OO CR118 - OBX-8

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Submitted by: Cindy Johns	Revision date: <<Revision Date>>
Submitted date: 29 November 2012	Change request ID: OO CR118
Standard/IG: LRI IG	Artifact ID, Name: <<Artifact ID, Name>>

Issue

During our LRI Pilots Testing Needs workgroup call on Monday, we were reviewing comments received for the EHR Test Methods publication. One commenter was concerned that the Test Cases included “Normal” flags in OBX-8. The commenter indicated that it would be very confusing for an EHR to display a Normal flag with every normal result and suggested that the EHR’s could ignore a “Normal” flag. While we agree that it would create a messy report if every normal result required a “Normal” flag, we also felt that most laboratories do not send a “Normal” flag routinely (i.e. it was never the intent of the guide to require every normal result to carry a “Normal” interpretation in OBX-8). However, our thinking is that if a laboratory does send a “Normal” flag, it is something that the laboratory feels needed to be communicated along with the result and should be consumed and displayed by the EHR. Consequently, the workgroup felt that it would be useful to include a clarification statement in the next LRI Errata to alleviate this concern. Our proposal is to include clarifying verbiage in the LRI Errata as stated below.

“It is not intended that every laboratory result be accompanied by a coded interpretation in OBX-8 (for example, every normal result does not require a “Normal” flag to be sent in OBX-8). However, if a laboratory populates OBX-8 with a coded interpretation, regardless of the coded interpretation sent, the EHR shall consume and display it.”

While we did not discuss specifically where this statement would best fit into the LRI IG, my suggestion is to add it to the end of the second paragraph in section 3.2.14 Observation Identifiers, Observation Values, Interpretations and Comments. Bob - If you have a suggestion for a different place in the guide where it would be better to incorporate this statement, please throw in your two cents’ worth.

Recommendation

“The Laboratory determines based on policy whether a result is accompanied by a coded interpretation in OBX-8. Therefore, if a laboratory populates OBX-8 with a coded interpretation, regardless of the coded interpretation sent, the EHR shall consume and display it.”

Rationale

• Motion to insert “The Laboratory determines based on policy whether a result is accompanied by a coded interpretation in OBX-8. Therefore, if a laboratory populates OBX-8 with a coded interpretation, regardless of the coded interpretation sent, the EHR shall consume and display it.” into OBX-8 Comment for the errata. Cindy Johns, Riki Merrick
  • Against: 0; Abstain: 0; In Favor: 4