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How should an OBX following a TXA in an MDM-T02 be interpreted?

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  • How should an OBX following a TXA in an MDM-T02 be interpreted?

    I'm doing some work to parse out an MDM message so that it can be persisted and presented to an end-user.

    I'm seeing examples in the HL7 specification that look like this:
    TXA|0001|HP^history &physical|TX^text|19960213213000|...
    OBX|1|CE|2000.40^CHIEF COMPLAINT|| ...
    OBX|2|ST|2000.01^SOURCE||PATIENT
    OBX|3|TX|2000.02^PRESENT ILLNESS||SUDDEN ONSET OF CHEST PAIN. 2 DAYS, PTA ASSOCIATED WITH NAUSEA, VOMITING & SOB. NO RELIEF WITH ANTACIDS OR NTG. NO OTHER SX. NOT PREVIOUSLY ILL

    The crude approach would be to treat the OBX's following the TXA as a plain text document and parse out the OBX segment as lines of text and treat each field as a separate block of text:

    2000.40^CHIEF COMPLAINT:
    2000.01^SOURCE: PATIENT
    2000.02^PRESENT ILLNESS: SUDDEN ONSET OF CHEST PAIN. 2 DAYS PTA ASSOCIATED WITH NAUSEA, VOMITING & SOB. NO RELIEF WITH ANTACIDS

    This will get the information in front of my user. However I'm not sure that its the appropriate or ideal way to interpret an OBX for a transcription.

    Can anyone suggest a more elegant way to handle this? Better still, can anyone cite an official specification that tells me how to interpret an OBX segment as part of a transcription?
    Jon Bartels

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  • #2
    Really there's no "right" answer here. It all depends on what the source system spits out at you. Some EMRs generate T02s that have a single OBX followed by several NTEs that contain the actual message. Others use a single OBX for each line of a report. Still others don't even generate MDMs, but instead use ORU^R03s. Once you've seen one HL7 message... you've only seen one HL7 message.
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    Nicholas Rupley
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