established profile laboratory scheduled workflow established profile laboratory scheduled workflow...
TRANSCRIPT
![Page 1: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/1.jpg)
Established Profile
Laboratory Scheduled WorkFlowEstablished Profile
Laboratory Scheduled WorkFlow
Charles ParisotCharles ParisotGE HealthcareGE Healthcare
IHE IT Technical Committee Co-chairIHE IT Technical Committee Co-chair
François MacaryFrançois MacaryAGFA Healthcare ITAGFA Healthcare IT
IHE Laboratory Committee Co-chairIHE Laboratory Committee Co-chair
![Page 2: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/2.jpg)
The IHE Laboratory CommitteeThe IHE Laboratory Committee
Contributing countries– France
– Japan
– Germany
– Italy
– The Netherlands
– UK
– US (CLSI - ex NCCLS)
• Development started in 2003
• First profile published in November 2003
• 10 systems validated in 2004
• 12 systems validated in 2005
• Four new profiles currently published for public comment
Cochairs: Francois Macary - Agfa Healthcare IT
Yoshimitsu Takagi - Hitachi
![Page 3: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/3.jpg)
IHE Lab today and to-morrow
• Five profiles:– Laboratory Scheduled Workflow (LSWF)– Laboratory Point Of Care Testing (LPOCT)– Laboratory Device Automation (LDA)– Laboratory Code Set Distribution (LCSD)– Laboratory Information Reconciliation (LIR)
• Future plans– Incorporate analyzer images in the result workflow– Cross-enterprise sharing of lab reports, using CDA-R2– Specimen labels workflow
• Ordering, placing, scheduling and performing clinical laboratory tests both for Hospital and Ambulatory.
• Microbiology included. Anatomic pathology and blood bank excluded
![Page 4: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/4.jpg)
Volume 1
![Page 5: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/5.jpg)
Scope of LSWF profile
• Integrate the clinical laboratory in the healthcare
enterprise
• Workflow: Ordering, placing, scheduling, performing
clinical laboratory tests, and delivering the results.
• In vitro testing: All specialties working on specimen, not
on the patient itself.
• Bound to clinical biology (anatomic pathology excluded)
![Page 6: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/6.jpg)
LSWF: Three major use cases
• Externally placed order with identified specimens– The ordering provider collects the specimens and uniquely identifies them
(in the message placing the order as well as on the container with a barcode label)
• Externally placed order with specimens unidentified or to be collected by the laboratory– The specimens are unidentified within the message placing the order
• Filler order with specimens identified by the laboratory– The order is created in the laboratory, and afterwards a number is
assigned to it in the placer application.
![Page 7: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/7.jpg)
Patient Administration
Clinical laboratoryWard or EHR
Lab-1: Placer order
Lab-2: Filler order
Rad1, Rad-12
Patient demographics & visit
Lab-5: Results
Rad-1, Rad-12
Lab-3: Results
Lab-4: Work order
Order Result Tracker
ADT
Automation Manager
Order Placer Order Filler
IHE Laboratory: LSWF
Clinicalvalidation
Technicalvalidation
![Page 8: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/8.jpg)
Actors Transactions Optionality
ADT Patient demographics [RAD-1, RAD-12] R
Order Placer Patient demographics [RAD-1, RAD-12] R
Placer Order management [LAB-1] R
Filler Order Management [LAB-2] R
Order Filler Patient demographics [RAD-1, RAD-12] R
Placer Order management [LAB-1] R
Filler Order Management [LAB-2] R
Order result management [LAB-3] R
Work Order management [LAB-4] R*
Test results management [LAB-5] R*
Automation Manager
Work order management [LAB-4] R
Test result management [LAB-5] R
Order Result Tracker
Patient demographics [RAD-1, RAD-12] R
Order result management [LAB-3] R
* In case the LIS encompasses both Order Filler and Automation Manager transactions LAB-4 and LAB-5 are irrelevant.
![Page 9: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/9.jpg)
Order management in LSWF profile
• Two parallel flows to keep synchronized– Electronic: The order
– Material: The specimen(s) required to perform the order
• A dynamic process– Specimen added by the placer to a running time study
– Specimen rejected by the filler (damaged or spoiled), tests held in wait for a new specimen
– Unordered test added by the filler (e.g. antibiogram in microbiology)
Order Placer and Order Filler must keep the same vision of the order (content and status) all along the process
![Page 10: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/10.jpg)
Results management in LSWF profile
• Results can be transmitted at various steps– After technical validation (by the lab technician)
– After clinical validation (by the clinical expert)
• Requirement to keep Order Result Tracker informed with all changes occurred to results previously sent – Send corrections
– Send validation or un-validation
– Send cancellation
• Other characteristics– Result type: Numeric, coded, textual, graphical (electrophoresis)
– Results are sent in recapitulative mode, appropriately sorted
![Page 11: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/11.jpg)
Laboratory Technical Framework Volume 2
![Page 12: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/12.jpg)
Choice of the standard
• Need for an international standard, fully implementable with guides and tools ready for use– Excluded HL7 v3
• Supporting specimen and container management– Excluded v2.3.1 and v2.4
• Choice of HL7 v2.5, released just before IHE Lab TF (end 2003)
HL7 v2.5 Transactions LAB-1, LAB-2, LAB-3, LAB-4, LAB-5
HL7 v2.3.1 Transactions RAD-1, RAD-12
Vertical bar encoding shall be supported. XML encoding may be supported
See Vol 2 section 1.1
![Page 13: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/13.jpg)
HL7 v2.5 profiling conventions
• Static definition: Usage of segments and fields– R: Required– RE: Required but may be empty– O: Optional = Usage not defined yet– C: Conditional (condition predicate in the textual description)– X: Not supported. Must not be sent.
• For a better readability:– Segments with usage X do not appear in message tables– Fields with usage O do not appear in segment tables
• Cardinalities of segments, segment groups and fields:– Min and max between square brackets: [0..*]– * stands for “no upper limit”
See Vol 2 section 2.2
![Page 14: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/14.jpg)
Example of message static definition
Specimen Segment group
![Page 15: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/15.jpg)
Example of segment description
![Page 16: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/16.jpg)
Vocabulary & tracking orders
– a CBC (complete blood count)
– an electrolyte (Na, K, Cl)
– a creatinine clearance
Order Placer allocates an Identifier to each ordered battery
Order Filler allocates an Identifier to each accepted battery
The physician places a lab request. The Order Placer allocates the unique Id “123” to this request consisting of:
Laboratory request 123
Placer Order Number(ordered battery)
12345
12346
12347
ordered battery 12347
Filler Order Number
(accepted battery)
F101
F102
F103
accepted battery F103
![Page 17: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/17.jpg)
Watch the 4 examples of section 9
• Each example is using the same layout:
– Storyboard
– List of human actors and organizations
– Ids and numbers
– List of interactions
– Interaction diagram
– Messages with key information highlighted.
For implementers: One of the most helpful parts of Laboratory Technical Framework.
![Page 18: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/18.jpg)
1st example: Two hematology batteries
![Page 19: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/19.jpg)
1st example: Two hematology batteries
![Page 20: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/20.jpg)
Two hematology batteries: One message
![Page 21: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/21.jpg)
Acknowledgements with MLLP (1)
• An OML message shall be acknowledged by one single ORL message.
• An OUL message shall be acknowledged by one single ACK message.
• These acknowledgements are application-level acknowledgements (i.e. not transport acknowledgements) and must be generated by the receiving application after it has processed the message semantic content, according to its own business rules.
• Intermediate message brokers do not have this capacity and therefore shall not be used to generate the contents of application acknowledgements.
• The receiving application shall automatically generate the application-level acknowledgement messages without waiting for human approval of the contents of the message that was received
See Vol 2 section 2.3
![Page 22: Established Profile Laboratory Scheduled WorkFlow Established Profile Laboratory Scheduled WorkFlow Charles Parisot GE Healthcare IHE IT Technical Committee](https://reader035.vdocuments.us/reader035/viewer/2022062517/56649ebc5503460f94bc455e/html5/thumbnails/22.jpg)
Thank you for your attention…