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Lab UV SB Micro Correct

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A 24-year old female, Eve Everywoman, presents at Community Urgent Care with
severe headaches, numbness and tingling.  Dr. Harold Hippocrates examines the
patient and learns that she is employed in the Manufacturing Industry where
she is exposed to Lead based products.  Dr Hippocrates wants to rule out Lead
poisoning.

Dr. Harold Hippocrates places the order for a STAT Lead Level test.  The order
fulfillment request is sent from the Clinical Information System to the
Laboratory.
The laboratory system receives the order fulfillment request and determines that
it meets its requirements.  It immediately responds with a promise to the clinical
information system.

Eve Everywoman goes to the laboratory one week later.  Rita Receptionist finds the
order for a Lead Level.  The system assigns the accession number and prints the
specimen label.  Boris Bleeder collects the specimen in a tan top (EDTA) tube.
He enters the collection date/time (0700 on December 24, 2003) and specimen type
into the laboratory system.  He delivers the specimen to be processed.  The
laboratory system sends a status message indicating “Specimen in Lab” process
step of its promise to the clinical information system.
The clinical information system receives the promise status message from the
laboratory system.  It updates the process step of its order to “Specimen in
Lab” and responds to the laboratory system with an order status response message.
Bill Beaker performs the test and determines that the level is within OSHA
guidelines.   He releases them for final reporting and faxes the report to
Dr. Hippocrates in accordance with STAT protocol.
Chemistry Observation/Test Name: Lead Level 
Result Value/Flag: 30 ug/dL
Normal Range: 40 ug/dL
Date/Time of Observation: December 24, 2003  0900
The laboratory system sends the final result to the clinical information system.
The clinical information system determines that the result meets its requirements
for confirming it.  It sends a message to the laboratory system indicating that
it has confirmed the final result.  The clinical information system sets its
order status to complete.
Dr Hippocrates reviews the result on December 27, 2003 and questions the result
because it does not appear to correlate with his diagnosis.  He calls the
laboratory and asks for the test to be performed again on the initial specimen.
Corrected Result
Bill Beaker re-runs the Lead Level on the initial specimen.  The result is 110 ug/dL.
 Just to confirm, he performs QA on the instrument. He analyzes the specimen again
due to the large discrepancy between the initial reported result and the new result.
 The result this time is 112 ug/dL.  He averages the two results and reports out
111 ug/dL.  He reviews the result and reports it out as corrected.
Chemistry Observation/Test Name: Lead Level 
Result Value/Flag: 111 HH
Normal Range: 40 ug/dL
Date/Time of Observation: December 27, 2003  1200

He notifies Dr. Stan Slide, Laboratory Pathologist of the discrepancy.  The
laboratory system sends the corrected result to the clinical information system.

The clinical information system determines that the corrected result meet its
requirements for confirming it.  It sends a message to the laboratory system
indicating that it has confirmed the corrected result. The clinical information
system updates its order status to reflect the corrected order completion date.

Bill Beaker initiates the panic value protocol which includes releasing the
corrected result with note attached indicating that Dr. Hippocrates was notified
on December 27, 2003 at 1200.  The information is sent to the appropriate
regulatory agencies governing Lead testing.

Business Process

This business process doesn’t introduce new objects, just new states for those objects and a few new transitions. The new states are ‘corrected’ for one or more Reporting objects and a new Fulfillment status ‘specimen received’. Diagrams will follow with these two additions, later in this document along with succeeding additions.

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