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Electronic laboratory reporting (ELR) - Issues
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updated 01/06/2011
- For lab system vendors and labs: States have a variety of reporting formats they require
- Itemize variations among states
- 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
- The HL7 manual is not crystal clear about when OBX-5 repetitions are appropriate and when they aren’t
- 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
- 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.”
- How much can we/should we harmonize with IHE profiles?
