MDM^T02 — Original Document Notification and Content

The message that carries a clinical document — radiology report, discharge letter, PDF — together with its metadata. Text/document counterpart of ORU^R01, which carries structured results.

Purpose

T02 notifies that a new document has been created and conveys its content (vs T01 which notifies without content). The document can be:

• a radiology or pathology report in structured text;
• a discharge letter;
• a base64-encoded PDF (OBX-5 in type ED);
• a base64-encoded CDA document.

The receiver stores the document, indexes it in its electronic archive (DMS / ECM), and makes it available in the patient chart on the next view.

MDM events (T01-T11)

Segment structure

MDM_T02
  MSH                              Message Header (mandatory)
  [ SFT ]                          Software Segment (optional)
  EVN                              Event Type (mandatory)
  PID                              Patient Identification (mandatory)
  [ PV1 ]                          Patient Visit
  TXA                              Transcription Document Header (mandatory)
  [ { OBX } ]                      Observation/Result (document content)

MSH

MSH-9 = MDM^T02^MDM_T02. The rest is analogous to ADT^A01.

EVN

EVN-1 = T02, EVN-2 = transcription timestamp, EVN-5 = transcriber.

PID

Same as in other messages — see ADT^A01.

TXA — Transcription Document Header

• TXA-1: Set ID within the message.
• TXA-2: Document Type — table 0270 (DI=Discharge Summary, RAD=Radiology Report, OP=Operative Note, LET=Letter, CN=Consultation Note…).
• TXA-3: Document Content Presentation — TX, FT, HTML, PDF, RTF.
• TXA-4: Activity Date/Time — clinical act timestamp.
• TXA-5: Primary Activity Provider Code/Name (XCN repeating) — clinician who originated the document.
• TXA-6: Origination Date/Time — creation.
• TXA-7: Transcription Date/Time — entry/transcription.
• TXA-8: Edit Date/Time.
• TXA-12: Unique Document Number — durable identifier.
• TXA-17: Document Completion Status — table 0271 (AU=Authenticated, DI=Dictated, DO=Documented, IN=Incomplete, IP=In Progress, PA=Pre-authenticated…).
• TXA-18: Document Confidentiality Status (table 0272).
• TXA-19: Document Availability Status — table 0273 (AV=Available, CA=Cancelled, OB=Obsolete, UN=Unavailable).

OBX — Document content

The textual content is carried by one or more OBX segments of type TX (short paragraphs) or FT (formatted text). For a PDF, use a single OBX of type ED (Encapsulated Data) with the binary base64-encoded.

Real-world example

Thoracic CT report for John Doe, dictated by Dr Brown, radiologist, Final status, text presentation.

MSH|^~\&|RIS|HOSP01|EHR|CLINIC02|20260514150000||MDM^T02^MDM_T02|MDM00000001|P|2.5.1|||AL|NE
EVN|T02|20260514150000|||DRJONES^Jones^Sarah^^^DR.
PID|1||MRN567890^^^HOSP^MR||DOE^JOHN^A^^MR.||19720515|M|||100 MAIN ST^^ANYTOWN^CA^90210^USA
PV1|1|I|ICU^101^A^HOSP01||||DRSMITH^Smith^James^A^^DR.|||CAR
TXA|1|RAD^Radiology Report^L|TX|20260514145500|DRBROWN^Brown^Linda^^^DR.|20260514145500|20260514145500|20260514150000|DRBROWN^Brown^Linda^^^DR.|DRBROWN^Brown^Linda^^^DR.|RAD20260514001||1|||DOC20260514001|AV|F
OBX|1|TX|||Indication: acute chest pain.||||||F
OBX|2|TX|||Technique: contrast-enhanced thoracic CT.||||||F
OBX|3|TX|||Findings: no pulmonary embolism detected. No parenchymal abnormality. Heart of normal size.||||||F
OBX|4|TX|||Conclusion: normal examination. No evidence of pulmonary embolism.||||||F

• TXA — type RAD, presentation TX, identifier DOC20260514001, status AV (Available), completion F (Final).
• OBX 1-4 — four structured text paragraphs (Indication, Technique, Findings, Conclusion).

Common errors

• Unstable TXA-12: the unique document identifier must remain stable across the full lifecycle (T02 → T07 → T09). Changing it across versions breaks DMS traceability.
• Inconsistent TXA-17 / TXA-19: a document flagged OB (Obsolete) in TXA-19 but F (Final) in TXA-17 is ambiguous. Convention: TXA-19 takes precedence for UI display.
• Non-base64 PDF: OBX-5 in ED type expects strictly base64 (RFC 4648). Mid-string CR/LF are tolerated by some parsers but not by strict HAPI.
• Unescaped reserved characters: |, ^, ~ in clinical text must be escaped (\F\, \S\, \R\). Curly apostrophes (’) can break an ISO-8859-1 parser.
• Missing PV1 when document is encounter-bound: prevents automatic linking to the encounter file in the EHR.

Related messages

• ORU^R01 — structured result (lab, vitals).
• ORM^O01 — prescription / order.
• ADT^A01 — patient admission.
• FHIR R5 — DocumentReference is the native equivalent (with embedded content or pointer to Binary).