689

(Definition from RXD.31 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility or the patient's location where the dispensing will occur.

(Definition from RXG.28 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

RXD-32: Pharmacy Order Type (ID) 01690

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 - Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

RXD-33: Dispense Type (CWE) 01691

Definition: This is the type of dispensing event that occurred. Refer to User-defined Table 0484 – Dispense Type for suggested values.

RXD-34: Pharmacy Phone Number (XTN) 02311

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXO-36 and RXE-45 to support pharmacy contact information in the context of the order, the encoded order and the dispense.

RXD-35: Dispense Tag Identifier (EI) 03392

Definition: This field contains an identifier for the individual product instance for the dispense occurrence. This may represent a barcode, RFID or other means of automatically-readable product instance. Repetitions represent the same instance where more than one barcode, RFID or other identification is present.

For example, the medication preparer, e.g., a semi-automatic system, can inform the nurse that "for the 8 a.m. administration event, the medication that has been assigned and available at the patient bedside has the barcode BBBBBBBBBBB." The nurse would scan the barcode to ensure that the right medication is being administered.

RXG - Pharmacy/Treatment Give Segment

HL7 Attribute Table - RXG - Pharmacy/Treatment Give Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXG
1 00342 Give Sub-ID Counter SHALL = [1..1] 4
NM
2 00334 Dispense Sub-ID Counter = [0..1] 4
NM
3 00221 Quantity/Timing SHALL NOT W [0..0]
4 00317 Give Code SHALL [1..1]
0292 Vaccines Administered
CWE
5 00318 Give Amount - Minimum SHALL [1..1]
NM
6 00319 Give Amount - Maximum [0..1]
NM
7 00320 Give Units SHALL [1..1]
0715
CWE
8 00321 Give Dosage Form [0..1]
0716
CWE
9 00351 Administration Notes [0..*]
0737
CWE
10 00322 Substitution Status [0..1] [1..1]
0167 Substitution Status
ID
11 01303 Dispense-to Location SHALL NOT W [0..0]
12 00307 Needs Human Review [0..1] [1..1]
0136 Yes/no Indicator
ID
13 00343 Special Administration Instructions [0..*] [1..250]
0738
CWE
14

00331 Give Per MAY
True:
False: 		C=
[1..1]
[0..1] 		20
ST
15 00332 Give Rate Amount = [0..1] 6
ST
16 00333 Give Rate Units [0..1]
0722
CWE
17 01126 Give Strength [0..1]
NM
18 01127 Give Strength Units [0..1]
0723
CWE
19 01129 Substance Lot Number = [0..*] 20
ST
20 01130 Substance Expiration Date [0..*]
DTM
21 01131 Substance Manufacturer Name [0..*]
CWE
22 01123 Indication [0..*]
0758
CWE
23 01692 Give Drug Strength Volume # [0..1] 5
NM
24 01693 Give Drug Strength Volume Units [0..1]
0744
CWE
25 01694 Give Barcode Identifier [0..1]
0745
CWE
26 01695 Pharmacy Order Type [0..1] [1..1]
0480 Pharmacy Order Types
ID
27 01688 Dispense to Pharmacy SHALL NOT W [0..0]
0714
CWE
28 01689 Dispense to Pharmacy Address SHALL NOT W [0..0]
XAD
29 01683 Deliver-to Patient Location [0..1]
PL
30 01684 Deliver-to Address [0..1]
XAD
31 03393 Give Tag Identifier [0..*]
EI
32

03316 Dispense Amount MAY
True:
False: 		C
[1..1]
[0..1]
NM
33 03317 Dispense Units MAY
True:
False: 		C
[1..1]
[0..1]
0746
CWE

RXG-1: Give Sub-ID Counter (NM) 00342

(Definition from RXG.1 in Ch. 4A)

Definition: Use if this RXG segment carries information about a single administration. This field must contain a unique number for the placer order number. This field along with the placer order number provides a unique reference to the specific scheduled give date/time transmitted by the pharmacy/treatment supplier for this order.

If the RXG segment carries information about multiple administrations, this field's value is zero (0), since in this case a one-to-one matching with the RXA segment is ambiguous.

(Definition from RXA.1 in Ch. 4A)

Definition: Use this field if matching this RXA segment to its corresponding RXG segment. If the two applications are not matching RXG and RXA segments, this field's value is zero (0).

RXG-2: Dispense Sub-ID Counter (NM) 00334

(Definition from RXD.1 in Ch. 4A)

Definition: This field starts with 1 the first time that medication/treatment is delivered/dispensed for this order. Increments by one with each additional issuance.

(Definition from RXG.2 in Ch. 4A)

Definition: This is the dispense sub-ID to which this give message is related.

RXG-3: Quantity/Timing

(Definition from ORC.7 in Ch. 4)

Attention: The ORC-7 field was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7. The reader is referred to the TQ1 and TQ2 segments described in sections 4.5.4 and 4.5.5, respectively.

(Definition from OBR.27 in Ch. 4)

Attention: The OBR-27 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

(Definition from RXE.1 in Ch. 4A)

Attention: The RXE-1 field was retained for backward compatibilty only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

(Definition from RXG.3 in Ch. 4A)

Attention: The RXG-3 field was retained for backward compatibilty only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

Note: The contents of fields 3-8 should be identical to the comparable fields in the RXE (RXE-2 thru 5).


(Definition from OBR.27 in Ch. 7)

Attention: The OBR-27 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7.

RXG-4: Give Code (CWE) 00317

(Definition from RXE.2 in Ch. 4A)

Definition: This field identifies the medical substance or treatment that has been ordered to be given to the patient, as encoded by the pharmacy or treatment supplier; it is equivalent to OBR-4-universal service ID in function. In the RXE segment, this give code must be fully encoded. The dispense fields, which define the units and amount of what is to be issued to the patient (see RXE-10-dispense amount and RXE-11-dispense units below) do not necessarily correlate with the instructions of what amount is to be "given" or administered with each dose, and may or may not be specified with the order. For example, the "give" part of the order may convey the field-representation of give 250 mg of Ampicillin, while the request to dispense part of the order may convey issue 30 tablets of generic equivalent for this outpatient prescription.

The coding system used is conditional on both the nature of the medical substance or treatment ordered and site-specific implementation considerations. For vaccines, HL7 Table 0292 – Vaccines Administered is the preferred coding system. For non-vaccine products, the coding system may be a local implementation of User-defined Table 0479 – Pharmaceutical Substances or an external coding system. Examples of external coding systems include, but are not limited to, National Drug Codes (NDC), Medispan Generic Product Identifier (MGPI), Drug Descriptor Identifier (DDID), and other drug codes listed in HL7 Table 0396 – Coding Systems. The following examples illustrate some code tables other than User-defined Table 0479:

NDC:                0006915404^Norvasc 10mg Tabs^NDC

DDID:                015189^Norvasc 10mg Tabs^DDID

CVX (HL70292):            30^HBIG^CVX

(Definition from RXG.4 in Ch. 4A)

Definition: This field is the identifier of the medical substance/treatment ordered to be given to the patient; it is equivalent to OBR-4-Universal service ID in function. See the RXE segment for a complete definition of the RXE-2-Give code. If the substance given is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines administered in Chapter 2C, Code Tables).

RXG-5: Give Amount - Minimum (NM) 00318

(Definition from RXE.3 in Ch. 4A)

Definition: This field contains the ordered amount as encoded by the pharmacy or treatment supplier. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

Note:    This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).


(Definition from RXG.5 in Ch. 4A)

Definition: This field contains the ordered amount as encoded by the pharmacy/treatment supplier. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; and thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).


RXG-6: Give Amount - Maximum (NM) 00319

(Definition from RXE.4 in Ch. 4A)

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose, this field is not used.

(Definition from RXG.6 in Ch. 4A)

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose order, this field is not used.

RXG-7: Give Units (CWE) 00320

(Definition from RXE.5 in Ch. 4A)

Definition: This field contains the units for the give amount as encoded by the pharmacy or treatment (e.g., respiratory therapy) application. Refer to Table 0715 - Give Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).


A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

(Definition from RXG.7 in Ch. 4A)

Definition: This field contains the units for the give amount. Refer to Table 0735 - Give Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).


A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

RXG-8: Give Dosage Form (CWE) 00321

(Definition from RXE.6 in Ch. 4A)

Definition: The dosage form indicates the manner in which the medication or treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXE-2-Give Code. Use the RXE-6-Give Dosage Form when the give code does not specify the dosage form. Refer to Table 0716 - Give Dosage Form in Chapter 2C for valid values.

(Definition from RXG.8 in Ch. 4A)

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXG-4-Give Code. Use this field when the give code does not specify the dosage form. Refer to Table 0736 - Give Dosage Form in Chapter 2C for valid values.

RXG-9: Administration Notes (CWE) 00351

(Definition from RXG.9 in Ch. 4A)

Definition: This field contains notes to the person administering the medication/treatment (may include the ordering provider's original notes, as well as any notes from the formulary or the pharmacy or treatment supplier). If coded, a user-defined table must be used. If free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration note|. Refer to Table 0737 - Administration Notes in Chapter 2C for valid values.

(Definition from RXA.9 in Ch. 4A)

Definition: This field contains notes from the provider administering the medication/treatment. If coded, requires a user-defined table. If free text (describing a custom IV, mixture, or salve, for example) place a null in the first component and the text in the second, e.g., |^this is a free text administration note|. Refer to Table 0691 - Administration Notes in Chapter 2C for valid values.

RXG-10: Substitution Status (ID) 00322

(Definition from RXE.9 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for valid values. If a substitution has been made, and a record of the original requested give code (RXO-1-requested give code) is needed, the optional RXO segment can be included in the RDE message.

(Definition from RXD.11 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for suggested values.

(Definition from RXG.10 in Ch. 4A)

Definition: Refer to HL7 Table 0167 - Substitution Status in Chapter 2C, Code Tables, for valid values.

Note: The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXG so that it may "stand alone" as a "give" instruction segment.


RXG-11: Dispense-to Location

(Definition from RXD.13 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 2.6 and withdrawn from the standard as of v 2.8. The reader is referred toRXD-30 and RXD-31.

(Definition from RXG.11 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 2.6 and removed from the standard as of v 2.8. The reader is referred to RXG-27 and RXG-28.

RXG-12: Needs Human Review (ID) 00307

(Definition from RXO.16 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that the pharmacist or non-pharmacist treatment supplier filling the order needs to pay special attention to the text in the RXO-6-provider's pharmacy/treatment instructions. A warning is present.

N    No - No warning is present. This is the equivalent default (null) value.

An example of the use of this field is given by the following case:

A smart Order Entry application knows of a possible drug or treatment interaction on a certain order, but the provider issuing the order wants to override the condition. In this case, the pharmacy or treatment application receiving the order will want to have a staff pharmacist or non-pharmacist treatment supplier review the interaction and contact the ordering physician.

(Definition from RXE.20 in Ch. 4A)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the encoded order needs to warn the person administering the drug or treatment to pay attention to the text in RXE-21-pharmacy/treatment special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXD.14 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/no indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXD-15-Special dispensing instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

(Definition from RXG.12 in Ch. 4A)

Definition: Refer to HL7 Table 0136 - Yes/No Indicator for valid values. The values have the following meaning for this field:

Y    Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXG-13-Special administration instructions.

N    No - Indicates no warning is present. This is the equivalent default (null) value.

RXG-13: Special Administration Instructions (CWE) 00343

Definition: This field contains pharmacy/treatment supplier-generated special instructions to the provider administering the order. Refer to Table 0738 - Special Administration Instructions in Chapter 2C for valid values.

RXG-14: Give Per (ST) 00331

(Definition from RXE.22 in Ch. 4A)

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical is to be administered.

Format:

S<integer>

=

<integer> seconds

M<integer>

=

<integer> minutes

H<integer>

=

<integer> hours

D<integer>

=

<integer> days

W<integer>

=

<integer> weeks

L<integer>

=

<integer> months

T<integer>

=

at the interval and amount stated until a total of <integer> "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.

INDEF

=

do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

This field is defined as conditional because it is required when the ordered substance is to be administered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

(Definition from RXG.14 in Ch. 4A)

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical/treatment is to be administered.

Format:

S<integer>

=

<integer> seconds

M<integer>

=

<integer> minutes

H<integer>

=

<integer> hours

D<integer>

=

<integer> days

W<integer>

=

<integer> weeks

L<integer>

=

<integer> months

T<integer>

=

at the interval and amount stated until a total of <integer> "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.

INDEF

=

do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

Required when relevant (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

RXG-15: Give Rate Amount (ST) 00332

(Definition from RXE.23 in Ch. 4A)

Definition: This field contains the rate at which the substance should be administered.

(Definition from RXG.15 in Ch. 4A)

Definition: This field contains the amount (number) of substance/treatment to be administered.

RXG-16: Give Rate Units (CWE) 00333

(Definition from RXE.24 in Ch. 4A)

Definition: This field contains the units for RXE-23-give rate amount. May be composite. The ratio of the RXE-23-give rate amount and RXE-24-give rate units defines the actual rate of administration. Thus, if RXE-23-give rate amount = 100 and RXE-24-give rate units = ml/hr, the requested rate of administration is 100 ml/hr. (See ISO+ figure 7-9 in Chapter 7 for possible compound units codes.) Refer to Table 0722 - Give Rate Units in Chapter 2C for valid values.

(Definition from RXG.16 in Ch. 4A)

Definition: This field contains the units for RXG-15-give rate amount. May be composite. The ratio of the RXG-15-give rate amount and RXG-16-give rate units fields define the actual rate of administration. Thus, if RXG-15-give rate amount = 100 and RXG-16-give rate units = ml/hr, the requested rate of administration is 100 ml/hr. Refer to Table 0740 - Give Rate Units in Chapter 2C for valid values.

RXG-17: Give Strength (NM) 01126

(Definition from RXE.25 in Ch. 4A)

Definition: Use when RXE-2-give code does not specify the strength. This is the numeric part of the strength, used in combination with RXE-26-give strength units.

(Definition from RXG.17 in Ch. 4A)

Definition: Use when RXG-4-Give code does not specify the strength. This is the numeric part of the strength, used in combination with RXG-18-Give strength units.

RXG-18: Give Strength Units (CWE) 01127

(Definition from RXE.26 in Ch. 4A)

Definition: Use when RXE-2-Give Code does not specify the strength. This is the unit of the strength, used in combination with RXE-25-Give Strength. Refer to Table 0723 - Give Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity"; i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


(Definition from RXG.18 in Ch. 4A)

Definition: Use when RXG-4-Give Code does not specify the strength. This is the unit of the strength, used in combination with RXG-17-Give Strength. Refer to Table 0741 - Give Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity"; i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


RXG-19: Substance Lot Number (ST) 01129

(Definition from RXD.18 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXG.19 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXA.15 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from SID.2 in Ch. 13)

Definition: This field specifies the lot number assigned by the manufacturer during production of the substance.

RXG-20: Substance Expiration Date (DTM) 01130

(Definition from RXD.19 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM^L.


(Definition from RXG.20 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


(Definition from RXA.16 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


RXG-21: Substance Manufacturer Name (CWE) 01131

(Definition from RXD.20 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered when it is a manufactured substance.

Note: For vaccines, code system MVX may be used to code this field. See Section 4A.7.1, "Vaccine administration data". This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-Administered code.


(Definition from RXG.21 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field (see section4A.7.1, "Vaccine administration data"). This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-administered code.


(Definition from RXA.17 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field. See section 4A.7.1, "Vaccine administration data." This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5- administered code. When using this code system to identify vaccines, the coding system component of the CWE field should be valued as "MVX", not as "HL70227."


RXG-22: Indication (CWE) 01123

(Definition from RXO.20 in Ch. 4A)

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0758 - Indication in Chapter 2C for valid values.

(Definition from RXD.21 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0708 - Indication in Chapter 2C for valid values.

(Definition from RXG.22 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0743 - Indication in Chapter 2C for valid values.

(Definition from RXA.19 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0694 - Indication in Chapter 2C for valid values.

RXG-23: Give Drug Strength Volume (NM) 01692

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXG-17, RXG-18, RXG-23 and RXG-24 as:

RXG|||||||||||||||||120|mg^^ISO|||||5|ml^^ISO ...<cr>

RXG-24: Give Drug Strength Volume Units (CWE) 01693

Description: This field indicates the volumetric unit associated with RXG-23 Give Drug Strength Volume. See example in RXG-23. Refer to Table 0744 - Give Drug Strength Volume Units in Chapter 2C for valid values.

RXG-25: Give Barcode Identifier (CWE) 01694

Definition: This field contains the pharmacy system's assigned barcode number for the give occurrence. For IV orders, many pharmacy systems generate a barcode number to identify a specific bag/bottle of the order. This number can be an instance identifier; unique for the patient, drug combination, and schedule instance or it may be just a drug identifier. Refer to Table 0745 - Give Barcode Identifier in Chapter 2C for valid values.

The composition and use of the barcode number is dependent on application negotiation. An example of this field follows: The barcode number is in the following format, 9XXXXXXX000. The number '9' is a constant, XXXXXXX is seven (7) characters for a unique identifier assigned or derived from the patient account and order ID and 000 is the zero-filled three (3) character IV bottle number.

The maximum length of the first component of this field is 40 characters to allow for the maximum existing barcode length in use today. The second component contains the description of the item being coded and the third component may define the barcode type.

12345678901^IV bottle^3X9

RXG-26: Pharmacy Order Type (ID) 01695

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

RXG-27: Dispense to Pharmacy

(Definition from RXD.30 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment. Refer to Table 0714 - Dispense to Pharmacy in Chapter 2C for valid values.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

(Definition from RXG.27 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

RXG-28: Dispense to Pharmacy Address

(Definition from RXD.31 in Ch. 4A)

Definition: This field is retained for backward compatibility only as of v 27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility or the patient's location where the dispensing will occur.

(Definition from RXG.28 in Ch. 4A)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

RXG-29: Deliver-to Patient Location (PL) 01683

(Definition from RXO.34 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

(Definition from RXE.42 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

(Definition from RXG.29 in Ch. 4A)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

RXG-30: Deliver-to Address (XAD) 01684

(Definition from RXO.35 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

(Definition from RXE.43 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

(Definition from RXG.30 in Ch. 4A)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

RXG-31: Give Tag Identifier (EI) 03393

Definition: This field contains an identifier for the individual product instance for the dispense occurrence. This may represent a barcode, RFID or other means of automatically-readable product instance. Repetitions represent the same instance where more than one barcode, RFID or other identification is present.

For example, the medication preparer, e.g., a semi-automated system, can inform the nurse that "for the 8.am administration event, the medication that has been assigned and available at the patient bedside has the barcode BBBBBBBBBBB." The nurse would scan the barcode to ensure that the right medication is being administered.

This differs from RXG-25 Give Barcode Identifier in that RXG-25 may include other workflow content or the product at various levels of granularity. RXG-31 specifically identifies the product instance.

RXG-32: Dispense Amount (NM) 03316

Definition: This field contains the amount to be dispensed as encoded by the pharmacy or treatment supplier.

RXG-33: Dispense Units (CWE) 03317

Definition: This field contains the units for the dispense amount as encoded by the pharmacy or treatment supplier. This field is required if the units are not implied by the actual dispense code. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units. Refer to Table 0746 - Dispense Units in Chapter 2C for valid values.

RXA - Pharmacy/Treatment Administration Segment

The ORC must have the filler order number and the order control code RE. As a site-specific variant, the RXO and associated RXCs and/or the RXE (and associated RXCs) may be present if the receiving application needs any of their data. The RXA carries the administration data.

HL7 Attribute Table - RXA - Pharmacy/Treatment Administration Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXA
1 00342 Give Sub-ID Counter SHALL = [1..1] 4
NM
2 00344 Administration Sub-ID Counter SHALL = [1..1] 4
NM
3 00345 Date/Time Start of Administration SHALL [1..1]
DTM
4 00346 Date/Time End of Administration SHALL [1..1]
DTM
5 00347 Administered Code SHALL [1..1]
0292 Vaccines Administered
CWE
6 00348 Administered Amount SHALL [1..1]
NM
7

00349 Administered Units MAY
True:
False: 		C
[1..1]
[0..1]
0689
CWE
8 00350 Administered Dosage Form [0..1]
0690
CWE
9 00351 Administration Notes [0..*]
0737
CWE
10 00352 Administering Provider SHALL NOT W [0..0]
11 00353 Administered-at Location SHALL NOT W [0..0]
12

00354 Administered Per MAY
True:
False: 		C=
[1..1]
[0..1] 		20
ST
13 01134 Administered Strength [0..1]
NM
14 01135 Administered Strength Units [0..1]
0692
CWE
15 01129 Substance Lot Number = [0..*] 20
ST
16 01130 Substance Expiration Date [0..*]
DTM
17 01131 Substance Manufacturer Name [0..*]
CWE
18 01136 Substance/Treatment Refusal Reason [0..*]
0693
CWE
19 01123 Indication [0..*]
0758
CWE
20 01223 Completion Status [0..1] [2..2]
0322 Completion Status
ID
21 01224 Action Code – RXA [0..1] [1..1]
0206 Segment Action Code
ID
22 01225 System Entry Date/Time [0..1]
DTM
23 01696 Administered Drug Strength Volume = [0..1] 5
NM
24 01697 Administered Drug Strength Volume Units [0..1]
0695
CWE
25 01698 Administered Barcode Identifier [0..1]
0696
CWE
26 01699 Pharmacy Order Type [0..1] [1..1]
0480 Pharmacy Order Types
ID
27 02264 Administer-at [0..1]
PL
28 02265 Administered-at Address [0..1]
XAD
29 03396 Administered Tag Identifier [0..*]
EI

RXA-1: Give Sub-ID Counter (NM) 00342

(Definition from RXG.1 in Ch. 4A)

Definition: Use if this RXG segment carries information about a single administration. This field must contain a unique number for the placer order number. This field along with the placer order number provides a unique reference to the specific scheduled give date/time transmitted by the pharmacy/treatment supplier for this order.

If the RXG segment carries information about multiple administrations, this field's value is zero (0), since in this case a one-to-one matching with the RXA segment is ambiguous.

(Definition from RXA.1 in Ch. 4A)

Definition: Use this field if matching this RXA segment to its corresponding RXG segment. If the two applications are not matching RXG and RXA segments, this field's value is zero (0).

RXA-2: Administration Sub-ID Counter (NM) 00344

Definition: This field starts with 1 the first time that medication/treatment is administered for this order. Increments by one with each additional administration of the medication/treatment.

Note: More than one RXA segment can be "matched" to a single RXG segment, as is the case when recording a change of the rate of administration of an IV solution.


RXA-3: Date/Time Start of Administration (DTM) 00345

Definition: If the order is for a continuous administration (such as an IV), and the rate is changed at a certain time after the start, an RAS message can be issued to record the change. For such an RAS message, this field records the time the rate was changed to the new value recorded in the RXA-12-Administered Per (time unit) of the same message.

RXA-4: Date/Time End of Administration (DTM) 00346

Definition: If null, the date/time of RXA-3-Date/Time Start of Administration is assumed.

RXA-5: Administered Code (CWE) 00347

Definition: This field contains the identifier of the medical substance/treatment administered. It is equivalent to OBR-4-universal service ID in function. If the substance administered is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines Administered). If CVX code is used to identify vaccines, the coding system component (RXA-5.3) should be valued as "CVX", not as "HL70292."

RXA-6: Administered Amount (NM) 00348

Definition: This field contains the amount administered.

RXA-7: Administered Units (CWE) 00349

Definition: This field is conditional because it is required if the administered amount code does not imply units. This field must be in simple units that reflect the actual quantity of the substance administered. It does not include compound units. Refer to Table 0689 - Administered Units in Chapter 2C for valid values.

RXA-8: Administered Dosage Form (CWE) 00350

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the dispense/give code in RXA-5-Administered Code. Use this field when the administered code does not specify the dosage form. Refer to Table 0690 - Administered Dosage Form in Chapter 2C for valid values.

RXA-9: Administration Notes (CWE) 00351

(Definition from RXG.9 in Ch. 4A)

Definition: This field contains notes to the person administering the medication/treatment (may include the ordering provider's original notes, as well as any notes from the formulary or the pharmacy or treatment supplier). If coded, a user-defined table must be used. If free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration note|. Refer to Table 0737 - Administration Notes in Chapter 2C for valid values.

(Definition from RXA.9 in Ch. 4A)

Definition: This field contains notes from the provider administering the medication/treatment. If coded, requires a user-defined table. If free text (describing a custom IV, mixture, or salve, for example) place a null in the first component and the text in the second, e.g., |^this is a free text administration note|. Refer to Table 0691 - Administration Notes in Chapter 2C for valid values.

RXA-10: Administering Provider

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

RXA-11: Administered-at Location

Definition: This field is retained for backward compatibility only as of v 2.6 and withdrawn from the standard as of v 2.8. The reader is referred to RXA-27 and RXA-28..

RXA-12: Administered Per (ST) 00354

Definition: This field contains the rate at which this medication/treatment was administered as calculated by using RXA-6-administered amount and RXA-7-administered units. This field is conditional because it is required when a treatment is administered continuously at a prescribed rate, e.g., certain IV solutions.

RXA-13: Administered Strength (NM) 01134

Definition: Use when RXA-5-Administered Code does not specify the strength. This is the numeric part of the strength, used in combination with RXA-14-Administered Strength Units.

RXA-14: Administered Strength Units (CWE) 01135

Definition: Use when RXA-5-Administered Code does not specify the strength. This is the unit of the strength, used in combination with RXA-13-Administered Strength. Refer to Table 0692 - Administered Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


RXA-15: Substance Lot Number (ST) 01129

(Definition from RXD.18 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXG.19 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXA.15 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from SID.2 in Ch. 13)

Definition: This field specifies the lot number assigned by the manufacturer during production of the substance.

RXA-16: Substance Expiration Date (DTM) 01130

(Definition from RXD.19 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM^L.


(Definition from RXG.20 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


(Definition from RXA.16 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


RXA-17: Substance Manufacturer Name (CWE) 01131

(Definition from RXD.20 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered when it is a manufactured substance.

Note: For vaccines, code system MVX may be used to code this field. See Section 4A.7.1, "Vaccine administration data". This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-Administered code.


(Definition from RXG.21 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field (see section4A.7.1, "Vaccine administration data"). This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-administered code.


(Definition from RXA.17 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field. See section 4A.7.1, "Vaccine administration data." This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5- administered code. When using this code system to identify vaccines, the coding system component of the CWE field should be valued as "MVX", not as "HL70227."


RXA-18: Substance/Treatment Refusal Reason (CWE) 01136

Definition: This field contains the reason the patient refused the medical substance/treatment. Any entry in the field indicates that the patient did not take the substance. Refer to Table 0693 - Substance/Treatment Refusal Reason in Chapter 2C for valid values.

RXA-19: Indication (CWE) 01123

(Definition from RXO.20 in Ch. 4A)

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0758 - Indication in Chapter 2C for valid values.

(Definition from RXD.21 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0708 - Indication in Chapter 2C for valid values.

(Definition from RXG.22 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0743 - Indication in Chapter 2C for valid values.

(Definition from RXA.19 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0694 - Indication in Chapter 2C for valid values.

RXA-20: Completion Status (ID) 01223

Definition: Status of treatment administration event. Refer to HL7 Table 0322 - Completion Status in Chapter 2C, Code Tables, for valid values.

RXA-21: Action Code – RXA (ID) 01224

Definition: Status of record. The information in this field enables the use of the RXA in the vaccine messages (see Section 4A.8, "Vaccine Segments"), where a method of correcting vaccination information transmitted with incorrect patient identifying information is needed. Refer To HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

RXA-22: System Entry Date/Time (DTM) 01225

Definition: Date/time the administration information was entered into the source system. This field is used to detect instances where treatment administration information is inadvertently entered multiple times by providing a unique identification field. Under usual circumstances, this field would be provided automatically by the computer system rather than being entered by a person.

RXA-23: Administered Drug Strength Volume (NM) 01696

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML , which would be encoded in RXA-13, RXA-14, RXA-23 and RXA-24 as:

RXA|||||||||||||120|mg^^ISO|||||||||5|ml^^ISO ...<cr>

RXA-24: Administered Drug Strength Volume Units (CWE) 01697

Description: This field indicates the volumetric unit associated with RXA-23 Administered Drug Strength Volume. See example in RXA-23. Refer to Table 0695 - Administered Drug Strength Volume Units in Chapter 2C for valid values.

RXA-25: Administered Barcode Identifier (CWE) 01698

Definition: This field contains the pharmacy system's assigned barcode number for the give occurrence. For IV orders, many pharmacy systems generate a barcode number to identify a specific bag/bottle of the order. This number can be an instance identifier; unique for the patient, drug combination, and schedule instance or it may be just a drug identifier. Refer to Table 0696 - Administered Barcode Identifier in Chapter 2C for valid values.

The composition and use of the barcode number is dependent on application negotiation. An example of this field follows: The barcode number is in the following format, 9XXXXXXX000. The number '9' is a constant, XXXXXXX is seven (7) characters for a unique identifier assigned or derived from the patient account and order ID and 000 is the zero-filled three (3) character IV bottle number.

The maximum length of the first component of this field is 40 characters to allow for the maximum existing barcode length in use today. The second component contains the description of the item being coded and the third component may define the barcode type.

Example: 12345678901^IV bottle^3X9

RXA-26: Pharmacy Order Type (ID) 01699

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 - Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

RXA-27: Administer-at (PL) 02264

Definition: This field specifies the location where the drug or treatment was administered.

RXA-28: Administered-at Address (XAD) 02265

Definition: This field specifies the address of the location where the drug or treatment was administered.

RXA-29: Administered Tag Identifier (EI) 03396

Definition: This field contains an identifier for the individual product instance for the dispense occurrence. This may represent a barcode, RFID or other means of automatically-readable product instance. Repetitions represent the same instance where more than one barcode, RFID or other identification is present.

For example, the medication preparer, e.g., a semi-automatic system, can inform the nurse that “for the 8.am administration event, the medication that has been assigned and available at the patient bedside has the barcode BBBBBBBBBBB.” The nurse would scan the barcode, to ensure that the right medication is being administered.

This differs from RXA-25 Administered Barcode Identifier in that RXA-25 may include other workflow content or the product at various levels of granularity. RXA-29 specifically identifies the product instance.

RXV - Pharmacy/Treatment Infusion Segment

The RXV segment details the pharmacy or treatment application’s encoding of specific infusion order parameters

HL7 Attribute Table - RXV - Pharmacy/Treatment Infusion Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXV
1 03318 Set ID - RXV [0..1]
SI
2 03319 Bolus Type SHALL [1..1] [1..1]
0917 Bolus Type
ID
3 03320 Bolus Dose Amount [0..1]
NM
4 03321 Bolus Dose Amount Units [0..1]
0767
CWE
5 03322 Bolus Dose Volume = [0..1] 20
NM
6 03323 Bolus Dose Volume Units [0..1]
0768
CWE
7 03324 PCA Type SHALL [1..1] [1..2]
0918 PCA Type
ID
8 03325 PCA Dose Amount = [0..1] 20
NM
9 03326 PCA Dose Amount Units [0..1]
0769
CWE
10 03327 PCA Dose Amount Volume = [0..1] 20
NM
11 03328 PCA Dose Amount Volume Units [0..1]
0770
CWE
12 03329 Max Dose Amount = [0..1] 20
NM
13 03330 Max Dose Amount Units [0..1]
0772
CWE
14 03331 Max Dose Amount Volume = [0..1] 20
NM
15 03332 Max Dose Amount Volume Units [0..1]
0773
CWE
16 03333 Max Dose per Time SHALL [1..1]
CQ
17 03334 Lockout Interval [0..1]
CQ
18 03339 Syringe Manufacturer [0..1]
CWE
19 03385 Syringe Model Number [0..1]
CWE
20

03386 Syringe Size MAY
True:
False: 		C=
[1..1]
[0..1] 		20
NM
21

03431 Syringe Size Units MAY
True:
False: 		C
[1..1]
[0..1]
CWE
22 00816 Action Code [0..1] [2..2]
0206 Segment Action Code
ID

RXV-1: Set ID - RXV (SI) 03318

Definition: For the first timing specification transmitted, the sequence number shall be 1; for the second timing specification, it shall be 2; and so on.

RXV-2: Bolus Type (ID) 03319

Definition: This field identifies the type of bolus being ordered. See HL7 Defined Table 0917 – Bolus Type in Chapter 2C, Code Tables, for example values.

RXV-3: Bolus Dose Amount (NM) 03320

Definition: This field contains the ordered bolus amount. For example, if the ordered bolus is 50 mg, this field contains the value of 50.

RXV-4: Bolus Dose Amount Units (CWE) 03321

Definition: This field indicates the amount units associated with the bolus dose amount. The preferred coding system is MDC; UCUM are also acceptable. Refer to Table 0767 - Bolus Dose Amount Units in Chapter 2C for valid values.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-5: Bolus Dose Volume (NM) 03322

Definition: This field defines the volume measurement for the ordered bolus amount. For example, if the ordered bolus is 5 ml, this field contains the value of 5.

RXV-6: Bolus Dose Volume Units (CWE) 03323

Definition: This field indicates the amount units associated with the bolus dose volume. The preferred coding system is MDC; UCUM are also acceptable. Refer to Table 0768 - Bolus Dose Volume Units in Chapter 2C for valid values.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-7: PCA Type (ID) 03324

Definition: This field identifies the type of bolus being ordered. See HL7 Defined Table 0918 – PCA Type in Chapter 2C, Code Tables, for example values.

RXV-8: PCA Dose Amount (NM) 03325

Definition: This field contains the order’s PCA dose amount. Example: if the ordered bolus is 3 mg, this field contains the value of 3.

RXV-9: PCA Dose Amount Units (CWE) 03326

Definition: This field indicates the amount units associated with the PCA dose amount. The preferred coding system is MDC; UCUM are also acceptable. Refer to Table 0769 - PCA Dose Amount Units in Chapter 2C for valid values.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-10: PCA Dose Amount Volume (NM) 03327

Definition: This field defines the volume measurement for the ordered PCA amount volume. For example, if the ordered bolus is 5 ml, this field contains the value of 5.

RXV-11: PCA Dose Amount Volume Units (CWE) 03328

Definition: This field indicates the amount units associated with the PCA dose volume. The preferred coding system is MDC; UCUM are also acceptable. Refer to Table 0770 - PCA Dose Amount Volume Units in Chapter 2C for valid values.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-12: Max Dose Amount (NM) 03329

Definition: This field contains the order’s maximum dose amount. For example, if the ordered bolus is 50 mg, this field contains the value of 50.

RXV-13: Max Dose Amount Units (CWE) 03330

Definition: This field indicates the amount units associated with the maximum dose volume. The preferred coding system is MDC; UCUM are also acceptable. Refer to Table 0772 - Max Dose Amount Units in Chapter 2C for valid values.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-14: Max Dose Amount Volume (NM) 03331

Definition: This field defines the volume measurement for the ordered max dose amount. For example, if the ordered bolus is 5 ml, this field contains the value of 5.

RXV-15: Max Dose Amount Volume Units (CWE) 03332

Definition: This field indicates the amount units associated with the maximum dose volume. The preferred coding system is MDC; UCUM are also acceptable. Refer to Table 0773 - Max Dose Amount Volume Units in Chapter 2C for valid values.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-16: Max Dose per Time (CQ) 03333

Definition: This field contains the time unit expression of the lock out parameter. For example, if the ordered max dose per time is 4 hours, this field format is "4^h&hours&UCUM".

RXV-17: Lockout Interval (CQ) 03334

Definition: This field contains the length of time that must expire between deliveries of PCA doses. For example, if the ordered max dose per time is 10 minutes, this field format is "10^min&minute&UCUM".

RXV-18: Syringe Manufacturer (CWE) 03339

Definition: This field contains the manufacturer of the syringe containing the ordered medication.

RXV-19: Syringe Model Number (CWE) 03385

Definition: This field contains the model number of the syringe containing the ordered medication.

RXV-20: Syringe Size (NM) 03386

Definition: This field contains the syringe’s numeric total volume size.

RXV-21: Syringe Size Units (CWE) 03431

Definition: This field indicates the amount units associated with the syringe size. The preferred coding system is MDC; UCUM are also acceptable.

Examples:

263890^MDC_DIM_MILLI_G^MDC

mg^milligram^UCUM

RXV-22: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

(Definition from RXV.22 in Ch. 4A)

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

CDO - Cumulative Dosage Segment

The Cumulative Dosage segment allows for the communication of cumulative dosage limits that administrations against this medication order should stay within. As part of one of the pharmacy messages, one may want to indicate one or more limits that apply, e.g., limit for the duration of the order, lifetime limit, or weekly limit.

HL7 Attribute Table - CDO - Cumulative Dosage Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
CDO
1 03430 Set ID – CDO [0..1] [1..4]
SI
2 00816 Action Code [0..1] [2..2]
0206 Segment Action Code
ID
3 03397 Cumulative Dosage Limit [0..1]
CQ
4 03398 Cumulative Dosage Limit Time Interval [0..1]
0924 Cumulative Dosage Limit UoM
CQ

CDO-1: Set ID – CDO (SI) 03430

Definition: For the first cumulative dose specification transmitted, the sequence number shall be 1; for the second cumulative dose, it shall be 2; and so on.

CDO-2: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

(Definition from RXV.22 in Ch. 4A)

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

CDO-3: Cumulative Dosage Limit (CQ) 03397

Definition: The Cumulative Dosage indicates the total dosage that may be administered within the scope of this order or within the interval indicated in CDO-4 Cumulative Dosage Time Interval, if supplied

CDO-4: Cumulative Dosage Limit Time Interval (CQ) 03398

Definition: The Cumulative Dosage Time Interval indicates the interval over which the cumulative dosage in CDO-3 Cumulative Dosage Limit is measured. If this field is not valued, the Cumulative Dosage Limit applies to the scope of the order.

Refer to HL7 Table 924 – Cumulative Dosage Limit UoM in Chapter 2C, Code Tables, for a list of suggested values, including applicable values from UCUM.

Pharmacy/Treatment Message Examples

The purpose of this section is to show how certain specific situations would be handled using the pharmacy/treatment protocol. The ellipses represent uncompleted details. The symbol // precedes comments for clarification.

Example of various levels of coding in an order

The order "give 500 mg Ampicillin P.O. Q6H for 10 days for a total of 40 tablets" is sent to the RX application from the OE application. This order can be coded with various levels of precision by an ordering application:

  1. E-mail only version (uses only free text, RXO-6-provider's pharmacy/treatment instructions or RXO-7-provider's administration instructions only); fully encoded version must be re-entered or verified manually by the pharmacy or treatment application.

  2. With RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and RXO-1-requested give code as free text.

  3. With RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but where RXO-1-requested give code does not include units.

  4. With RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and where RXO-1-requested give code does include units.

In this case, the units are optional. The rule for this case (on orders, dispense results, give results, and administration results) is as follows: if units are coded, they override or supersede the units value implied by the give code.

  1. The E-mail only version of the order: no coded fields exist in the RXO.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|...<cr>

RXO||||||500 mg Polycillin Q6H for 10 days, dispense 40 Tablets|...<cr>

  1. A partially coded version of the order. This version has the RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but the RXO-1-requested give code as free text.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|^Q6H^D10^^^R|...<cr>

RXO|^Polycillin 500 mg TAB^|500||MG|||||Y||40|...<cr>

RXR|PO|...<cr>

  1. A more completely coded version of the order, with the RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but where RXO-1-requested give code does not imply units.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|^Q6H^D10^^^R|...<cr>

RXO|RX1001^Polycillin^L|500||MG|||||Y||40|...<cr>

RXR|PO|...<cr>

  1. A completely encoded version, with the RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and where RXO-1-requested give code does imply units.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|^Q6H^D10^^^R|...<cr>

RXO|RX1001^Polycillin 500 mg TAB^L|500||MG|||||G||40|...<cr>

RXR|PO|...<cr>

  1. Pharmacy or treatment supplier's encoded version (RDE message) sent to nursing application (a generic substitution).

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||RDE^O11^RDE_O11|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXE|^^^200612100600^^R|0047-0402-30^Ampicillin 250 MG

TAB^NDC|2||TAB|||||G|80||||123456|rx#1001|...<cr>

RXR|PO|...<cr>

  1. Pharmacy or treatment supplier's dispense results (RDS message).

MSH|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXD|1|0047-0402-30^Ampicillin 250 MG TAB^NDC|199012100400|8|TAB||RX#1001|

123456|G|8|...<cr>

  1. Pharmacy or treatment supplier's give results (RGV message).

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||RGV^O15^RGV_O15|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXG|1|1|^^200612100600^^R|0047-0402-30^Ampicillin 250 MG TAB^NDC|500||MG|||G|...<cr>

RXR|PO|...<cr>

  1. Nursing application Medications Administration results to pharmacy, treatment, or Order Entry application.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||RAS^O17^RAS_O17|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXA|1|1|200612100615||0047-0402-30^Ampicillin 250 MG TAB^NDC|2|TAB|...<cr>

RXR|PO|...<cr>

RXO segment field examples

RXO segment field examples

RXO-1 Requested Give code example

RXO|58160040000110^Fluoxetine HCL 10mg Capsule^GPI^00777310402^Prozac 10 mg caps^NDC|...<cr>

RXO-18 and RXO-19 Requested Strength and Strength Unit examples

The need for strength and strength unit fields in addition to the amount and amount units fields included in various RX_ segments requires explanation. Physicians can write a prescription for a drug such as Ampicillin in two ways. One way would be: "Ampicillin 250 mg capsules, 2 capsules four times a day." In this case the give amount would be 2, the give units would be capsules, the strength would be 250 and the strength units would milligrams.

ORC|||||||1^QID|...<cr>

RXO|01200020200105^Ampicillin 250 mg capsule^GPI^00047040230^Ampicillin 250 mg caps^NDC|2||caps^capsule^FDB||||||||||||||250|mg|...<cr>

However, the provider could also write the prescription as "Ampicillin 500 mg four times a day." In this case the give amount would be 500 and the give units would be milligrams. The strength would not be reported in the RXO segment because it is not specified; the drug could be given in two 250 mg caps or one 500 mg cap. But the pharmacist would dispense a specific capsule size and would record the strength in the RXE segment as 250 or 500, depending upon which pill size was dispensed.

ORC|||||||1^QID|...<cr>

RXO|012000202001^Ampicillin capsule^GPI |500||mg^milligram^ISO||...<cr>

RXD segment field examples

RXD segment field examples

RXD-4 and RXD-5 Dispense amount and Actual dispense units

The RXD-4 and RXD-5 together might say

100 tabs:

RXD||||100|TAB^tablet^FDB|...<cr>

Or, 100 each

RXD||||100|EA^each^FDB|...<cr>

Or, perhaps a volume, 3 liters

RXD||||3|L^liter^ISO|...<cr>

Actual dispense amount, Actual dispense units, Actual strength, Actual strength units

For example, the RXD-4, RXD-5, RXD-16 and RXD-17 together might say

100 tabs of 240 mg strength:

RXD||||100|tab^tablet^FDB|||||||||||240|mg|...<cr>

Or, 100 each of 60 units per cc

RXD||||100|EA||||||||||||60|iu/ml^^ISO+|...<cr>

Or, perhaps a volume, 3 liters with 60 grams per liter

RXD||||3|L^liter^ISO|||||||||||60|g/L^^ISO+|...<cr>

Valuing the Dispense Package Size Unit

If the package given to the patient is 2, 4 ounce bottles with a strength of 100/5ml, but the cough suppressant is stocked in 1 gallon bottles, then the field contains 1 gallon.

RXD||||8|ounce^^ISO|||||||||||20|mg/ml|||||1|gal^gallon^ISO|...<cr>

If one were to dispense Mevacor 100 tablets with a strength of 20 mg/tablet, and the package from the manufacturer is a 60 tablet package, then the fields reflect 60 tablets (the size of the package stocked by the pharmacy).

RXD||||100|tab^^FDB|||||||||||20|mg|||||60|tab|...<cr>

RDS with FT1 segments example

Example: Adam Everyman appears in the Pharmacy with a prescription for Veramil 120 mgm B.I.D. The prescription is filled and the $5 co-pay is collected. The following RDS message is generated:

MSH|^&~\|Pharm|GenHosp|IE||2006052911150700||RDS^O13^RDS_O13||...<cr>

PID|||444-33-3333^^^MPI&GenHosp&L^MR||Everyman^Adam||19600614|M||C|2222 Home St^^Anytown^US^12345||^^^^^555^5552004| ...<cr>

ORC|RE||89968665||||||2006052910300700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^ 5551004|...<cr>

RXE|1^BID^^20060529|^Verapamil|120||mg^milligram^FDB.MDDB||...<cr>

RXD|1|00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |200605291115-0700|100|||1331665|3|...<cr>

RXR|PO|...<cr>

FT1|1|||200605291115-0700||CO^Co-Pay^HL70017 |00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |||1|5&USD^TP|...<cr>

FT1|2|||200605291115-0700||PY^Payment^HL70017 |00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |||1|5&USD|...<cr>

Alternating IV order messages

Encoding Note: For readability, these examples do not show encoding of the subcomponents of the Give Codes (CWE data type) in the RXC and RXO segments. In practice, the subcomponents should be encoded as described in the HL7 specification.

  1. Example #1

D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Run in at a rate of 100mL/hr.

(Other message data: placer order #123, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical.)

This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and a RXO, incompletely elaborated in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. The placer system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B.

The parent:

ORC|NW|123^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|123A1^SMS|||||1^C^^^^^^^^C&123B&SMS&&&*ES+0M|123|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The second child:

ORC|CH|123A2^SMS|||||1^C^^^^^^^^C&123A1&SMS&&&ES+0M|123|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The third child:

ORC|CH|123B^SMS|||||1^C^^^^^^^^C&123A2&SMS&&&#ES+0M|123|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

Discussion points:

Placer Order Number - Three alternatives must be discussed for placer order number.

  1. Each child could have its own placer order number.

  2. Each child could have the order number of the parent plus some appended identifier (for examples, 123A or 123.A or 123.1 etc.) that labels each child or each unique combination of ingredients.

  3. In addition to the appended identifier discussed in 'B' above, a further suffix could be attached to uniquely identify each repetition of a particular member of the sequence. The example (a cycle of bottles 'A' and 'B' in the sequence A-A-B) identified the order numbers of the children as 123A1, 123A2, and 123B, thereby enabling the quantity/timing to be completely unambiguous. This could be expressed many other ways, such as 123A.1 or 123.A.1 or 123.A#1 etc. HL7 does not specify a format for the expression of order number suffixes, nor does it specify a delimiter to use for such a purpose.

Sequence Condition Value - In this example, the first child contains an asterisk (*) as the first character of the Sequence Condition Value and the third (last) child contains a pound sign (#).

The asterisk and pound sign are important for designating the first and last bottles especially when children are sent in separate messages, although this example is not constructed that way.

Note that computing the duration of the bottle is dependent upon the presence of all of the following fields:

  • RXO-2-requested give amount-minimum

  • RXO-4-requested give units

  • RXC-3-component amount

  • RXC-4-component units

For cyclic IV orders, these fields are all required in order to determine how long each occurrence of a child will last.

While HL7 allows either sending the parent and children in one message or sending the parent and children in separate messages, it appears simpler and therefore recommended to have the parent and all children included in a single message. The example is constructed that way.

  1. Example #2

D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL at 125mL/hr

(Other message data: placer order #124, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical)

This example is a variation on the first example where two different base solutions are used. In this example, the placer system deals with this as one order with two alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) and B (D5/LR + 20mEq KCl 1000mL @ 125mL/hr) in the cycle A-B. The principles discussed in Example #1 apply equally to this example.

The parent:

ORC|NW|124^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|124A^SMS|||||1^C^^^^^^^^C&124B&SMS&&&*ES+0M|124|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|125||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5W|1000|ML|...<cr>

RXC|A|KCL|40|MEQ|...<cr>

The second child:

ORC|CH|124B^SMS|||||1^C^^^^^^^^C&124A&SMS&&&#ES+0M|124|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|125||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/LR|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

  1. Example #3

D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Add 10mL of multi-vitamins to the one bag daily. Run in at a rate of 100mL/hr.

(Other message data: placer order #134, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical. Note that the encoding of the multi-vitamins statement in the above order, adding multi-vitamins to one IV bag each day, may vary by institution to put it into the first or last bottle of the day.)

This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and a RXO, although one is not completely elaborated in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. This order is complicated by the request to add one component into any one of the three repeating bottles, depending upon which of the bottles will occur first on any particular day. Further complicating this order is a rate of infusion (10 hours for a 1000mL bottle) which results in a fractional number of daily administrations. Most legacy systems have a great deal of trouble accommodating orders like this within their existing database structures; however there a few vendors who now are able to handle the situation. The placer system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B with a cyclical component (multi-vitamins).

The parent:

ORC|NW|134^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|134A1^SMS|||||1^C^^^^^^^^C&134B&SMS&&&*ES+0M|134|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The second child:

ORC|CH|134A2^SMS|||||1^C^^^^^^^^C&134A1&SMS&&&ES+0M|134|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The third child:

ORC|CH|134B^SMS|||||1^C^^^^^^^^C&134A2&SMS&&&#ES+0M|134|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

The fourth child:

ORC|CH|134X^SMS|||||1^Q1D^^^^^^^^|134|...<cr>

RXO|MULTIVITAMINS|10||ML|INJECTABLE|...<cr>

Discussion points:

This method for accommodating the Multi-vitamins Daily scenario does not pretend to be the best or only way to express the message, but simply demonstrates adapting the current specification to a highly complex order without adding new components.

The Multi-vitamins component may be sent as a fourth child.

In this example, its ORC-7-quantity/timing includes an interval of "Q1D" (every 1 days).

Its order number consists of the placer's parent order number plus an appended identifier ('X' in the above example) that labels this child as a special case. This convention would need to be agreed upon by sending and receiving applications.

  1. Example #4

D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL alternating with D5/0.45NaCl 1000mL. Infuse the D5W and D5/0.45 at 125mL/hr, and the D5/LR at 100mL/hr.

(Other message data: placer order #177, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical)

This example is another variation of Example 1 where the rate for each bottle is different, and this can be expressed within the RX segments of the children using current components. In this example, the placer system deals with this as one order with three alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) , B (D5/LR + 20mEq KCl 1000mL @ 100mL/hr) , and C (D5/0.45NaCl 1000mL @ 125mL/hr) in the cycle A-B-C. The principles discussed in Example #1 apply equally to this example.

The parent:

ORC|NW|177^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|177A^SMS|||||1^C^^^^^^^^C&177C&SMS&&&*ES+0M|177|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5W|1000|ML|...<cr>

RXC|A|KCL|40|MEQ|...<cr>

The second child:

ORC|CH|177B^SMS|||||1^C^^^^^^^^C&177A&SMS&&&ES+0M|177|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|100||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/LR|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

The third child:

ORC|CH|177C^SMS|||||1^C^^^^^^^^C&177B&SMS&&&#ES+0M|177|...<cr>

RXO Segment,    Requested Give Amount-Minimum: ...|125||ML|...

        Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/0.45NACL|1000|ML|...<cr>

Query examples

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v2.7. The reader is therefore referred to chapter 5, section 5.4, for the current query/response message structure.


Pharmacy/Treatment Transaction Flow Diagram

The following are possible routes at a generic site.

OMP:

The Ordering application generates a pharmacy/treatment OMP and sends it to the pharmacy or treatment application, Nursing application, and/or other applications as appropriate at the site.

RDE:

The pharmacy/treatment application may send the RDE, the Pharmacy/Treatment Encoded Order message, a fully encoded order to the Nursing application, Ordering application, and/or other system applications as appropriate at the site.

RDS:

The pharmacy/treatment application may send the RDS, the Pharmacy/Treatment Dispense message, to the Nursing application or other applications as appropriate at the site, each time a medication is dispensed for this order. This message may occur multiple times for each order.

RGV:

The pharmacy application may send the RGV, the Pharmacy/Treatment Give message, to the Nursing application or other applications as appropriate at the site, for each scheduled date/time of administration of a medication for a given order. This message may occur multiple times for each order.

RAS:

The Nursing application (and other applications) can generate the RAS, the pharmacy/treatment Administration Results message, whenever a medication is given to the patient. This message may occur multiple times for each order.

Note:    Sites having a long term clinical data repository may wish to route data to the data repository from copies of all or any of the five messages.


Vaccine Trigger Events & Message Definitions

Vaccine administration data

Immunization information systems (IIS) that maintain vaccination records need to be able to transmit patient-specific records of vaccine administration to other health information systems to provide access to the record at the time healthcare is given and to allow tracking of progress in reaching age-appropriate immunization coverage. The unsolicited update is the result of a vaccine administration update or delete. This message permits the transmission of immunization records from care providers to immunization registries. Messages containing immunization records carry patient identifying information in the PID segment. They may also carry parent or guardian information in the NK1 segments to help identify a child. The RXA segment is used to report the details of the immunization event: the type of vaccine (e.g., DTaP, polio, MMR), the date administered, the sequence (1st, 2nd, etc.), the amount (e.g., 0.5 ml), and location and provider of the immunization. In addition, the RXA provides a place to record the lot number, manufacturer and date of expiration of the immunization. The RXA can also be used to report the fact that a specified immunization was refused. This section references two tables (CVX and MVX as referenced in HL7 Table 0396 – Coding Systems in Chapter 2C, Code Tables) maintained by the U.S. Centers for Disease Control and Prevention (CDC). These tables are recommended in the U.S. for identifying the immunization in field RXA-5-Administered Code and the vaccine manufacturer in field RXA-17-substance manufacturer name.

Queries for immunization records (QRF Segments)

Attention: Retained for backwards compatibility only as of v 2.4.and withdrawn as of v 2.7. Refer to Chapter 5, section 5.4, for the current query/response message structure.

XQ - Query for Vaccination Record (Event V01)

Attention: Retained for backwards compatibility only as of v 2.4.and withdrawn as of v 2.7. Refer to Chapter 5, section 5.4, for the current query/response message structure.

VXX - RESPONSE TO VACCINATION QUERY RETURNING MULTIPLE PID MATCHES (Event V02)

Attention: Retained for backwards compatibility only as of v 2.4.and withdrawn as of v 2.7. Refer to Chapter 5, section 5.4, for the current query/response message structure.

VXR - Vaccination Record Response (Event V03)

Attention: Retained for backwards compatibility only as of v 2.4.and withdrawn as of v 2.7. Refer to Chapter 5, section 5.4, for the current query/response message structure.

VXU - Unsolicited Vaccination Record Update (Event V04)

Definition: When a provider wishes to update the patient's vaccination record being held in a registry, the provider will transmit an unsolicited update of the record (a V04 trigger event).

An unsolicited update will follow this format. The three-letter code in the leftmost column indicates the segment that is included; the column on the right specifies the chapter in which that segment is fully defined.

VXU^V04^VXU_V04: Unsolicited Vaccination Update
HL7 MessageStructure Table - VXU_V04
Segment Cardinality Must Implement Status
VXU_V04
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
PID 1..1 Yes
PD1 0..1
PRT 0..*
NK1 0..*
ARV 0..* B
PATIENT_VISIT 0..1
PV1 1..1 Yes
PV2 0..1
PRT 0..*
ARV 0..* B
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..1
PERSON_OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*
ORDER 0..*
ORC 1..1 Yes
PRT 0..*
RXA 1..1 Yes
PRT 0..*
RXR 0..1
TIMING 0..*
TQ1 1..1 Yes
TQ2 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
NTE 0..*

Original Mode Acknowledgement Choreography for VXU^V04^VXU_V04

Send Application Ack: ACK^V04^ACK

Enhanced Mode Acknowledgement Choreography for VXU^V04^VXU_V04

When the MSH-15 value of a VXU^V04^VXU_V04 message is AL or ER or SU, an ACK^V04^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a VXU^V04^VXU_V04 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a VXU^V04^VXU_V04 message is AL or ER or SU, an ACK^V04^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a VXU^V04^VXU_V04 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^V04^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^V04^ACK
NE (none)

Vaccine Segments

Vaccination Message Examples

VXQ - query for vaccination record

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v 2.7. The reader is therefore referred to Chapter 5, section 5.4, for the current query/response message structure.


VXX - response to vaccination query with multiple PID matches

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v 2.7. The reader is therefore referred to Chapter 5, section 5.4, for the current query/response message structure.


VXR - vaccination record response

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v 2.7. The reader is therefore referred to Chapter 5, section 5.4, for the current query/response message structure.


VXU - unsolicited vaccination record update

MSH|^~VALUEamp;||AZVACREC||GAVACREC|200605221606||VXU^V04^VXU_V04|...<cr>

PID|...<cr>

NK1|...<cr>

NK1|...<cr>

PV1|...<cr>

PV2|...<cr>

IN1|...<cr>

IN2|||||||NUCLEAR^NANCY^D|909686637A|...<cr>

ORC|...<cr>

RXA|0|1|20060901115500|20060901115500|03^MMR^CVX|.5|MG^^ISO+| 222557777^KIDDER^KAREN^K^^DR|^^^ CHILD HEALTHCARE CLINIC^^^^^1044 Healthcare Drive^^METROPOLIS^AZ||||W23487909876456|20061125|MSD^Merck \T\ Co., Inc.^MVX|...<cr>

RXR|IM^INTRAMUSCULAR^HL70162|LG^LEFT GLUTEUS MEDIUS^HL70163|...<cr>

OBX|1|NM|1000.3^TEMP.RECTAL^AS4||102.9|DEGF^^ANSI+|||||F|||20060901153000|...<cr>

NTE|||PATIENT DEVELOPED HIGH FEVER APPROX 3 HRS AFTER VACCINE INJECTION. PROBABLE ADVERSE REACTION|...<cr>

This message shows an unsolicited update of a vaccination record. The message type is VXU-Unsolicited Vaccination Record Update, with event code V04 (unsolicited vaccination record update). This example is given to show possible uses for some of the optional segments in the message.

Query acknowledgment with no records found

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v 2.7. The reader is therefore referred to Chapter 5, section 5.4, for the current query/response message structure.