OUL^R21 — Unsolicited Laboratory Observation

Lab result pushed without a prior explicit ORM^O01 order from the client system. Typical for POC devices or QC results emitted spontaneously by the LIS.

Purpose

OUL^R21 carries a lab result emitted by the LIS without any preceding EHR order. Common cases: continuous OR monitoring, ward capillary glucose, mass screening, internal QC. The message carries the specimen (SPM), the container (SAC) and the results (OBR/OBX).

Segment structure

Structure OUL_R21: MSH, [SFT], NTE, [PID, [PD1], [NK1], [NTE], [PV1, [PV2]]], SPM, [SAC], OBR, OBX, NTE.

Real-world example

Fasting glucose measured then pushed by the LIS without a request:

MSH|^~\&|LIS|LAB01|EHR|HOSP02|20260518093000||OUL^R21^OUL_R21|MSG00R21001|P|2.5.1|||AL|NE
PID|1||MR700123^^^HOSP^MR||LAURENT^CAMILLE^^^MS.||19840714|F
PV1|1|O|EXT^^^HOSP02|||||DR_ROUSSEL^Roussel^Henri
SPM|1|SPECNO99887^LAB01||BLDV^Venous Blood^HL70487|||||||||||||20260518083000
SAC|||CTR778899|||||||TUBE-EDTA-4ML
OBR|1||LAB778899|GLUFAST^Fasting Glucose^L|||20260518083000|||||||||DR_ROUSSEL^Roussel^Henri||||||20260518090000||CH|F
OBX|1|NM|2345-7^Glucose [Mass/volume] in Serum or Plasma^LN||1.08|g/L|0.70-1.10|N|||F|||20260518090000

Acknowledgment (ACK)

MSH|^~\&|EHR|HOSP02|LIS|LAB01|20260518093002||ACK^R21^ACK|ACKR21001|P|2.5.1
MSA|AA|MSG00R21001

Common errors

• Confusion with ORU^R01: ORU answers an order, OUL is unsolicited.
• Missing SPM-4: the specimen code is required for EHR correlation.
• OBX-11 not Final: P (preliminary) without a later F (final) pollutes the chart.
• Missing SAC date/time: makes container traceability impossible.

Related messages

• ORU^R01 — solicited result.
• ORU^R30 — point-of-care.
• ORM^O01 — order request.