The HL7 OBR segment transmits information about an exam, diagnostic study/observation, or assessment that is specific to an order or result. It is used most frequently in ORM (Order) and ORU (Observation Result) messages, and has an important role in carrying the placer and filler order numbers.
An OBR segment should always be included in orders where a request is made for a given set of observations. For lab tests and diagnostic studies, each OBR segment generally applies to a single specimen or diagnostic study only. With lab testing, there may not necessarily be a 1:1 relationship between test and specimen (i.e different test batteries may have multiple OBR segments even though it is a single specimen). ORU (Observation Result) messages should contain the OBR segment followed by the OBX segment for each observation.
In an ORM message, the OBR segment is part of an optional group that provides details about the order. When the order placer creates the ORM message, they will include the Placer Order Number in the OBR-2 and/or ORC-2 fields. These two fields should contain the same information, and at least one of the two must contain the placer order number. The message may contain multiple orders for which the rules still apply.
The OBR segment (show in red) from an ORM message is shown below:
OBR|1|2156286||MRSHLR-C^MR Shoulder right wo/contrast|||||||||R/O RCT VS TENDONITIS|||TBU^BUTLER JR
* Note that the Placer Order Number in the OBR-2 matches the Placer Order Number in the ORC-2.
Usage in the ORU Message
In an ORU message, the OBR segment is used as a report header and contains important information about the order being fulfilled (i.e. order number, request date/time, observation date/time, ordering provider, etc.). It is part of a group that can be used more than once for each observation result that is reported in the message.
When the filler creates the ORU message, they will include the Filler Order Number (such as an accession number) in the OBR-3 and/or ORC-3 fields. If the filler order number is not present in the ORC-3, it must be present in the OBR-3 because the ORC segment is optional in the ORU message.
The OBR segment (shown in red) from an ORU message is shown below:
OBR|1|2156286|A140875|MRSHLR-C^MR Shoulder right wo/contrast||| 20060220141000|||||…
* Note that the Filler Order Number in the OBR-3 matches the Filler Order Number in the ORC-3, and that the Placer Order Number is also included in the OBR-2 and ORC-2 fields. This is typically the case for ORU messages.