^O19
OMG^O19 — General Clinical Order
OMG^O19 is the IHE-recommended replacement for ORM^O01 for general clinical orders including radiology and other ancillary services. It provides a structured message framework aligned with IHE Scheduled Workflow (SWF) and is the preferred order message in new PACS/RIS integration deployments.
When Is This Sent?
When a clinician places a general clinical order (radiology, cardiology, other diagnostics) via CPOE or the EHR. Used in IHE SWF-compliant environments as the order message from the Order Filler to the Order Placer.
Real-World Usage
OMG^O19 is increasingly adopted in modern radiology interfaces alongside IHE SWF. It is more explicit than ORM^O01 in separating order management concerns. However, many legacy PACS and RIS systems still only accept ORM^O01 — always verify the receiving system's support before deploying OMG^O19. ORM^O01 remains far more common in installed base deployments.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with OMG^O19 in MSH.9 | R | — |
| 2 | PID | Patient demographics | R | — |
| 3 | ORC | Order common segment with order control and placer/filler order numbers | R | — |
| 4 | OBR | Observation request with procedure code and ordering provider | R | — |
| 5 | PV1 | Patient visit context | O | — |
| 6 | DG1 | Clinical indication | O | Yes |
| 7 | NTE | Order notes | O | Yes |
| 8 | OBX | Pre-existing relevant observations | O | Yes |
| 9 | SPM | Specimen details (when order involves specimen collection) | O | Yes |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|EPIC|HOSPITAL_A|RIS|HOSPITAL_A|20260310143205||OMG^O19^OMG_O19|OMG00001|P|2.5.1 2PID||1||123456^^^HOSP_A^MR||Smith^John^M^^Mr.||19850315|M 3PV1||1|I|4A^201^1^^^HOSP_A||||1234^Ahmed^Dr.^Khalid 4ORC||NW|ORD20260310002^EPIC|ACC20260310002^RIS||SC||||20260310143205|1234^Ahmed^Dr.^Khalid 5OBR||1|ORD20260310002^EPIC|ACC20260310002^RIS|71046^Chest 2 Views^CPT4|||20260310143205|||||||||1234^Ahmed^Dr.^Khalid
Troubleshooting Scenarios
RIS rejects OMG^O19 with 'unsupported message type' error
Cause
The RIS is configured to accept ORM^O01 only and has not been upgraded to support OMG^O19.
Fix
Check with the RIS vendor whether OMG^O19 is supported in the current version. If not, use ORM^O01 as an interim solution. Some interface engines can translate OMG^O19 to ORM^O01 transparently.
Order status updates not flowing back after initial OMG^O19
Cause
OMG^O19 workflows expect OML^O21 or ORU acknowledgment patterns — the status feedback loop differs from ORM^O01.
Fix
Confirm the complete IHE SWF message flow with both system vendors: OMG^O19 (order) → OML^O21 or ORL^O22 (order response) → ORU^R01 (results). Ensure each step is configured end-to-end.
Common Confusions
OMG^O19 (general clinical order) vs ORM^O01 (legacy general order). OMG^O19 is IHE SWF-aligned and preferred for new deployments; ORM^O01 is the de facto standard in legacy environments. Also: OMG^O19 vs OML^O21 — use OML^O21 when a physical specimen is required (lab); use OMG^O19 for imaging and non-specimen orders.
Related Message Types
Segment Reference
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