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Difference between revisions of "Electronic laboratory reporting (ELR) - Issues"
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[[http://wiki.hl7.org/index.php?title=Public_Health_and_Emergency_Response_work_group_%28PHER%29 PHER main page]] | [[http://wiki.hl7.org/index.php?title=Public_Health_and_Emergency_Response_work_group_%28PHER%29 PHER main page]] | ||
| − | + | ==Jurisdictional requirements== | |
| − | |||
*For lab system vendors and labs: States have a variety of reporting formats they require | *For lab system vendors and labs: States have a variety of reporting formats they require | ||
**Itemize variations among states | **Itemize variations among states | ||
| + | |||
| + | ==Message structure== | ||
| + | |||
*For states: Labs send message in a variety of formats | *For states: Labs send message in a variety of formats | ||
**Itemize variations among submitting labs/vendors | **Itemize variations among submitting labs/vendors | ||
| Line 13: | Line 15: | ||
**Some labs submit NTE segments with observation information that should be in OBX segments | **Some labs submit NTE segments with observation information that should be in OBX segments | ||
**Some labs use OBX-5 repetitions incorrectly, or at least questionably: simply to chop up a long Text result into short pieces | **Some labs use OBX-5 repetitions incorrectly, or at least questionably: simply to chop up a long Text result into short pieces | ||
| − | |||
*Microbiology linkage | *Microbiology linkage | ||
**Most labs don’t do it | **Most labs don’t do it | ||
| Line 19: | Line 20: | ||
**Of those who do it, none does it completely correctly | **Of those who do it, none does it completely correctly | ||
**The 2.5.1 IG is not clear enough about certain requirements | **The 2.5.1 IG is not clear enough about certain requirements | ||
| + | *The HL7 manual is not crystal clear about when OBX-5 repetitions are appropriate and when they aren’t | ||
| + | |||
| + | ==Terminology== | ||
| + | *Placeholder | ||
| + | |||
| + | ==Implementation== | ||
| + | |||
*Discussion between Jimmy Dee and Lily Tatham on PhConnect, ELR CoP forum, and further discussion on the CSI (Collaborative Software Initiative, authors of Utah’s TriSano) forum. | *Discussion between Jimmy Dee and Lily Tatham on PhConnect, ELR CoP forum, and further discussion on the CSI (Collaborative Software Initiative, authors of Utah’s TriSano) forum. | ||
*Not all labs have CLIA codes, e.g. Veterans Administration hospital labs. | *Not all labs have CLIA codes, e.g. Veterans Administration hospital labs. | ||
| Line 24: | Line 32: | ||
**“Implementers don’t like to use Structured Numeric.” | **“Implementers don’t like to use Structured Numeric.” | ||
**“No microbiology lab wants to flag abnormals.” | **“No microbiology lab wants to flag abnormals.” | ||
| + | |||
| + | ==Harmonization== | ||
*How much can we/should we harmonize with IHE profiles? | *How much can we/should we harmonize with IHE profiles? | ||
Revision as of 21:54, 6 January 2011
Contents
Jurisdictional requirements
- For lab system vendors and labs: States have a variety of reporting formats they require
- Itemize variations among states
Message structure
- For states: Labs send message in a variety of formats
- Itemize variations among submitting labs/vendors
- For states: Labs submit messages in a variety of erroneous or questionable or suboptimal formats, although they may be syntactically correct
- New York State (collect samples of all the conditions below)
- Some labs submit a multiple-observation message as multiple messages with one observation (OBX) per message
- some labs submit OBX segments containing information that should be in NTE (Note) segments
- Some labs submit NTE segments with observation information that should be in OBX segments
- Some labs use OBX-5 repetitions incorrectly, or at least questionably: simply to chop up a long Text result into short pieces
- Microbiology linkage
- Most labs don’t do it
- Some labs even send the drug sensitivity observations in separate messages/files from the organism results: no linkage is possible
- Of those who do it, none does it completely correctly
- The 2.5.1 IG is not clear enough about certain requirements
- Most labs don’t do it
- The HL7 manual is not crystal clear about when OBX-5 repetitions are appropriate and when they aren’t
Terminology
- Placeholder
Implementation
- Discussion between Jimmy Dee and Lily Tatham on PhConnect, ELR CoP forum, and further discussion on the CSI (Collaborative Software Initiative, authors of Utah’s TriSano) forum.
- Not all labs have CLIA codes, e.g. Veterans Administration hospital labs.
- Clem McDonald comments during WG webinar
- “Implementers don’t like to use Structured Numeric.”
- “No microbiology lab wants to flag abnormals.”
Harmonization
- How much can we/should we harmonize with IHE profiles?
