Conversion from document to HL7 with results ranges in multiple date format

Question

Question

Minn Bo Bo · Jul 27, 2023

#FHIR #HL7 #InterSystems IRIS for Health

I have been successfully able to transform hand-written medical test results documents to HL7 ORU_R01 v2.x, then to SDA, which will be trasformed to FHIR or C-CDA.

However, I have a category of documents which contains reference range in multiple date formats, which are measured for each gestation period.
For example, below is one of the documents.

Analyte: HCG, Value: 1968, Unit: mlU/mL

Reference Range:
Week of gestation: 3, Range: 5.8-71.2
Week of gestation: 4, Range: 9.5-750
Week of gestation: 5, Range: 217-7138
Week of gestation: 6, Range: 158-31795

How do I put the reference ranges into OBX segment, or is there any other possible method to include such multiple reference into HL7 ORU_R01 for each test result?

Any input of idea or reference would be very helpful. Thank you.

Product version: IRIS 2022.1

$ZV: IRIS for Windows (x86-64) 2022.1 (Build 209U) Tue May 31 2022 12:16:40 EDT

Discussion (4)3

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score 0 · Answer 1 · 2023-07-27T07:19:48-04:00

Do you mean how to write the range in the OBX segment? I've this example of a range:

OBX|13|NM|MO^# Monocitos^SNM||0.00|#|0.2-0.9||||F|||20230330133551

score 0 · Answer 2 · 2023-07-30T11:25:16-04:00

I have knowledge on writing a single reference range in the OBX segment. However, in the above sample, there are multiple reference ranges, changing with time. Is it possible to add multiple reference ranges in a single OBX, or is there any way to add them in any other format in a HL7 file?

Thank you very much for your consideration.

score 0 · Answer 3 · 2023-07-30T22:29:53-04:00

I would expect such narrative/descriptive information to be included with the result in associated NTE (note) segments, since the reference range field is non-repeating text, maximum 60 characters in length (through HL7 2.6). The Reference Range field itself may have a directive to see the ranges in the NTE segment(s).

score 0 · Answer 4 · 2023-07-31T01:47:27-04:00

Jeffrey is totally right, you can't add multiple ranges in an OBX segment, the idea of that field is just to add the valid range for the observation, you can see that there is another field in that segment (OBX:12 - Efective date of Reference Range) in wich you can define the date when the range start to be valid.

Another option to the NTE segment is to repeat the OBX segment with the same value of the observation so many times as range values you have, informing the OBX:12 with a different date and the valid range for that date.