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Conformance Statements have been developed to help in formulating conformance testing of pathology messaging implementations in Australia against this Implementation Guide. The list below is not exhaustive. The entries are included here primarily if they:-

  • are important from a safety or quality perspective, or
  • are commonly not correctly implemented, or
  • are at variance with the base HL7 v2.4 specifications.

Conformance of messages to base HL7 2.4 standards is otherwise assumed, and individual conformance tests or test applications may check against the base specification.

The following table indicates whether a conformance statement applies to a message sender, a message receiver, or both. In the case where a conformance statement applies to a message sender, it is expected that automated conformance checking can be carried out on one or more real or sample messages. For testing conformance of receiving implementations, the behaviour of the system must be observed in response to one or more real or sample messages.

The table of conformance statements indicates, for each statement, if it applies to order messages only, result messages only, or both.

Note: For the conformance points, generally the rule is stated first followed by the reason.  The reason may also be referenced in other sections.

Note: HL7au Identifiers in () parenthesis are headings/groupers and not conformance points in themselves.

Conformance points which are revised will have their revision number in brackets after their HL7au identifier. For example HL7au:00000x.y.z (r2).

The values of Message Type Applicability column and their meanings are: -

  • Orders = ORM messages
  • Results = ORU messages
  • Referrals = All REF messages (includes all profiles)
  • Referrals(L1) = Simplified Referral Profile Level 1
  • Referrals(L2) = Simplified Referral Profile Level 2
  • Acknowledgement = ACK messages
  • Referral Response = RRI messages

HL7au Identifier

Applicable to Senders/Receivers/BothMessage Type ApplicabilityConformance point text

Comments

HL7au:000001
Senders/ReceiversOrdersOrder addressing - Senders and receivers must ensure an order message is addressed using MSH-6 Receiving facility, as per rules in sub points of HD Datatype conformance heading HL7au:00044.2. 

HL7au:000001.1

ReceiversOrders

The system must actively reject an order message where the MSH-6 Recieving Facility does not identify their organisation

 

HL7au:000001.2
SendersOrdersWhen using SMD refer to HL7au:000044.2 otherwise; senders should address order messages in MSH-6 Receiving facility using the NATA number if available. 
HL7au:000001.2.1
SendersOrdersIn MSH-6 the namespace ID should contain the registered NATA name for the laboratory as published by NATA ( www.nata.com.au ) 

HL7au:000002 (r2)

ReceiversResults, ReferralsThe system receiving messages must ensure that any document identifiers (OBR-3 Filler order number (EI)) in the received message are fully specified, with the authoring organisation's HD qualifying the identifier. This is done by testing that all components of Entity Identifier (EI) are valued, and when not returning error acknowledgement.Document updating depends on a reliable document identifier and without a namespace for the identifier safe updating/corrections to documents is not possible.
HL7au:000003
Senders

Orders, Results, Referrals

To ensure the uniqueness of the Entity Identifier (EI) in OBR-2 (Placer Order Number) for a request identifier across different organisations, the Entity identifier (first component) in addition to the Namespace ID (second component) and/or Universal ID (third component) and Universal ID type (4th component) must be populated.field optionality is still allowed ie. field may be completely unvalued

HL7au:000004.1 (r2)

SendersOrders, Results, ReferralsTo ensure the uniqueness of the Entity Identifier (EI) in OBR-3 (Filler Order Number) for a result identifier across different organisations, the Entity identifier (first component) in addition to the Namespace ID (second component) and/or Universal ID (third component) and Universal ID type (4th component) must be populated.It is vital that a unique identifier within the authoring facility HD is used in the first component. The ability to issue corrected documents depends the uniqueness of this document identifier. Future updates to a document will use the same identifier in OBR-3.
HL7au:000004.2
ReceiversOrders, Results, ReferralOlder results with identical Entity Identifier (EI) in OBR-3 (Filler Order Number) to that of a newly received result message (by comparing OBR-22 Rpt/Status Change Date/Time field) must be replaced with the new message, and the older marked as deleted/superseded.This applies independently to each ORR/OBX group
HL7au:000005
SendersOrders, Results, ReferralsTo ensure the uniqueness of the Entity Identifier (EI) in ORC-2 (Placer Order Number) for a request identifier across different organisations, the Entity identifier (first component) in addition to the Namespace ID (second component) and Universal ID (third component) and Universal ID type (4th component) must be populated.field optionality is still allowed ie. field may be completely unvalued
HL7au:000006
ReceiversOrders, ResultsTo ensure the uniqueness of the Entity Identifier (EI) in ORC-3 (Filler Order Number) for a result identifier across different organisations, the Entity identifier (first component) in addition to the Namespace ID (second component) and Universal ID (third component) and Universal ID type (4th component) must be populated. 
HL7au:000007
SendersOrders, Results, Referrals

To ensure the uniqueness of the Entity Identifier (EI) in ORC-4 (Placer Group Number) for a request identifier across different organisations, the Entity identifier (first component) in addition to the Namespace ID (second component) and Universal ID (third component) and Universal ID type (4th component) must be populated. 

field optionality is still allowed ie. field may be completely unvalued

(HL7au:000008)Display Segments
HL7au:000008
SendersResults, ReferralsThe message must contain at least one OBX display segment per OBR/OBX group.

**wordingupdated, same intention

HL7au:000008.1 (r2)

SendersResults, Referrals

Display segments must use the appropriate valid values within the AUSPDI coding system in OBX-3 for the content that is represented in it:

  • OBX||ED|HTML^Display format in HTML^AUSPDI||^text^HTML^A^<?xml
    version="1.0"…

  • OBX||ED|PDF^Display format in PDF^AUSPDI||^application^pdf^Base64^

  • OBX||ED|RTF^Display format in RTF^AUSPDI||

  • OBX||FT|TXT^Display format in text^AUSPDI||

(Referral Level 1 receivers are only required to support PDF display segments. See HL7au:000008.3.1)
 

HL7au:000008.1.1 (r4)

ReceiversResults, Referrals

For Referrals Level 1

Receivers must be capable of displaying PDF (either via an embedded viewer or an external viewer)

For other profiles:

Receivers should be capable of displaying all display formats HTML, PDF, RTF, TXT (HL7 FT) (either via an embedded viewer or an external viewer), and must provide users access to all of these in an external viewer application if they are unable to fully display the format.

*This conformance point was relaxed 31/10/2017.

Some formats may be viewed with an embedded viewer and external viewer, while other formats may be viewed with just an external viewer e.g. RTF). It is important that all can be accessed and viewed.

HL7au:000008.1.2
Senders and ReceiversResultsAn OBX display segment is identified using OBX-3 Identifier (CE-1) and Name of Coding System (CE-3) components. The text component of the CE may be blank and only CE1 and CE-3 components need to match. 
HL7au:000008.1.3
Senders and ReceiversResultsIn an OBX display segment, the OBX-2 Value Type field must match its corresponding display format specified in OBX-3 Identifier (ST) component as per table Display Format codes in Section 4.5. 
HL7au:000008.1.4
Senders and ReceiversResultsIn an OBX display segment, the OBX-3 <name of coding system (IS)> must be valued "AUSPDI". 
HL7au:000008.1.5
SendersResults, ReferralsThe OBX display segment(s) must be the last in a set of OBX segments in each OBR/OBX group, with the exception of digital signature OBX(s) which may be after the display segments OBXs. (Display segments can be identified by having AUSPDI OBX-3 <name of coding system>)  
HL7au:000008.1.6
ReceiversResults, ReferralsWhen a display segment is shown, the earlier atomic OBX segments must not be rendered. 
HL7au:000008.2
SendersResultsThere must NOT be conflicting content between the OBX display segment and the preceding OBX atomic data. A compliant rendering of the atomic data (if present) must contain the same clinical information.

 

HL7au:000008.2.1
SendersReferralsFor OBX within the supporting information OBR/OBX groups. There must NOT be conflicting content between the OBX display segment and the preceding OBX atomic data. A compliant rendering of the atomic data (if present) must contain the same clinical information. 
HL7au:000008.2.2
SendersReferralsFor OBX within the current summary OBR/OBX group as indicated by OBR-4 as per section 4.4.1.4.1 OBR-4 codes in referral messages. There must NOT be conflicting content between the OBX display segment and the preceding OBX atomic data and the medication and allergy segments of the REF message.  
HL7au:000008.3.1
SendersReferrals

For Referrals Level 1:

The single OBR/OBX group of the message must contain an OBX display segment in PDF format.

For other profiles:

Each OBR/OBX group of the message must contain at least one of the following OBX display segments HTML, PDF, TXT (HL7 FT).

 
HL7au:000008.3.2
SendersReferrals(L2)If an RTF display segment is sent in an OBR/OBX group, then the same content must be sent in one of either HTML, PDF, or TXT (HL7 FT) same OBR/OBX group. 
   
(HL7au:000008.2.3)
XHTML Display Segment
(HL7au:000008.2.3.1)
XHTML Display Segment - Sender
HL7au:000008.2.3.1.01
SendersResults, Referrals

Any OBX HTML display segments must be valid HTML and conform to the Document Type defined in 'XHTML 1.0 Strict' standard. Refer to  http://validator.w3.org/ to validate XHTML content.

 
HL7au:000008.2.3.1.02
SendersResults, Referrals

All embedded hyperlinks must be secure hyperlinks ie. https:// . That is http:// is disallowed.

 
HL7au:000008.2.3.1.03
SendersResults, Referrals

Sender must not use external style sheets. Internal style sheets are allowed.

Note: external stylesheets are a security risk and could affect presentation of content.

 
HL7au:000008.2.3.1.04
SendersResults, Referrals

Sender must not use scripts e.g. Javascript etc.

Note: active content is not allowed either inline or as external references.

 
HL7au:000008.2.3.1.05
SendersResults, Referrals

Sender must not use the following elements:

  • base
  • link
  • xlink
  • frame
  • iframes
  • form
  • object
 
HL7au:000008.2.3.1.06
SendersResults, Referrals

If there is an image map, senders must have an additional mechanism for communicating that information because there is no obligation on receiving systems to deal with image maps.

 
HL7au:000008.2.3.1.07
SendersResults, ReferralsEmbedded CSS shall conform to the CSS3 specification. 
HL7au:000008.2.3.1.08
SendersResults, ReferralsThe core display of the report must be encapsulated in a 'div' element of html class ‘reportDisplay’. 
HL7au:000008.2.3.1.09
SendersResults, ReferralsLetter head information should be encapsulated in XHTML elements outside of the the scope of the core display of the report identified by 'div' html class 'reportDisplay'. 
HL7au:000008.2.3.1.10
SendersResults, ReferralsLetter head images may not be embedded in the html but served externally. 
HL7au:000008.2.3.1.11
SendersResults, Referrals

External letter head image sources must not be used, except when used outside a 'div' 'reportDisplay' class html element and only when that 'div' it is present.

 

 
HL7au:000008.2.3.1.12
SendersResults, ReferralsThe core report must display in a readable way with the CSS removed. 
HL7au:000008.2.3.1.13
SendersResults, ReferralsInformation in the core report data must not be hidden by CSS formatting directives.  
HL7au:000008.2.3.1.14
SendersResults, ReferralsImage element "src" attributes must use the value "hl7v2://OBX.<setID>" where the setID reference the OBX in the message containing the Encapsulated Data (ED) image or Reference Pointer (RP) to the data, except for images which are a part of a letterhead as per HL7au:000008.2.3.1.10. 
HL7au:000008.2.3.1.15
SendersResults, ReferralsExternal images may be linked from the report body via a clickable link which the user can manually select.eg. to access a PACS image
     
(HL7au:000008.2.3.2)
XHTML Display segment - Receiver
HL7au:000008.2.3.2.01
ReceiversResults, Referrals(L2)HTML display segments must be displayed using a HTML/CSS component that is compliant for rendering of XHTML and CSS3. 
HL7au:000008.2.3.2.03
ReceiversResults, Referrals(L2)Secure hyperlinks (https://) must be able to be clicked by a user and client application must enable navigation to secure https:// sites . 
HL7au:000008.2.3.2.04
ReceiversResults, Referrals(L2)Receiving software may filter or disable all embedded javascript. 
HL7au:000008.2.3.2.05
ReceiversResults, Referrals(L2)Receiving software may suppress objects, iframes, forms with base/link/xlink 
HL7au:000008.2.3.2.06
ReceiversResults, Referrals(L2)Receiving software may block access to insecure hyperlinks eg file://, http:// 
HL7au:000008.2.3.2.07
ReceiversResults, Referrals(L2)It should be possible for users in receiving software to selectively hide content outside of the 'div' element of html class ‘reportDisplay’. 
HL7au:000008.2.3.2.08
ReceiversResults, Referrals(L2)Receiving software should not selectively hide any html when no 'div' element of html class ‘reportDisplay’ is not present in XHTML content. 
HL7au:000008.2.3.2.02
ReceiversResults, Referrals(L2)Receiver must support embedded images in XHTML that must be proper URLs suitable for browser use directly, or use the HL7 V2: scheme defined in the HTML Appendix.

Receivers may choose to parse the xml and replace the hl7v2 scheme content with a base64 encoded image from the appropriate OBX. eg.

<img src="data:image/png;base64,iV......" />
HL7au:000008.2.3.2.09
ReceiversResults, Referrals(L2)XHTML containing images with a source referring back to an RP OBX segment using the 'hl7v2://OBX.<setID>' must be resolved so that the images are viewable.** Note that regular browsers do not support this feature directly, xhtml preprocessing is required before display with browser
HL7au:000008.2.3.2.10
ReceiversResults, Referrals(L2)XHTML containing images with a source referring back to an ED OBX segment using the 'hl7v2://OBX.<setID>' must be resolved so that the images are viewable.** Note that regular browsers do not support this feature directly, xhtml preprocessing is required before display with browser
     
(HL7au:000008.2.4)
PDF Display segment
(HL7au:000008.2.4.1)
PDF Display segment - Sender
HL7au:000008.2.4.1.1
SendersResults, ReferralsDocuments must be valid according to the PDF/A-1b profile. 
HL7au:000008.2.4.1.2
SendersResults, ReferralsMust embed fonts 
HL7au:000008.2.4.1.3
SendersResults, ReferralsMust not use encryption/password protection 
HL7au:000008.2.4.1.4
SendersResults, ReferralsMust not use PDF Comments 
HL7au:000008.2.4.1.5
SendersResults, ReferralsMust not restrict printing. 
HL7au:000008.2.4.1.6
SendersResults, Referrals

Must not restrict copying.

 
HL7au:000008.2.4.1.7
SendersResults, ReferralsMay use PDF digital signature 
HL7au:000008.2.4.1.8
SendersResults, ReferralsMay use PDF restrict changes 
HL7au:000008.2.4.1.9
SendersResults, ReferralsMay use PDF compression 
(HL7au:000008.2.4.2)
PDF Display segment - Receiver
HL7au:000008.2.4.2.1
ReceiversResults, ReferralsReceiver software must display the received PDF with a PDF viewer component. 
HL7au:000008.2.4.2.2
ReceiversResults, ReferralsReceiver software must be capable of rendering PDF/A-1b content. 
HL7au:000008.2.4.2.3
ReceiversResults, ReferralsReceiver must support embedded fonts. This is because content is laid out based on font metrics. 
HL7au:000008.2.4.2.4
ReceiversResults, ReferralsReceiver must support PDF compression. 
HL7au:000008.2.4.2.5
ReceiversResults, ReferralsReceivers may validate for PDF digital signatures. 
HL7au:000008.2.4.2.6
ReceiversResults, ReferralsReceiver software must not allow changes to documents in all circumstances. This is irrespective of PDF flags to restrict changes. 
     
(HL7au:000008.2.4.3)
RTF Display segment
(HL7au:000008.2.4.3.1)
RTF Display segment - Sender
HL7au:000008.2.4.3.1.1
SendersResults, ReferralsRTF must not contain nested tables (ie. tables inside tables) 
HL7au:000008.2.4.3.1.2
SendersResults, ReferralsRTF must not contain active content such as Objected Linking and Embedding Objects (OLE), except with image rendition subject to site-specific negotiation. 
HL7au:000008.2.4.3.1.3
SendersResults, ReferralsRTF must not contain embedded fonts 
HL7au:000008.2.4.3.1.4
SendersResults, ReferralsRTF must not contain smart shapes/other drawing objects (convert these to PNG images) 
HL7au:000008.2.4.3.1.5
SendersResults, Referrals

RTF must not contain smart tags

 
HL7au:000008.2.4.3.1.6
SendersResults, ReferralsRTF must not contain change tracking markup or comments 
HL7au:000008.2.4.3.1.7
SendersResults, ReferralsRTF must not contain section specific page layout 
HL7au:000008.2.4.3.1.8
SendersResults, ReferralsRTF must not contain word forms 
HL7au:000008.2.4.3.1.9
SendersResults, Referrals

Clinical information must not be presented in Header/footer/cross-references.

 
HL7au:000008.2.4.3.1.10
SendersResults, ReferralsBranding information may be presented in Header/footer/cross-references. 
HL7au:000008.2.4.3.1.11
SendersResults, ReferralsWatermark must not be required to be viewed. 
HL7au:000008.2.4.3.1.12
SendersResults, Referrals

All field values are up to date, as fields may not updated, only displayed as text.

 
(HL7au:000008.2.4.3.2)
RTF Display segment - Receiver
   Note: Referral receivers may choose to support the required RTF receiver capability by allowing the user to launching a compliant external RTF viewer application (such as Microsoft Word Viewer / Microsoft Word). It is not a requirement to embed a viewer. 
HL7au:000008.2.4.3.2.01
ReceiversResults, Referrals(L2)Receivers must process the \binXXXX control word and skip processing of RTF control words for XXX bytes.Refer to Word 2007: Rich Text Format (RTF) Specification, version 1.9.1 page 211 where it says "the reader must explicitly check each control word found to see if it is a \binN control, and if found, skip that many bytes before resuming its scanning for braces."
HL7au:000008.2.4.3.2.02
ReceiversResults, Referrals(L2)Receivers must support tables, except for nested tables 
HL7au:000008.2.4.3.2.03
ReceiversResults, Referrals(L2)Receivers must support hyperlinks 
HL7au:000008.2.4.3.2.04
ReceiversResults, Referrals(L2)Receivers must allow secure https:// hyperlinks to be clickable and navigable into a web browser. 
HL7au:000008.2.4.3.2.05
ReceiversResults, Referrals(L2)

Receivers must support display of RTF embedded bmp, gif, png, jpg, and emf.

 
HL7au:000008.2.4.3.2.06
ReceiversResults, Referrals(L2)Receivers must support display of RTF columns 
HL7au:000008.2.4.3.2.07
ReceiversResults, Referrals(L2)Receivers must support Lists including bullet and numbers. 
HL7au:000008.2.4.3.2.08
ReceiversResults, Referrals(L2)

Receivers must support display of nested lists with indication of logical nesting.

 
HL7au:000008.2.4.3.2.09
ReceiversResults, Referrals(L2)Display of selected field values.Editors such as Microsoft Word allow form fields to be created such as combo boxes, radio buttons and check boxes which users can select a value from. This the selected field value refers to the answer which should be present in the RTF field.
HL7au:000008.2.4.3.2.10
ReceiversResults, Referrals(L2)Receivers may support Header/footer/cross-references 
HL7au:000008.2.4.3.2.11
ReceiversResults, Referrals(L2)Receivers may support watermarks 
HL7au:000008.2.4.3.2.12
ReceiversResults, Referrals(L2)Receivers must display field values.This refers to fields such as page numbers. RTF senders should include the value in the field.
HL7au:000008.2.4.3.2.13
ReceiversResults, Referrals(L2)Receivers may not calculate field values. 
(HL7au:000008.2.4.4)
FT Display segment
(HL7au:000008.2.4.4.1)
FT Display segment - Sender
HL7au:000008.2.4.4.1.01
SendersResults, ReferralsSenders must escape '|' character to the field separator character escape sequence "\F\" 
HL7au:000008.2.4.4.1.02
SendersResults, ReferralsSenders must escape '^' character to the component separator character escape sequence "\S\" 
HL7au:000008.2.4.4.1.03
SendersResults, ReferralsSenders must escape '&' character to the sub-component separator character escape sequence "\T\" 
HL7au:000008.2.4.4.1.04
SendersResults, ReferralsSenders must escape '~' character to the repeat character escape sequence "\R\" 
HL7au:000008.2.4.4.1.05
SendersResults, ReferralsSenders must escape '\' character to the escape character escape sequence "\E\" 
HL7au:000008.2.4.4.1.06
SendersResults, ReferralsSenders must escape new line character(s) to the escape sequence "\.br\" 
HL7au:000008.2.4.4.1.07
SendersResults, ReferralsSenders must design FT content for presentation with a monospaced font 
HL7au:000008.2.4.4.1.08
SendersResults, ReferralsSenders must not use "\Xdddd...\" hexadecimal data escape sequences 
HL7au:000008.2.4.4.1.09
SendersResults, ReferralsSenders must not use "\Zdddd..\" locally defined escape sequences 
HL7au:000008.2.4.4.1.10
SendersResults, ReferralsSenders must not use "\.ce\" escape sequences. 
HL7au:000008.2.4.4.1.11
SendersResults, ReferralsSenders must not break FT content into multiple components or repeats. 
HL7au:000008.2.4.4.1.12
SendersResults, ReferralsSenders must limit intended display line lengths to 80 characters. 
HL7au:000008.2.4.4.1.13
SendersResults, ReferralsSenders must not use "\M" escape sequences. 
HL7au:000008.2.4.4.1.14
SendersResults, ReferralsSenders must not use "\C" escape sequences. 
(HL7au:000008.2.4.4.2)
FT Display segment - Receiver
HL7au:000008.2.4.4.2.01
ReceiversResults, Referrals(L2)FT datatype content SHALL be displayed using monospaced font  
HL7au:000008.2.4.4.2.02
ReceiversResults, Referrals(L2)Receivers must de-escape "\F\" to the field separator character '|'

 

HL7au:000008.2.4.4.2.03
ReceiversResults, Referrals(L2)Receivers must de-escape "\S\" to the component separator character '^' 
HL7au:000008.2.4.4.2.04
ReceiversResults, Referrals(L2)Receivers must de-escape "\T\" to the sub-component separator character '&' 
HL7au:000008.2.4.4.2.05
ReceiversResults, Referrals(L2)Receivers must de-escape "\R\" to the repetition character '~' 
HL7au:000008.2.4.4.2.06
ReceiversResults, Referrals(L2)Receivers must de-escape "\E\" to the escape character '\' 
HL7au:000008.2.4.4.2.07
ReceiversResults, Referrals(L2)Receivers must start highlighting text whenever "\H\" escape sequence is encountered 
HL7au:000008.2.4.4.2.08
ReceiversResults, Referrals(L2)Receivers must end highlighting text whenever "\N\" escape sequence is encountered. 
HL7au:000008.2.4.4.2.09
ReceiversResults, Referrals(L2)Receivers must support "\.sp <number>\" escape sequences, and must maintain horizontal position while skipping positive <number> vertical spaces. (If <number> is not specified 1 must be assumed). 
HL7au:000008.2.4.4.2.10
ReceiversResults, Referrals(L2)Receivers must support "\.br\" escape sequence and must begin a new left justified line. 
HL7au:000008.2.4.4.2.11
ReceiversResults, Referrals(L2)Receivers must support the fill mode (word wrap) "\.fi\" escape sequence. This means that after this sequence is encountered a soft line break must be introduced when horizontal space runs out. 
HL7au:000008.2.4.4.2.12
ReceiversResults, Referrals(L2)Receivers must support the no fill mode (no word wrap) "\.nf\" escape sequence. This means after this sequence is encountered a soft line break must not be introduced when horizontal space runs out. 
HL7au:000008.2.4.4.2.13
ReceiversResults, Referrals(L2)Receivers must support indent "\.in <number>\" escape sequences. This means that on encountering this sequence each subsequent new line should be indented by positive <number> characters until the end of the document or another indent escape sequence sets the indent state. 
HL7au:000008.2.4.4.2.14
ReceiversResults, Referrals(L2)Receivers must support temporary indent "\.ti <number>\" escape sequences. This means that on encountering this sequence the first character of the each line in the paragraph (ie until \.br\ is encountered) will be indented to the absolute <number> value of fixed-width characters from the left hand side (not relative to the current .in value). 
HL7au:000008.2.4.4.2.15
ReceiversResults, Referrals(L2)Receivers must support skip "\.sk <number>\" escape sequences. This means that on encountering a skip sequence that the next character position will be advanced by <number> spaces to the right. 
HL7au:000008.2.4.4.2.16
ReceiversResults, Referrals(L2)Receivers must ensure that 80 characters of text (using a non-proportional font) can be displayed without word wrapping the line of text. 
HL7au:000008.2.4.4.2.17
ReceiversResultsReceivers must support 8859/1 character encoding when specified in MSH-18. 
(HL7au:000010)
Digital signatures
HL7au:000010Receivers

Orders, Results, Referrals(L2)

If a digital signature is received in an OBX segment, receiving systems must recognise the digital signature and not inadvertently process it as data for display.

Refer to Standards Australia publication HB 308HB 308 - Location of Digital Signatures in HL7v2

Digital signature OBX can identified by OBX-3 (CE) identifier component starting with "AUSETAV", and OBX-3 name of code system component "L")

HL7au:000010.1
ReceiversOrders, Results, Referrals(L2)If a digital signature is received in an OBX segment, then the signature and report content should if possible be verified and the results presented to the user on the display with the report. 
     
HL7au:000019
Senders and ReceiversOrders, Results, Referrals(L2)

A single message of up to 16 MB (16,777,216 bytes) must be able to be received by both the transmitters and receivers of messages.

Note: Larger sized messages are feasible, but only under specific trading partner agreements.



HL7au:000020
SendersOrders, Results, Referrals(L2)

All message types and trigger event codes beginning with the letter “Z” are reserved for locally-defined messages and must NOT be used.

 

HL7au:000021
SendersResults, Referrals(L2)Data type TX must NOT be used as a value in the OBX-2 Value Type field.

 

     
(HL7au:000022)
File and Batch Segments
HL7au:000022.1
SendersOrders, Results, ReferralsIf the batch header is used it must specify individual message acknowledgement. No information from the file header/footer or batch segments must be used. 
HL7au:000022.2
ReceiversOrders, ResultsAll messages between the batch header (BHS) and the file trailer (FTS) must be acknowledged individually. The batch itself is not acknowledged.

 

HL7au:000022.3
SendersReferralsSenders must generate batches containing no more than 1 message.
HL7au:000022.4
ReceiversOrders, Results, ReferralsReceivers must support receiving messages contained inside HL7 batch protocol or a stand alone HL7 message.
HL7au:000023
SendersOrders, Results, ReferralsThe NTE segment must NOT be used in messages.

 

(HL7au:000024)
Delimiters of ‘|^~\&’ from HL7 V2.4 must be used in the message.

 

HL7au:000024.1
SendersOrders, Results, ReferralsFHS, BHS, and MSH segments must specify the Field separator character as '|' 
HL7au:000024.2
SendersOrders, Results, ReferralsFHS, BHS, and MSH segments must specify the Components separator character as '^' 
HL7au:000024.3
SendersOrders, ResultsFHS, BHS, and MSH segments must specify the Sub-components separator characteras '&' 
HL7au:000024.4
SendersOrders, ResultsFHS, BHS, and MSH segments must specify the repeat separator character as '~' 
HL7au:000024.5
SendersOrders, ResultsFHS, BHS, and MSH segments must specify the escape separator character as '\' 
 General Conformance Points
HL7au:000025
Senders

Orders, Results, Referrals

The sending facility must ensure their MSH-4 Sending facility identifier is unique.

 
HL7au:000026
SendersResults

When sending a report to multiple "copy to " doctors the MSH-10 Message control ID must be unique in each message produced for each recipient.

 
HL7au:000026.2
SendersReferralsWhen sending copies of the same referral to multiple providers, the MSH-10 Message control ID must be unique in each message produced for each recipient, and the PRD "IR: Intended recipient role must be set appropriately for the intended recipient for each message. 
HL7au:000027
SendersOrders, Results, Referrals

When re-transmitting a message the MSH-10 Message control ID must be unique.

 
HL7au:000028
SendersResultsWhen there are multiple OBR segments in an ORU message, the OBR-3 Filler order number must be unique within messages. 
HL7au:000028.2SendersReferralsWhen there are multiple OBR/OBX groups in a REF message, each OBR-3 Filler order number pair must be unique for each OBR/OBX group. 
HL7au:000029 
SendersResults, ReferralsWhen re-transmitting/forwarding a message content from one system to another the MSH-4 Sending facility must be the re-transmitting/forwarding Sending facility (HD components) and not the original authoring organisation (HD components). 
HL7au:000030
SendersResults, ReferralsWhen re-transmitting/forwarding a message's content from one system to another the MSH-10 Message control ID must be unique for each message. 
HL7au:000031

Senders

Results, Referrals

When re-transmitting/forwarding a message's content from one system to another OBR-3.2 Filler order number.namespace ID must be used for the display of the authoring organisation e.g. |123456^Path Lab Name^43210^AUSNATA|. The Filler order number of a result must not be changed. 
HL7au:000032
SendersResultsIn the ORU message the field OBR-24 "Diagnostic serv sect ID" must be valued and must have values from HL7 table 0074 - diagnostic service section. 
HL7au:000032.2
SendersReferralsIn the REF message the field OBR-24 "Diagnostic serv sect ID" must be valued and must have values from HL7 table 0074 - diagnostic service section appropriate for the content in the OBR/OBX group. 
HL7au:000032.3
Receivers

Results, Referrals

If the receiving system has a various categories for their inbound communications in their application. eg. Letters, Radiology, then each OBR/OBX group content must be added to those by classifying the OBR/OBX group content based on OBR-24 value. PHY, LAB, RAD are the most common ones. The system must map each value in HL7 Table 0074 - Diagnostic service section ID  to the appropriate category. 
HL7au:000033
SendersResultsIn Pathology ORU messages the field OBX-3 "Observation identifier" should, if possible, have values from the LOINC coding system except for display segments and digital signature OBX. 
     
(HL7au:000034)
Use of Codes
HL7au:000034.1
SendersResults, ReferralsWhen using CE, CWE, CNE data types in an OBX segment in either OBX-3 (Observation Identifier) or as an Observation Value, if the system transmits both the public (e.g. LOINC) and local terminology, then the public (eg LOINC) code must appear in the identifier.  
HL7au:000034.2
SendersResults, ReferralsWhen using CE, CWE, CNE data types in an OBX segment, in OBX-3 (Observation Identifier), if the system transmits both a public (e.g. LOINC) and a local terminology, then the local terminology must be transmitted in the second CE triplet i.e. the alternate identifier. 
HL7au:000034.3
SendersResults, ReferralsWhen using CE, CWE, CNE data types in an OBX segment, In either OBX-3 (Observation Identifier) or as an Observation Value, if the system transmits both a public (e.g. LOINC) and a local terminology, then concepts from the different terminologies must convey the same clinical meaning. Generally this means there is no need to populate the Alternate Text field. 
HL7au:000034.4
ReceiversResultsReceivers must recognize Result and Report comment LOINC codes and Template ID/Section Header LOINC codes and display appropriately.See 4.6 Specific LOINC codes
(HL7au:000040)
MSH-12 Version ID Field Conformance Points
HL7au:000040.1
SendersOrders, Results, Referrals, ACK, RRISenders conforming to this specification must specify "2.4" as the value of version ID (ID) component of MSH-12 Version ID (VID) 

HL7au:000040.2 (r2)

SendersOrders, Results, Referrals, ACK, RRIMSH-12 Version ID <internationalization code (CE)> component must be valued "AUS&Australia&ISO3166_1" 
HL7au:000040.3
SendersOrders, ResultsMSH-12 Version ID <internal version ID (CE)> component must be valued as "HL7AU-OO-201701&&L". (Note that the number scheme used in this identifier is HL7 date format: YYYYMM)** errata

HL7au:000040.4 (r2)

SendersReferrals, RRI

MSH-12 Version ID <internal version ID (CE)> component must be valued as

"HL7AU-OO-REF-SIMPLIFIED-201706&&L" (for Level 2) or

"HL7AU-OO-REF-SIMPLIFIED-201706-L1&&L" (for Level 1). 
(Note that the number scheme used in this identifier is HL7 date format: YYYYMM)
The RRI should echo the received MSH-12 <internal version (ID)>. This is a hint to the SMD agent as to the service category to be used.

HL7au:000040.5

Receivers

Orders, Results, Referrals

Receiving systems must use MSH-12 to affect the behaviour of message processing, when supporting various versions of the HL7 message standards and profiles. 
   

HL7au:000041 (r2)

SendersOrders, Results, Referrals, ACK, RRIThe country of origin of the message must be specified in MSH-17 Country code. For Australian originators the value must be "AUS". 
HL7au:000040.5
SendersOrders, Results, Referrals, ACK, RRIMSH-19 must be valued as "en^English^ISO639". 
(HL7au:000043)
MSH-4 Sending Facility conformance points
HL7au:000043.1
SendersOrders, Results, Referrals

MSH-4 – Sending Facility must be filled in with the sending facility HPI-O when sending a message via Secure Message Delivery (SMD) and secured by NASH Certificates.

The format must be "registered organisation name in HI service^1.2.36.1.2001.1003.0.<hpio>^ISO" where <hpio> is a 16-digit number.

The identifier is essentially used to locate the endpoint of the sending facility and will be used by the receiving facility to return an acknowledgement.

** errata was inconsistent with 44.2.1
HL7au:00043.2
ReceiversOrders, Results, ReferralsMSH-4 – Sending Facility when using SMD with NASH certificates must be validated against the SMD sending organisation. The message must be rejected if the SMD certificate does not match. (This is an anti spoofing check)** This conformance point applies only to SMD Agent implementers, this check should be performed before handing off a the message to the receiving system.
HL7au:00043.3
SendersOrders, Results, ReferralsWhen SMD is used with vendor based certificates and identifiers, then the components of the MSH-4 HD must match with content of the sender as valued in the provider directory and also as identified in the senders X.509 certificate.
HL7au:00043.4
SendersOrders, Results, ReferralsWhen SMD is used with vendor based certificates and identifiers, then the components of the MSH-6 HD must match with content of the receiver as valued in the provider directory and also as identified in the senders X.509 certificate.need detailed component mapping from directory and x.509 certs
(HL7au:00044)

Datatype conformance points

HL7au:00044.0.1
SendersOrders, Results, ReferralsUser defined datatypes are prohibited in all segment fields, components, and subcomponents. (Note that this prohibits the use of user defined datatypes in varable datatype fields such as OBX-5). 
(HL7au:00044.1)
CX datatype conformance points
HL7au:00044.1.1
SendersOrders, Results, ReferralsCX <ID (ST)> component must be specified and valid according to the identifier scheme of selected by the Identifier type code and Assigning Authority components. 

HL7au:00044.1.2 (r2)

SendersOrders, Results, ReferralsCX <assigning authority (HD)> component must be valued and must conform to sub points of HL7au:00044.2. 
HL7au:00044.1.3
SendersOrders, Results, ReferralsCX <identifier type code (ID)> component must be valued with a valid value from HL7 Table 0203 - Identifier type. 
(HL7au:00044.2)
HD Datatype conformance points
HL7au:00044.2.1
SendersOrders, Results, ReferralsWhen SMD with NASH certificates are used the HD Namespace ID component must contain the registered organisation name as registered by in the Medicare Australia HPOS/HI service, otherwise it must contain the registered NATA name for the laboratory as published by NATA ( www.nata.com.au ) 
HL7au:00044.2.2
SendersOrders, Results, ReferralsWhen SMD with NASH certificates are used the HD Universal ID component must contain the HPI-O formatted as 1.2.36.1.2001.1003.0.<hpio>, otherwise it must contain the registered NATA number for the laboratory as published by NATA ( www.nata.com.au ) 
HL7au:00044.2.3
SendersOrders, Results, ReferralsWhen SMD with NASH certificates are used the HD Universal ID Type component must be "ISO", otherwise if the laboratory NATA number is number used in HD Universal ID Type must be "AUSNATA". 
HL7au:00044.2.4
SendersOrders, Results, ReferralsWhen SMD is used with vendor based certificates and identifiers, then the components of the HD must match with content of the receiver as valued in the provider directory and also as identified in the organisation's X.509 certificate. 
(HL7au:00044.3)
EI datatype conformance points
HL7au:00044.3.1
SendersOrders, Results, ReferralsThe EI Entity identifier component must be valued 
HL7au:00044.3.2
SendersOrders, Results, ReferralsWhen SMD with NASH certificates are used the EI Namespace ID component must contain the registered organisation name as registered by in the Medicare Australia HPOS/HI service, otherwise it must contain the registered NATA name for the laboratory as published by NATA ( www.nata.com.au ) 
HL7au:00044.3.4
SendersOrders, Results, ReferralsWhen SMD with NASH certificates are used the EI Universal ID component must contain the HPI-O formatted as 1.2.36.1.2001.1003.0.<hpio>, otherwise it must contain the registered NATA number for the laboratory as published by NATA ( www.nata.com.au ) 
HL7au:00044.3.3
SendersOrders, Results, ReferralsWhen SMD with NASH certificates are used the EI Universal ID Type component must be "ISO", otherwise if the laboratory NATA number is number used in EI Universal ID Type must be "AUSNATA". 
HL7au:00044.3.4
SendersOrders, Results, ReferralsWhen SMD is used with vendor based certificates and identifiers, then the components of the HD must match with content of the receiver as valued in the provider directory and also as identified in the organisation's X.509 certificate. 
(HL7au:00044.4)
CE datatype conformance points
HL7au:00044.4.1
SendersOrders, Results, ReferralsWhen an <identifier (ST)> component is specified, the <name of the coding system> must also be specified. 
HL7au:00044.4.2
SendersOrders, Results, ReferralsIf no <identifier (ST)> component is specified then no <name of coding system> (primary coding system) must be specified 
HL7au:00044.4.3
SendersOrders, Results, Referrals<text (ST)> component must be valued as what is intended for display to the user. (In some locations user display is not intended and the text may be blank.) 
HL7au:00044.4.4
SendersOrders, ResultsWhen multiple codes are used LOINC codes (LN) must be placed first using the identifier rather than the alternate identifier.  
HL7au:00044.4.5
SendersOrders, Results, ReferralsWhen an <alternate identifier (ST)> component is specified, the <name of alternate coding system> must also be specified. 
HL7au:00044.4.6
SendersOrders, Results, ReferralsIf no <alternate identifier (ST)> component is specified then no <name of alternate coding system> must be specified 
HL7au:00044.4.7
SendersOrders, Results, Referrals

Both <identifer> and <alternative identifier> must reflect the same concept in each of the primary and alternate coding system respectively. Each code may reflect differing levels of granularity within each coding system as the level of granularity differs between coding systems.

 
HL7au:00044.4.8
SendersOrders, Results, ReferralsAlternate coding system must be a different from the primary coding system. As the 2 codes must describe the same concept the alternate text is optional. 
(HL7au:00044.5)
CNE datatype conformance points
HL7au:00044.5.1
SendersOrders, Results, ReferralsAn <identifier (ST)> component is specified, the <name of the coding system> must also be specified. 
HL7au:00044.5.2
SendersOrders, Results, ReferralsIf no <identifier (ST)> component is specified then no <name of coding system> must be specified 
HL7au:00044.5.3
SendersOrders, Results, Referrals<text (ST)> component must be valued and this must be what is intended for display to the user. 
HL7au:00044.5.4
SendersOrders, Results, ReferralsWhen an <alternate identifier (ST)> component is specified, the <name of alternate coding system> must also be specified. 
HL7au:00044.5.5
SendersOrders, Results, ReferralsIf no <alternate identifier (ST)> component is specified then no <name of alternate coding system> must be specified 
HL7au:00044.5.6
SendersOrders, Results, Referrals<alternate text (ST)> component must be valued and this must be what is intended for display to the user. 
(HL7au:00044.6)
CWE datatype conformance points
HL7au:00044.6.1
SendersOrders, Results, ReferralsWhen an <identifier (ST)> component is specified, the <name of the coding system> must also be specified. 
HL7au:00044.6.2
SendersOrders, Results, ReferralsIf no <identifier (ST)> component is specified then no <name of coding system> must be specified 
HL7au:00044.6.3
SendersOrders, Results, Referrals<text (ST)> component must be valued and this must be what is intended for display to the user. 
HL7au:00044.6.4
SendersOrders, Results, ReferralsWhen an <alternate identifier (ST)> component is specified, the <name of alternate coding system> must also be specified. 
HL7au:00044.6.5
SendersOrders, Results, ReferralsIf no <alternate identifier (ST)> component is specified then no <name of alternate coding system> must be specified 
HL7au:00044.6.6
SendersOrders, Results, Referrals<alternate text (ST)> component must be valued and this must be what is intended for display to the user. 
(HL7au:00044.7)
XCN datatype conformance points
HL7au:00044.7.1
SendersOrders, Results, ReferralsXCN <ID (ST)> component must be specified and valid according to the identifier scheme of selected by the Identifier type code and Assigning Authority components. 
HL7au:00044.7.2
SendersOrders, Results, ReferralsXCN <assigning authority (HD)> component must be valued and valid. 
HL7au:00044.7.3
SendersOrders, Results, ReferralsXCN <name type code (ID)> component must be valued and valid from HL7 Table 200. 
HL7au:00044.7.4
SendersOrders, Results, ReferralsXCN <identifier type code (ID)> component must be valued with a valid value from HL7 Table 203. 
HL7au:00044.7.5
SendersOrders, Results, ReferralsXCN <family name (FN)> :<surname (ST)> sub-component must to be valued. 
HL7au:00044.7.6
SendersOrders, Results, ReferralsXCN <given name (ST)> should be valued. 
(HL7au:00044.8)
TS datatype conformance points
HL7au:00044.8.1
SendersOrders, Results, ReferralsCorrect timezone must be specified 
     
(HL7au:00044.10)
ED datatype conformance points
(HL7au:00044.10.1)
ED datatype - Senders
HL7au:00044.10.1.1
SendersResults, ReferralsED <type of data (ID)> must be valued. 
HL7au:00044.10.1.2
SendersResults, ReferralsED <data subtype (ID)> must be valued. 
HL7au:00044.10.1.3
SendersResults, ReferralsED <encoding (ID)> must be valued. 
HL7au:00044.10.1.4
SendersResults, ReferralsED <data (ST)> must be valued. 
HL7au:00044.10.1.5
SendersResults, ReferralsWhen the ED <subtype (ID)> component is valued with a MIME sub-type value, then the corresponding MIME type must be used in the <Type of data (ID)> component. 
HL7au:00044.10.1.6
SendersResults, ReferralsWhen the ED <subtype (ID)> component is valued with a HL7 2.4 defined <Subtype (ID)> (Table 0291)  value, then the corresponding HL7 2.4 type of data (Table 0191) must be used in the <Type of data (ID)> component. 
(HL7au:00044.10.2)
ED datatype - Receivers
HL7au:00044.10.2.1
ReceiversResults, ReferralsReceivers must process <type of data (ID)> component case insensitively. 
HL7au:00044.10.2.2
ReceiversResults, ReferralsReceivers must process <data subtype (ID)> case insensitively. 
HL7au:00044.10.2.3
ReceiversResults, ReferralsReceivers must process the <encoding (ID)> component case insensitively. 
   
(HL7au:00044.11)
RP datatype conformance points
(HL7au:00044.11.1)
RP datatype (senders)
HL7au:00044.11.1.1
SendersResults, ReferralsRP <pointer (ST) > component must be valued 
HL7au:00044.11.1.2
SendersResults, ReferralsRP <application ID (HD)> component must be valued 
HL7au:00044.11.1.3
SendersResults, ReferralsRP <type of data (ID)> component must be valued 
HL7au:00044.11.1.4
SendersResults, ReferralsRP <subtype (ID)> component must be valued 
HL7au:00044.11.1.5
SendersResults, ReferralsWhen the RP <subtype (ID)> component is valued with a MIME sub-type value, then the corresponding MIME type must be used in the <Type of data (ID)> component. 
HL7au:00044.11.1.6
SendersResults, ReferralsWhen the RP <subtype (ID)> component is valued with a HL7 2.4 defined <Subtype (ID)> (Table 0291)  value, then the corresponding HL7 2.4 type of data (Table 0191) must be used in the <Type of data (ID)> component. 
HL7au:00044.11.1.7
ReceiversResults, Orders, Referrals

Receivers must understand that a LOINC code of 60572-5 (Report Template ID) signifies the identifier of the report template used to structure the data and not render as patient data.

See 4.6 Specific LOINC codes
(HL7au:00044.11.1.5)
Encoding URLs into RP datatype
HL7au:00044.11.1.5.1
SendersResults, ReferralsWhen "URI" is specified in RP <application ID (HD)> component - <universal id type (ID)> sub-component value: the URL must be specified by the concatenation of the RP <application ID (HD)> component, <universal id (ST)> sub-component followed by the RP <pointer (ST)>. 
HL7au:00044.11.1.5.2
SendersResults, ReferralsWhen "URI" is specified in RP <application ID (HD)> component - <universal id type (ID)> sub-component value: the RP <application ID (HD)> component-<namespace id (IS)> sub-component must not be valued. 
HL7au:00044.11.1.5.3
SendersResults, ReferralsWhen "URI" is specified in RP <application ID (HD)> component - <universal id type (ID)> sub-component value: the RP <application ID (HD)> component, <universal id (ST)> sub-component must be the scheme | server and application path parts of the URL. 
     
     
(HL7au:00045)
Message Acknowledgement
HL7au:00045.1
ReceiversOrdersReceivers of a valid ORM Order messages must produce an application level acknowledgement - order response message ORR and transmit it back to the original sender, when specified by MSH-16. 
HL7au:00045.2
ReceiversResultsReceivers of valid ORU result messages must produce an application level acknowledgement - ACK^R01 and transmit it back to the original sender, when specified by MSH-16. 
HL7au:00045.3
ReceiversOrders, Results, ReferralsReceiving systems unable to process a HL7 message must produce the appropriate reject or error application level application level acknowledgement and transmit it back to the sender, provided that the message has a valid MSH and Sending Facility and MSH Control ID field. 

HL7au:00045.4 (r2)

ReceiversReferralsReceivers of valid (parsable) REF^I12 result messages must produce an application level acknowledgement - RRI^I12 and transmit it back to the original sender. 
HL7au:00045.5
SendersReferralsSenders of REF^I12 messages must have the capacity to receive and process RRI^I12 referral response (acknowledgement) messages and indicate success to the sender of the message, and report failures indicated in the response. 
HL7au:00045.6
SendersReferralsSenders of REF^I12 messages must publish in their secure messaging directory their capability to receive RRI^I12 acknowledgement messages. 

HL7au:00045.7

SendersReferralsSecure messaging agents must ensure that there is a valid referral response entry in their provider directory before proceeding to transmit the message. If not the SMD agent must produce an error acknowledgement and return it to the sending application. 
HL7au:00045.8
ReceiversOrders, Results, Referrals, Acknowledgement, Referral ResponseReceivers must copy exactly all components of the received message's MSH-3 Sending Application field into the MSH-5 Receiving Application field of the acknowledgement / response message that they produce. 
HL7au:00045.9
ReceiversOrders, Results, Referrals, Acknowledgement, Referral ResponseReceivers must copy exactly all components of the received message's MSH-4 Sending Facility field into the MSH-6 Receiving Facility field of the acknowledgement / response message that they produce. 
(HL7au:00046)
General HL7
(HL7au:00046.1)
Sender Escaping Rules
HL7au:00046.1.1

Senders

Orders, Results, ReferralsSenders must escape | characters as '\F\' in all fields, components, subcomponents 
HL7au:00046.1.2
SendersOrders, Results, ReferralsSenders must escape '^' characters as '\S\' in all HL7 fields, components and subcomponents 
HL7au:00046.1.3
SendersOrders, Results, ReferralsSenders must escape '&' characters as '\T\' in all HL7 fields, components and subcomponents 
HL7au:00046.1.4
SendersOrders, Results, ReferralsSenders must escape '~' characters as '\R\' in all HL7 fields, components and subcomponents 
HL7au:00046.1.5
SendersOrders, Results, ReferralsSenders must escape '\' characters as '\S\' in all HL7 fields, components and subcomponents 
(HL7au:00046.2)
Receiver Escaping Rules
HL7au:00046.2.1
ReceiversOrders, Results, ReferralsReceivers must unescape '\F\' escape sequences to character '|' for all fields, components, subcomponents 
HL7au:00046.2.2
ReceiversOrders, Results, ReferralsReceivers must unescape '\S\' escape sequences to character '^' for all fields, components, subcomponents 
HL7au:00046.2.3
ReceiversOrders, Results, ReferralsReceivers must unescape '\T\' escape sequences to character '&' for all fields, components, subcomponents 
HL7au:00046.2.4
ReceiversOrders, Results, ReferralsReceivers must unescape '\R\' escape sequences to character '~' for all fields, components, subcomponents 
HL7au:00046.2.5
ReceiversOrders, Results, ReferralsReceivers must unescape '\E\' escape sequences to character '\' for all fields, components, subcomponents 
HL7au:00046.3
SendersOrders, Results, ReferralsAll fields required by HL7 segments table must be validly valued. 
HL7au:00046.4
ReceiversOrders, Results, ReferralsReceiving implementations when receiving HL7 messages and converting their contents to data values must ignore segments, fields, components, sub-components, and extra repetitions of a field that are present but were not expected.HL7 2.4 2.11
HL7au:00046.5
ReceiversOrders, Results, ReferralsReceiving implementations when receiving HL7 messages and converting their contents to data values must treat segments that were expected but are not present as consisting entirely of fields that are not present HL7 2.4 2.11
HL7au:00046.6
ReceiversOrders, Results, ReferralsReceiving implementations when receiving HL7 messages and converting their contents to data values must treat fields and components that are expected but were not included in a segment as not present.
HL7 2.4 2.11
HL7au:00047.1
SendersOrders, Results, ReferralsMSH-15 Accept acknowledgement type (ID) must be valued AL 
HL7au:00047.2
SendersOrders, Results, ReferralsMSH-16 Application acknowledgement type (ID) must be valued AL 
HL7au:00048.1
SendersOrders, Results, Referrals

When MSH-18 is unvalued or valued as "ASCII" the message must contain only characters in the range ASCII 32 to ASCII 127 and cursor return ASCII 13 which must only be used as segment separator.

 
HL7au:00048.2
SendersOrders, Results, ReferralsWhen MSH-18 is valued and is not "ASCII" encoding the message must not contain characters less than ASCII 32, except for ASCII 13 which must only be used as segment separator. 

HL7au:00048.3.1 (r2)

SendersOrders, ResultsMSH-18 may only contain one of the following values "", "ASCII", "UNICODE UTF-8", "8859/1"** errata "UNICODE UTF-8" was incorrectly added as "UTF-8"
HL7au:00048.3.2
SendersReferralsMSH-18 must only contain one of the following values "", "ASCII".It is hoped to allow "UNICODE UTF-8" in a future version, but this depends on widespread receiver support. Receivers are encouraged to develop capability for UTF-8.

HL7au:00048.3.3

SendersOrders, Results, ReferralsThe encoding of characters in the message must match the value specified in MSH-18 
HL7au:00048.4
SendersOrders, ResultsWhen "UNICODE" is specified in MSH-18 a byte order mark (BOM) must be present at the start of the transmission. 
HL7au:00049.1
SendersOrders, Results, ReferralsMSH-9 Message type <message type (ID)> component must be valued. 
HL7au:00049.2
SendersOrders, Results, ReferralsMSH-9 Message type <trigger event (ID)> component must be valued. 
HL7au:00049.3
SendersOrders, Results, ReferralsMSH-9 Message type <message structure (ID)> component must be valued. 

HL7au:00050.1

Pathology Sending


HL7au:00050.1.2

Senders (Pathology only)ResultsWhen sending pathology messages OBX-3 must be valued according to the APUTS standard where a code is available. 
HL7au:00050.1.3
Senders (Pathology only)Results

The OBX-6 (Units) <text (ST)> component of the primary identifier must be valued according to APUTS preferred unit for the term.

 
HL7au:00050.1.4
Senders (Pathology only)Results

The OBX-6 (Units) <identifier (ST)> component of the primary must be the case sensitive UCUM code.

 
HL7au:00050.1.5
Senders (Pathology only)ResultsThe OBX-6 (Units) <name of coding system (IS)> component must be "UCUM". 
HL7au:00050.1.6
Senders (Pathology only)ResultsThe OBX-7 References range (ST) should be valued as the APUTS harmonised reference intervals where defined and applicable. 
HL7au:00050.1.7
Senders (Pathology only)ResultsDisplay segments must be produced according to the APUTS Chapter 7 rendering rules. 
HL7au:00050.2.1
ReceiversResultsWhere a receiving system renders an atomic pathology result it must comply with the rendering APUTS Chapter 7 rendering rules. 
HL7au:00050.2.2
ReceiversResultsWhen rendering a cumulative table or graph of pathology data, do not combine series which have different LOINC codes or have the "Do not combine" flag indicated in any repeat of OBX-17 which is indicated by "765921000168105^Do not combine laboratory test result^SCT".See 4.13
HL7au:00060.1
Senders

Orders, Results, Referrals

HL7 message elements with a usage of R (required) must be valued. 
HL7au:00060.2
SendersOrders, Results, ReferralsHL7 message elements with a usage of RE (required or empty) must be valued, except if the data is unknown to the sending application. 
HL7au:00060.3
SendersOrders, Results, ReferralsHL7 message elements with a usage of C (conditional) must be valued when the associated predicate is satisfied.From HL7 Conformance Implementation Manual.
HL7au:00060.4
SendersOrders, Results, ReferralsHL7 message elements with a usage of C (conditional) must not be valued when the associated predicate is not satisfied.From HL7 Conformance Implementation Manual.
HL7au:00060.5
SendersOrders, Results, ReferralsHL7 message elements with a usage of CE (condition or empty) must be valued when known to the application, and must be unvalued when the application does not know the value. 
HL7au:00060.6
SendersOrders, Results, ReferralsSending application must be capable of knowing which conditional elements to populate when conditonal rules (predicate) are satisfied for conditional or empty elements.

Adapted from HL7 Conformance Implementation Manual.

HL7au:00060.7
SendersOrders, Results, ReferralsHL7 message elements with a usage of CE (condition or empty) must not be valued when the associated predicate (conditonal rule) is not satisfied.Adapted from HL7 Conformance Implementation Manual.
HL7au:00061.1
ReceiversOrders, Results, ReferralsIf a HL7 message element with a usage of CE is not present, the receiving application shall not raise an error due to the presence or absence of the element. 
     

HL7au:00100.1 (r2)

SendersReferrals

The current referral summary OBR/OBX group must appear as the first OBR/OBX group in the message.



HL7au:00100.2
ReceiversReferrals(L2)The receiver when displaying the inbound referral, must primarily show the content of a referral letter display segment belonging the Clinical Information for the referral OBR/OBX group indicated by the OBR-4 code as per section 4.4.1.4.1 OBR-4 codes in referral messages. 

HL7au:00100.3 (r3)

ReceiversReferrals(L2)The receiver must also show clearly that there is supporting information for the referral and allow the user to view those, each must have a either a PDF/HTML/TXT/RTF display segment.  
HL7au:00101.1
SendersResults, Referrals(L2)Each OBR/OBX group may contain arbitrary encapsulated data attachments as per 4.26 Encapsulated data attachments. 
HL7au:00101.2
Senders

Results, Referrals(L2)

Encapsulated data attachments must use Base64 encoding. 
HL7au:00101.3
SendersResults, Referrals(L2)Senders must not send critical data in encapsulated data attachments, since it may be unreliable in that the MIME type may be unsupported by the receiver and content unviewable. 
HL7au:00101.4
ReceiversResults, Referrals(L2)While displaying the content for each OBR/OBX group any encapsulated data attachments as described in 4.26 Encapsulated data attachments must be listed to the user. 
HL7au:00101.5
ReceiversResults, Referrals(L2)Encapsulated data attachments listed to the user in the previous point must be accessible to the user if a suitable viewer for the MIME type and MIME subtype is available on the system. 
HL7au:00101.6
ReceiversResults, Referrals(L2)Receivers must support viewing attachments with MIME type/subtype of application/pdf and text/html. 
HL7au:00101.7
ReceiversResults, Referrals(L2)

Receivers may support encapsulated data attachments MIME type/subtype such as OpenXML Documents:
application/vnd.openxmlformats-officedocument.wordprocessingml.document

application vnd.openxmlformats-officedocument.spreadsheetml.sheet

 
HL7au:00101.8
ReceiversResults, Referrals(L2)Receiver systems must restrict access to attachments of trusted MIME types (the trusted MIME types may be configurable according to an organisation policy). 

HL7au:00102.1.2 (r2)

SendersReferralsFor the "Referral Summary" OBR/OBX group (indicated by the OBR-4 code as per section 4.4.1.4.1 OBR-4 codes in referral messages) in the referral message, the Report template ID OBX must be included when atomic data is to be provided and it must specify the unique root sub id in OBX-4 subID. eg sub id "1" 

HL7au:00102.2.1 (r2)

SendersReferralsFor the "Referral Summary" OBR/OBX group (indicated by the OBR-4 code as per section 4.4.1.4.1 OBR-4 codes in referral messages) in the referral message, atomic data must be sent in OBXs with their appropriate OBX-2 value as specified the method specified in Appendix 9 HL7v2 Virtual Medical Record 

HL7au:00102.2.2 (r2)

SendersReferralsFor the "Referral Summary" OBR/OBX group (indicated by the OBR-4 code as per section 4.4.1.4.1 OBR-4 codes in referral messages) in the referral message, atomic data must be sent in OBXs with their appropriate OBX-3 value as specified the method specified in Appendix 9 HL7v2 Virtual Medical Record 

HL7au:00102.2.3 (r2)

SendersReferralsFor the "Referral Summary" OBR/OBX group (indicated by the OBR-4 code as per section 4.4.1.4.1 OBR-4 codes in referral messages) in the referral message, atomic data must be sent in OBXs with their appropriate OBX-4 subID value relative to the subID specified in the Report template ID OBX as specified the method specified in Appendix 9 HL7v2 Virtual Medical Record 

HL7au:00103.3 (r2)

SendersReferrals

For the current "Referral Summary" OBR/OBX group (indicated by the OBR-4 code as per section 4.4.1.4.1 OBR-4 codes in referral messages) in the referral message, the display segment must reflect content from taht OBR/OBX group as well as the Allergies, and Medication segments of the REF message. 

 

HL7au:00104.1.1

SendersReferralsThere must be exactly one PRD with a PRD-1 value of "AP" (Authoring Provider) in the REF message. 
HL7au:00104.1.1
ReceiversReferralsThe receiving system must identify the authoring provider in its display of the message content (indicated by "AP" in the associated PRD-1). 
HL7au:00104.2.1
SendersReferralsThere must be exactly one PRD with a PRD-1 value of "IR" (Intended Recipient) in the REF message. 
HL7au:00104.2.2
ReceiversReferralsThe receiving system must present the referral message to intended recipient indicated by PRD-1 value of "IR". 

HL7au:00104.7.0 (r2)

SendersReferralsPRD-7 must have at least 1 repeat (for providers receiving electronic communication). 

HL7au:00104.7.1.2

SendersReferralsPRD-7 <ID number (ST)> must be valued with a location or organisationally scoped identifier (for providers receiving electronic communication). 

HL7au:00104.7.1.3 (r2)

SendersReferralsPRD-7 <ID number (ST)> must not contain an HPI-I value (for providers receiving electronic communication).HPI-I values must be qualified by the HPI-O. See NPIO in HL7 Table 0203 - Identifier Type.

HL7au:00104.7.1.4

SendersReferrals

For a PRD-7 <ID number (ST)> the correct matching <type of ID number (IS)> and <other qualifying info (ST)> must be used as per table Table 7.3.3.7.1 - Valid PRD-7 component matches

 
HL7au:00104.7.2.1
SendersReferralsPRD-7 <type of ID number (IS)> must be valued from User-defined Table 0363 - Assigning Authority 
HL7au:00104.7.3.1
SendersReferrals<other qualifying info (ST)> must be a valued from HL7 Table 0203 - Identifier Type. 
     

HL7au:00110.1

Senders

Orders, Results, Referrals, Acknowledgment, Referral Response

Senders must populate the MSH-3 Sending application (HD) field components as per the values specified in the provider directory of their secure messaging system being used.The intent of this point is to enable a receiver the ability to lookup the sender in the directory, which will allow return messaging. This also applies to senders of acknowledgements.
HL7au:00110.2
SendersOrders, Results, Referrals, Acknowledgment, Referral ResponseSenders must populate the MSH-4 Sending facility (HD) field components as per the values specified in the provider directory of their secure messaging system being used.The intent of this point is to enable a receiver the ability to lookup the sender in the directory, which will allow return messaging. This also applies to senders of acknowledgements.
     

 


** note that regular browsers do not support this feature directly, xhtml preprocessing is required before display with browser

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29 Comments

  1. Point 9 says TX SHALL NOT be used in messages. This needs qualifying, since TX is cited for components of some datatypes, such as TQ (OBR-27)

    1. I've changed the text from:
      "The TX data type SHALL NOT be used in messages."
      to:
      "As an individual data type the TX data type SHALL NOT be used in messages, though it maybe be a component of another data type eg TQ"
      But is there a better example of  the TX data type being used as a component of another data type as HB 262-2012 says that of the TQ data type only components 4 Date and Time (TS) and 6 Priority (ST) are used.  The TX component is component 8 text and is not referenced as being used.
      Question: if there isn't a better example, should the conformance point revert back to "The TX data type SHALL NOT be used in messages."??

       

      1. Would the wording " 'TX' SHALL NOT be allowed as a value in the OBX-2 Value Type field" be suitable? This is effectively disallowed a value from table 0125. It also reflects what a validator has to do to implement the rule.

        Is there any other place where TX shouldn't be used apart from here?

        1. OK - sounds good to me.
          Text changed from:

          "As an individual data type the TX data type SHALL NOT be used in messages, though it maybe be a component of another data type eg TQ"

          to:

          "Data type TX SHALL NOT be allowed as a value in the OBX-2 Value Type field."

  2. Conformance points should have a single rule, some of the above conformance points have multiple statements.

    1. Agree - but ask at the next meeting if the conformance points that are currently grouped be part of a sub-grouping number of separated out completely eg

      Instead of:

      "Conformance point 13:

      Message uniqueness:

      • The sending facility SHALL ensure their MSH-4 Sending facility identifier is unique .
      • When sending a message to multiple "copy to " doctors the MSH-10 Message control ID SHALL be unique.
      • When re-transmitting a report the MSH-10 Message control ID SHALL be unique.
      • When there are multiple OBR segments the OBR-3 Filler order number SHALL be unique within messages."

       

      Have:

      "HL7AusConformance-13 (or whatever the unique identifier is to be)

      Message uniqueness:

      • HL7AusConformance-13.1: The sending facility SHALL ensure their MSH-4 Sending facility identifier is unique .
      • HL7AusConformance-13.2: When sending a message to multiple "copy to " doctors the MSH-10 Message control ID SHALL be unique.
      • HL7AusConformance-13.3: When re-transmitting a report the MSH-10 Message control ID SHALL be unique.
      • HL7AusConformance-13.4: When there are multiple OBR segments the OBR-3 Filler order number SHALL be unique within messages.

      Note: HL7AusConformance-13 shall be passed when all HL7AusConformance-13.1 to HL7AusConformance-13.4 are passed."

      Or have a separate HL7AusConformance-xx for each item??

      1. email correspondence between Jared and D Mc.

        Re:  Creating unique identifiers for the conformance points.

         I’ve had a chat with Stephen Royce who is more knowledgeable on oids/uri’s etc than myself.

        We both agree that the current process of having “conformance point number 1” to “Conformance point number 17” with different content across AS 4700.2 and HB 262 is not appropriate.

        OIDs have been suggested as a means of identifying each conformance point, but an alternative would be URIs.  URIs have the advantage of being human-readable and can also be URLs with locatable content.  (OIDs are losing favour in the FHIR community for these reasons.)

         

        URIs can be allocated from http://ns.electronichealth.net.au  (managed by the Agency); alternatively URIs can be allocated by HL7 Australia from http://hl7.org.au. (Note however, that HL7 Australia are working towards setting up capacity to manage this, but it is lacking at the moment.)

        If OIDs are preferred, these too can be allocated by the Agency, but HL7 Australia do not have any capacity for doing so, nor for managing them going forward.

         

  3. Point 7 - suggest to define number of bytes eqivalent for 16 MB.

    1. Added "(16,777,216 bytes)" to the text.

  4. TX SHALL NOT - here's the conundrum. OBX-2 has the data type, which we assert SHAL NOT be TX. But the data in OBX-5 can 'conditionally repeat' - "May repeat for multipart, single answer results with appropriate data types, e.g., CX, TX and FT data types". Now lots of Path results are "multipart" results - typically multiple lines of text. And frequently, those lines are separated by the repeat delimiter (~). HOWEVER, TX is the only data type in which the repeat delimiter has this meaning - "Since TX data is intended for display purposes, the repeat delimiter, when used with a TX data field, implies a series of repeating lines to be displayed on a printer or terminal. Therefore, the repeat delimiters are regarded as paragraph terminators or hard carriage returns (e.g. would display as though a CR/LF were inserted in the text (DOS type system) or as though a LF were inserted in the text (UNIX style system))."

    No other data type supports this interpretation of the repeat delimiter. Anyone using the repeat delimiter in any other data type, and thinking that it implies this behaviour, is misinterpreting the HL7 standard. Banning TX, and requiring conformance to the HL7 standard, may mean a massive re-write for many Pathology vendors.

    1. This is not the case Russell, FT fields can be multiline and thats the way most pathology is done in the wild. Yes TX can become multiline with the repeat delimiter but that gives you 2 ways to do something and getting people to do it correctly one way is hard enough. Its been using FT for years with multiline text

      Andrew McIntyre

    2. Andrew, you are repeating the mistakes of the past. We are no longer 'trying to get people to do it'. We are trying to get international implementations like Cerner and Epic into Australia, and make it possible for them to adapt to Australian requirements. We shouldn't be trying to get them to adapt to Australian idiosyncratic rules, based upon the superstitions of the past that "it's all too hard". Time to grow up. Time to accept that we are a minor flavor in international waters. And that the minimal change possible is the best way forward. We should only be stipulating constraints where it is absolutely essential to do so in order to meet mandatory Australian requirements. 

  5. The original banning of TX was a mistake that we should correct, not perpetuate.

  6. The conformance point for requirement for valid CSS has been lost from what was HB262/CP11. Could we please add a new separate point to address this? Perhaps we should say something about the CSS version (the validator currently supports the following profiles: css1, css2, css21 (default), css3, svg, svgbasic, svgtiny, atsc-tv, mobile, tv)

    1. I've got some advice about the version of CSS. Apparently browser support for css features is fairly optional. Eg css21 features may not be implemented in some browsers, and similarly in css3. 

      The advice I have so far it is thought that eariler css features aren't removed from later versions in general.

      So on the advice I have so far it seems that the spec should specify that the CSS should be compliant to css3, and this can be validated. The point should be made that message producers should test the CSS features to be used on the browsers likely to be used in practice. The css validator doesn't check browser compatibility. 

      Another conformance sub point in regards to CSS could be that CSS must be embedded in the XHTML rather than referenced to an external source (which could disappear/change or be unavailable at the time of viewing).

       

    2. Not that CSS versions are in my space, but I asked another guy who knows about it and he suggested that unless you wanted to restrict the CSS versions being used ie exclude the older css1 and css2 versions, then there didn't seem a lot of point having this conformance.  

      Other people in the Agency who are in the know agree that making css3 compliant is a good thing as the earlier versions ie css1 & css2 are still valid css3.

      Hence, css3 is worthwhile as there is little risk with all recent versions of major browsers eg Friefox, chrome etc are almost all 100% css3 compliant.

      Apparently, version of IE older than IE9 are a problem.

  7. Conformance sub point request regarding XHTML. "All embedded hyperlinks must be secure hyperlinks ie. https:// . That is http:// is disallowed". The point is to ensure that confidential information cannot be leaked unintentionally. eg. Sometimes access keys into URLs, patient identifying information, and https secures the path portion of the url.

    There is a table in HB262-2012 page 142 which says what the sender must not do. Could we please make these all conformance points.

    1. I've added the CP about hyperlinks being https:// and the items listed in the table on page 142 of HB 262-2012 to the CP item 6 above. Some items may need clarification ie to me there doesn't seem to be enough detail on what is required or not.

  8. There is a contradiction between conformance point "In the ORU message the field OBX-3 "Observation identifier" should have values from the LOINC coding system." and the requirement to have at least one display segment which uses AUSPDI as coding system.

    Perhaps alternate wording would be ""In the ORU message the field OBX-3 "Observation identifier" should have values from the LOINC coding system, except for display segments". I suggest grouping these two conformance points as they both relate to OBX-3 and there is a choice between the rules.

    That means we need to define the coding system for a display segment as another conformance point. "Display segments must use the appropriate valid values within the AUSPDI coding system in OBX-3 for the content that is represented in it". Then we need to define the valid values of the AUSPDI coding system (HTML, PDF, RTF , TXT , PIT (deprecated)). It is important to validate this as mistakes here can lead to adverse display output.

     

    By the way, I'm not sure why the restriction to ORU in, does this document define any other messages that contain OBX? if not i suggest dropping that part a it unnecessarily restricts its application. These segments should be able to be reused in other messages although this document doesn't prescribe how.

    1. 1) As per Jared's suggestion added " except for display segments" to CP 16 above.

      2) Added a new conformance point regarding display segments with appropriate AUSPDI content - will need to be checked.

  9. With respect to display formats, I think we should state that they must conform to applicable standards for the AUSPDI code used. Also we could make recommendation on which versions of these standards should be used. (each of these could be a subconformance point)

    PDF   - PDF/A-3 ISO 19005-3 may be relevant as it "prohibiting features ill-suited to long-term archiving, such as font linking (as opposed to font embedding) and encryption". Missing fonts is a common cause for PDF display issues. https://en.wikipedia.org/wiki/PDF/A

    RTF, https://www.microsoft.com/en-us/download/details.aspx?id=10725

    PIT although deprecated reference the specification

    TXT - define what this is. ie HL7 FT datatype, and content should conform.

    1. Should this specific content be added to the newly created AUSPDI content CP above?  If so, what text wouild you like added?

      1. Yes as sub conformance points that would be fine.

  10. With RTF, display format it would be useful to make support for the "bin" control word mandatory for receivers.

    To quote the RTF 1.9.1 spec page 209: "the reader must explicitly check each control word found to see if it is a \binN control, and if found, skip that many bytes before resuming its scanning for braces."

    This should be a conformance point for receivers processing RTF display segments.

    A conformance point for senders could be recommendation to avoid using the (\binN #BDATA) syntax and instead use #SDATA (Hexadecimal data) syntax.

    See formal definition of <data> on page 148.

    <data>

    (\binN #BDATA) | #SDATA

    1. Jared, once you get editing rights, I'm happy for you to add this further information to the CP.

  11. Conformance points should identify whether they apply to Senders, Receivers or Both

    1. Some are indicated, but agree that it could be better across all CP's.  Query develop some metadata for each CP that indicates sender, receiver or both??

      1. I think a letter or something that might work.

        S = Sender

        R = Receiver

        SR = Sender and Receiver

        eg.

        1.2.3 (SR)

        1.3 (R)

        1.4 (S)