MDM^T02 signals that a clinical document has been created and authenticated. The message carries both notification metadata (TXA) and the document content itself (OBX).
What is MDM^T02?
MDM = Medical Document Management. T02 = Original Document Notification and Content. The TXA segment carries document type, author, authentication status (TXA-17), and document ID. OBX carries the document text or a reference pointer to an external file.
- Document authenticated by physician (TXA-17 = AU)
- Transcription complete
- Radiology report finalized
- Discharge summary signed
- Pathology report released
Message Flow
HIM/EHR/Transcription→
MDM^T02→
Integration Engine→
EHR Document RepositoryExternal HIEPatient PortalBilling
Segments in this Message
Cardinality: [X] optional · {X} repeating · [{X}] optional & repeating
| Segment | Name | Required | Description |
|---|---|---|---|
MSH | Message Header | Required | MSH-9 = MDM^T02^MDM_T02. |
EVN | Event Type | Required | EVN-1 = T02. EVN-2 = authentication timestamp. |
PID | Patient Identification | Required | Links document to patient record. |
PV1 | Patient Visit | Required | Visit context — links document to specific encounter. |
TXA | Transcription Document Header | Required | TXA-2=document type (DS=Discharge Summary, RR=Radiology), TXA-12=document ID, TXA-17=status (AU=Authenticated), TXA-19=availability (AV=Available). |
OBX | Document Content | Required | OBX-2=TX (text) or RP (reference pointer), OBX-3=LOINC document type, OBX-5=document text, OBX-11=F (final). |
HL7 Message Example
MSH|^~&|DICTATION|MERCY|EHR|MERCY|20240116171530||MDM^T02^MDM_T02|MSG20240116007|P|2.5.1
EVN|T02|20240116171530
PID|1||MRN-78234^^^MERCY^MR||SMITH^JOHN^ROBERT^^MR||19800315|M
PV1|1|I|MICU^2B^01^MERCY||||1234^JONES^DAVID^R^^DR
TXA|1|DS^Discharge Summary^HL70270|TEXT|20240116170000|1234^JONES^DAVID^R^^DR||20240116171500|||||DS-MERCY-20240116-001||AU^Authenticated^HL70271||AV^Available^HL70272
OBX|1|TX|11506-3^Discharge summarization note^LN||Patient discharged home in stable condition following treatment for hypertensive urgency. Lisinopril 10mg daily prescribed.||||||F|||20240116171500FHIR Mapping
| Segment | FHIR | Notes |
|---|---|---|
| TXA | DocumentReference | Official IG: ConceptMap-message-MDM_T02-to-bundle.json |
| TXA-2 type | DocumentReference.type | HL70270 → LOINC document codes |
| TXA-17 status | DocumentReference.docStatus | AU→final |
| OBX-5 content | DocumentReference.content.attachment | contentType: text/plain |
Common Errors & Pitfalls
- TXA-17 not AU — documents without authentication status AV may be rejected by repositories.
- OBX-11 not F — document content must have status F for authenticated documents.
- Large documents exceed MLLP frame limit — use OBX-2=RP with a URL for large documents.
- No document ID in TXA-12 — without a unique ID, duplicate detection is impossible.
Vorro Integration Tip
Vorro buffers large MDM^T02 documents and streams using chunked delivery to avoid MLLP overflow. Configure document type routing to send DS (Discharge Summary) to the clinical repository and RR (Radiology Report) to the PACS separately.
