ORU^R32 — Unsolicited Point-of-Care Observation

Spontaneous transmission of observations from point-of-care testing (POCT) equipment: bedside glucometer, portable arterial gas analyzer, HbA1c reader, bedside INR/PT meter. No prior query — the device pushes directly.

Purpose

R32 solves a common connectivity problem in ICU and intensive care: POCT devices (Accu-Chek Inform glucometer, RAPIDPoint gas analyzer, etc.) push their measurements to a middleware (POCT01-A for example) that transcodes to HL7 ORU^R32 to the EHR. No prior query — the measurement is triggered bedside, the push follows.

Segment structure

Structure ORU_R32: MSH, [SFT], { PID, [PV1], { ORC, OBR, {OBX} } }.

• ORC-1 — Order Control Code: RE (Observations to follow).
• OBR-4 — Universal Service Identifier: local or LOINC code.
• OBR-25 — Result Status: F (Final), P (Preliminary), C (Correction).
• OBX-3 — Observation Identifier: LOINC mandatory in US (Meaningful Use).
• OBX-18 — Equipment Instance Identifier: POCT device serial number (traceability, calibration).

Real-world example

Capillary glucose 126 mg/dL measured in ICU on Accu-Chek Inform II:

MSH|^~\&|GLUCOMTR_POCT|ICU01|EHR|HOSP_CTR|20260519161200||ORU^R32^ORU_R32|ORUR32001|P|2.5.1|||AL|NE
PID|1||MR400506^^^HOSP^MR||MOREAU^LUC^^^MR.||19410307|M
PV1|1|I|ICU^ICU01-12^03|||||DR_HENRI^Henri^Paul|||ICU
ORC|RE|POCT-2026-77123|POCT-2026-77123|||||20260519161000|||DR_HENRI^Henri^Paul
OBR|1|POCT-2026-77123||GLUC_POCT^Glucose POC^L|R|20260519161000|20260519161200|||||||||DR_HENRI^Henri^Paul||||||20260519161200|||F
OBX|1|NM|2339-0^Glucose [Mass/volume] in Blood^LN||126|mg/dL|70-110|H|||F|||20260519161200|||ACCUCHEK_INFORM_II^Roche^L
OBX|2|ST|81229-1^Sample type^LN||CAPILLARY||||||F|||20260519161200

R30 vs R31 vs R32 — when to use what

• R30 — Unsolicited Point-of-Care Observation Message without existing order. Standalone case (officinal glucometer).
• R31 — Unsolicited New Point-of-Care Observation Message creating a new order on the receiving system.
• R32 — Unsolicited POC Observation tied to existing order (ORC-3 references a placer/filler from the HIS).

Common errors

• OBX-18 missing: no device serial number — impossible to trace in case of vendor recall or calibration failure.
• OBR-25 = F without biologist validation: in France, a POCT must stay P until a biologist validates (LBM).
• PID-3 non-MRN: some POCT scan a poorly mapped bracelet barcode — verify the MRN qualifier.
• OBX-3 without LOINC: blocks cross-facility semantics (DMP, INS).

ORU family (Observation Reporting)

See also: ORU^R01, ORU^R30, ORU^R31.