RDE^O11
RDE - Pharmacy/treatment encoded order
This message communicates the pharmacy or treatment application's encoding of the pharmacy/treatment order ,OMP, message. It may be sent as an unsolicited message to report on either a single order or multiple pharmacy/treatment orders for a patient.
The RDE/RRE message pair can also be used to communicate a refill authorization request; however, a specific trigger event has been assigned. See section 4A.3.13 "RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)." As a site-specific variant, the original order segments (RXO, RXRs, associated RXCs, and any NTEs) may be sent optionally (for comparison).
Message Types
Message Type
Trigger Structure
Event Flow
TriggerO11
SendRDE_O11
ReceiveNUL
Worked Examples
RDE - Pharmacy/Treatment Encoded Order Message (Event O11)
This message communicates the pharmacy or treatment application's encoding of the pharmacy/treatment order ,OMP, message. It may be sent as an unsolicited message to report on either a single order or multiple pharmacy/treatment orders for a patient.
The RDE/RRE message pair can also be used to communicate a refill authorization request; however, a specific trigger event has been assigned. See section 4A.3.13 "RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)." As a site-specific variant, the original order segments (RXO, RXRs, associated RXCs, and any NTEs) may be sent optionally (for comparison).
Message Structure: RDE_O11(RDE^O11^RDE_O11: Pharmacy/Treatment Encoded Order Message)
Note: The RXCs which follow the RXO may not be fully encoded, but those that follow the RXE must be fully encoded.
The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.
The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.
The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.
The NTE segment(s) following the RXV segment are intended to communicate notes and comments relative to the encoded order.
The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).
The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.
HL7 v2
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/.45NACL|1000|ML|...The second child:
HL7 v2
ORC|CH|123A2^SMS|||||1^C^^^^^^^^C&123A1&SMS&&&ES+0M|123|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/.45NACL|1000|ML|...The third child:
HL7 v2
ORC|CH|123B^SMS|||||1^C^^^^^^^^C&123A2&SMS&&&#ES+0M|123|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/.45NACL|1000|ML|...
RXC|A|KCL|20|MEQ|...Discussion points:
Placer Order Number - Three alternatives must be discussed for placer order number.
Each child could have its own placer order number.
Each child could have the order number of the parent plus some appended identifier (for examples, 123A or 123.A or 123.1 etc.) that labels each child or each unique combination of ingredients.
In addition to the appended identifier discussed in 'B' above, a further suffix could be attached to uniquely identify each repetition of a particular member of the sequence. The example (a cycle of bottles 'A' and 'B' in the sequence A-A-B) identified the order numbers of the children as 123A1, 123A2, and 123B, thereby enabling the quantity/timing to be completely unambiguous. This could be expressed many other ways, such as 123A.1 or 123.A.1 or 123.A#1 etc. HL7 does not specify a format for the expression of order number suffixes, nor does it specify a delimiter to use for such a purpose.
Sequence Condition Value - In this example, the first child contains an asterisk (*) as the first character of the Sequence Condition Value and the third (last) child contains a pound sign (#).
The asterisk and pound sign are important for designating the first and last bottles especially when children are sent in separate messages, although this example is not constructed that way.
Note that computing the duration of the bottle is dependent upon the presence of all of the following fields:
RXO-2-requested give amount-minimum
RXO-4-requested give units
RXC-3-component amount
RXC-4-component units
For cyclic IV orders, these fields are all required in order to determine how long each occurrence of a child will last.
While HL7 allows either sending the parent and children in one message or sending the parent and children in separate messages, it appears simpler and therefore recommended to have the parent and all children included in a single message. The example is constructed that way.
Example #2
D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL at 125mL/hr
(Other message data: placer order #124, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical)
This example is a variation on the first example where two different base solutions are used. In this example, the placer system deals with this as one order with two alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) and B (D5/LR + 20mEq KCl 1000mL @ 125mL/hr) in the cycle A-B. The principles discussed in Example #1 apply equally to this example.
The parent:
HL7 v2
ORC|NW|124^SMS|||||1^C^^200611280900^^R^^^^C|...
RXO|Cyclic IV|...The first child:
HL7 v2
ORC|CH|124A^SMS|||||1^C^^^^^^^^C&124B&SMS&&&*ES+0M|124|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5W|1000|ML|...
RXC|A|KCL|40|MEQ|...The second child:
HL7 v2
ORC|CH|124B^SMS|||||1^C^^^^^^^^C&124A&SMS&&&#ES+0M|124|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/LR|1000|ML|...
RXC|A|KCL|20|MEQ|...Example #3
D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Add 10mL of multi-vitamins to the one bag daily. Run in at a rate of 100mL/hr.
(Other message data: placer order #134, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical. Note that the encoding of the multi-vitamins statement in the above order, adding multi-vitamins to one IV bag each day, may vary by institution to put it into the first or last bottle of the day.)
This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and a RXO, although one is not completely elaborated in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. This order is complicated by the request to add one component into any one of the three repeating bottles, depending upon which of the bottles will occur first on any particular day. Further complicating this order is a rate of infusion (10 hours for a 1000mL bottle) which results in a fractional number of daily administrations. Most legacy systems have a great deal of trouble accommodating orders like this within their existing database structures; however there a few vendors who now are able to handle the situation. The placer system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B with a cyclical component (multi-vitamins).
The parent:
HL7 v2
ORC|NW|134^SMS|||||1^C^^200611280900^^R^^^^C|...
RXO|Cyclic IV|...The first child:
HL7 v2
ORC|CH|134A1^SMS|||||1^C^^^^^^^^C&134B&SMS&&&*ES+0M|134|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/.45NACL|1000|ML|...The second child:
HL7 v2
ORC|CH|134A2^SMS|||||1^C^^^^^^^^C&134A1&SMS&&&ES+0M|134|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/.45NACL|1000|ML|...The third child:
HL7 v2
ORC|CH|134B^SMS|||||1^C^^^^^^^^C&134A2&SMS&&&#ES+0M|134|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/.45NACL|1000|ML|...
RXC|A|KCL|20|MEQ|...The fourth child:
HL7 v2
ORC|CH|134X^SMS|||||1^Q1D^^^^^^^^|134|...
RXO|MULTIVITAMINS|10||ML|INJECTABLE|...Discussion points:
This method for accommodating the Multi-vitamins Daily scenario does not pretend to be the best or only way to express the message, but simply demonstrates adapting the current specification to a highly complex order without adding new components.
The Multi-vitamins component may be sent as a fourth child.
In this example, its ORC-7-quantity/timing includes an interval of "Q1D" (every 1 days).
Its order number consists of the placer's parent order number plus an appended identifier ('X' in the above example) that labels this child as a special case. This convention would need to be agreed upon by sending and receiving applications.
Example #4
D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL alternating with D5/0.45NaCl 1000mL. Infuse the D5W and D5/0.45 at 125mL/hr, and the D5/LR at 100mL/hr.
(Other message data: placer order #177, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical)
This example is another variation of Example 1 where the rate for each bottle is different, and this can be expressed within the RX segments of the children using current components. In this example, the placer system deals with this as one order with three alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) , B (D5/LR + 20mEq KCl 1000mL @ 100mL/hr) , and C (D5/0.45NaCl 1000mL @ 125mL/hr) in the cycle A-B-C. The principles discussed in Example #1 apply equally to this example.
The parent:
HL7 v2
ORC|NW|177^SMS|||||1^C^^200611280900^^R^^^^C|...
RXO|Cyclic IV|...The first child:
HL7 v2
ORC|CH|177A^SMS|||||1^C^^^^^^^^C&177C&SMS&&&*ES+0M|177|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5W|1000|ML|...
RXC|A|KCL|40|MEQ|...The second child:
HL7 v2
ORC|CH|177B^SMS|||||1^C^^^^^^^^C&177A&SMS&&&ES+0M|177|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/LR|1000|ML|...
RXC|A|KCL|20|MEQ|...The third child:
HL7 v2
ORC|CH|177C^SMS|||||1^C^^^^^^^^C&177B&SMS&&&#ES+0M|177|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|...
RXC|B|D5/0.45NACL|1000|ML|...