OBX contains a field
004 Observation Sub ID
Which is used to enumerate multiple OBX records when they
1) pertain to the same LOINC code, for example when there are
multiple pathologists' comments:
ORC|RE||03000032-PATHC-0|||||||||12345^DR_SURN^DR_FIRST^
OBR|5||03000032-PATHC-0|PATHC^Pathologist
Comments|R|20030827091101|20070827091101|||||||20070827091101||
12345^DR_SURN^DR_FIRST^||||||20070901105929|||F||^^^^^R|
87878^DOE^JANE~12345^DR_SURN^DR_FIRST^
OBX|1|TX|X10011^Pathologist Comments|1|Result 1||||||F|||20070901105402
OBX|2|TX|X10011^Pathologist Comments|2|Result 2||||||F|||20070901105402
OBX|3|TX|X10011^Pathologist Comments|3|Result 3||||||F|||20070901105402
2) describe Microbiology results that describe sites, potentially
multiple organisms, and their antibiotic susceptibilities (see also
HL7 V2.3 Section 7.4.5):
Here is one format and example in which reported first are all the
Culture results; the Observation Sub-ID contains the id of the
culture (i.e. 1, 2, 3 etc); after this, the Organism is reported,
followed by all the antibiotics, in the order of the culture result:
OBR|1||02-123456-URC-0^bcb|URC^URINE CULTURE^L||200011081429|
200011081429|||||||200011081429||TTTT2^TEST^BLAIR^^^^^L||||||
200011300944|MICRO|LAB_ORG
|F||^^^200011081429|||||||204
OBX|1|FT|19803-6^SITE^L||Urine|||N|||F|||200011081430|EDM|204
OBX|2|FT|6463-4^Culture^L|1|Light growth of: Klebsiella sp.|||N|||F|||
200011081434
OBX|3|FT|28-1^Ampicillin^L|1|R|||N|||F|||200011081434
OBX|4|FT|149-5^Cephalexin^L|1|R|||N|||F|||200011081434
OBX|5|FT|267-5^Gentamicin^L|1|S|||N|||F|||200011081434
OBX|6|FT|7057-3^TMP/SMX^L|1|S|||N|||F|||200011081434
OBX|7|FT|363-2^Nitrofurantoin^L|1|S|||N|||F|||200011081434
OBX|8|FT|6463-4^Culture^L|2|Light growth of: Staphylococcus aureus|||
N|||F|||200011081434
OBX|9|FT|6932-8^Penicillin^L|2|R|||N|||F|||200011081434
OBX|10|FT|197-4^Cloxacillin^L|2|R|||N|||F|||200011081434
OBX|11|FT|233-7^Erythromycin^L|2|S|||N|||F|||200011081434
OBX|12|FT|7057-3^TMP/SMX^L|2|S|||N|||F|||200011081434
OBX|13|FT|193-3^Clindamycin^L|2|R|||N|||F|||200011081434
OBX|14|FT|524-9^Vancomycin^L|2|R|||N|||F|||200011081434
OBX|15|FT|Ms.OX2^Cloxacillin^L|2|R|||N|||F|||200011081434
OBX|16|FT|28-1^Ampicillin^L|2|S|||N|||F|||200011081434
OBX|17|FT|149-5^Cephalexin^L|2|S|||N|||F|||200011081434
OBX|18|FT|20-8^Amoxicillin/clavulanate^L|2|S|||N|||F|||200011081434
The above would carry little meaning as individual items in a GNUmed
test_result table... They seem to need to be linked to the test panel
from which they originated (in this case, Urine culture) so maybe we
need a foreign key to the test_profile as a nullable column in
test_results...
Do we see some value or need (or none) to the OBX sequence counter
(above, OBX|1 through OBX|18) and similarly any need to store the
'Observation SubID" which in this case associates the individual
species (Klebsiella sp versus Staphylococcus aureus) with their
specific antibiotic profile?
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