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Figured it out.

I basically used this ER7 sample message to create a patient along with a Modality Worklist in my DCM4CHEE:

MSH|^~\&|HMIS|DUHS|PACS||20181016115248||OMI^O23^OMI_O23|20181016115248|P|2.5.1||||||UNICODE UTF-8
PID|||18131495254749211102 71^^^FR&UNKNOWN&ISO^NH~DDS-30938^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO^PI||Isidor^Raphaël||19281231201400|M|||
ORC|NW|12028^IHE_OM_OP^1.3.6.1.4.1.12559.11.1.2.2.4.2^ISO|12841^IHE_OM_OF^1.3.6.1.4.1.12559.11.1.2.2.4.3^ISO||SC||||||||||||
OBR|1|12028^IHE_OM_OP^1.3.6.1.4.1.12559.11.1.2.2.4.2^ISO||MAWF0017^Breast Specimen Mammography, left^99IHE^9MAWF0017^MG: Breast specimen, left^99IHE|||||||||||||||OMRP1345|OMSPS1372||||CT||||||||||||||||||||MAWF0017^Brest Specimen Mammography, left^IHE99

The key was to use OMI^O23^OMI_O23 as the trigger event and providing Modality at OBR-24, and (for some reason) not leaving OBR-19 and OBR-20 empty.

I am not sure about your exact workflow and I do not know DCM4CHEE. I am answering in terms of HL7 only.

ORM (Order Entry) message is generally good candidate to process Orders. The Order is then converted to Modality Worklist Item. I do not know if this works with DCM4CHEE though.

Following is general template of ORM message O01 event:

MSH|^~\&|HIS_APP|HIS_FACILITY|PACS_APP|PACS_FACILITY|20130614131415||ORM^O01|MsgCtrlId_ORM|P|2.3
PID|1||PatientID||Patient Name||20000514|F||||||||||AdmID
PV1|1|OP||||||^Ref Phy||||||||||||50
ORC|NW|||||||||||^Req Phy|||||^Institution Name
OBR|1|ACC.NO.01||SPSID^SPSDesc|ROUTINE||||||||||RPDesc|||SSName|RPID|SPSLocation|SSAETitle|||CT|||||||Reason For Proc|||SchPerPhyName||20130614132030
ZDS|StudyIUID

This is from 2.3 version; you are using 2.5.1. All 2.x versions are backward compatible; so I hope that should not be an issue.

Note the ZDS segment which also accepts Study Instance UID.

Following links may be helpful:

https://datica.com/academy/hl7-203-the-hl7-orm-order-entry-message/
https://corepointhealth.com/resource-center/hl7-resources/hl7-orm-message/

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