O3 Labs & Tests
Historic Links:
Community Discussion Thread: https://talk.openmrs.org/t/o3-lets-move-forward-on-lab-orders/37155
Designs in Zeplin (same as link in the first email) https://zpl.io/g8LornO
UI Patterns for the Order Basket (*new*) https://zeroheight.com/23a080e38/p/71ad91-order-basket (The design team is looking for any feedback on this page right now actually)
End-to-End Walkthrough video of the Lab Orders - this will show more detail than either of the assets above, especially the "result entry" flow Paul & Wamz are proposing. Grace is not sure if we should be building those pieces into the EMR or not. Recording from the cmty design call 2023-March-13: https://iu.mediaspace.kaltura.com/media/t/1_nzrv9fzr?st=2894 (I've linked directly to the timestamp where Paul does this walkthrough)
Meeting Notes
Squad for Labs v2: Call Oct 24 2023
Attendees: Wamz, Grace, Casey, Gilbert, David, Pius, Eudson
Reached consensus on designs for a new "Orders" page in the O3 RefApp; Wamz has updated the designs based on the Squad's feedback from last week (see the updated version here) and Pius has begun work implementing this.
Wamz & Casey agreed to become co-leads of this Feature Squad This squad will meet weekly on Tuesdays at 2pm UTC (5pm EAT / 7:30pm IST / 10am EDT / 7am PDT). Added to OMRS community calendar; co-leads to make calendar changes as needed.
All agreed to use the OMRS Jira Labs Epic to track this work here:
Error rendering macro 'jira' : Unable to locate Jira server for this macro. It may be due to Application Link configuration..Wamz to move relevant docs into OMRS wiki.
Squad for Labs v2: Kick-Off Call Oct 16 2023
Attendees: Brandon, Burke, Casey, David, Eudson, Gilbert, Grace, Michael B
Link to Wamz's demo on Oct 12th Squad call: https://iu.mediaspace.kaltura.com/media/t/1_2b8r9rf1?st=1810
Area | Now: What we have now (as of Oct 16th) | Where we want to go: Next Priorities | Notes |
---|---|---|---|
Order Labs/Tests |
|
| Implementation: Options are from all concepts called "Test" Lower priority: Provider's "Favorites" (_____) Ideally, any order generated in OpenMRS would be automatically assigned a unique and human-friendly (not a UUID) order number (stored in |
Per Patient: Order Status and Lab Status | Nothing |
| Order status, lab status, and lab result interpretation are different things
Given the above, "critically high" is a lab interpretation, not an order status or lab status. If we want to create a dashboard showing We need to figure out how to handle exceptions (e.g., insufficient specimen) in a way that aligns us with FHIR. In HL7 v2, the observation's status would be set to "X" and the reason for exception (e.g., "Insufficient specimen") would be placed in the observation comment. FHIR documentation implies the observation status be set to cancelled and the Observation..dataAbsentReason be used; however, the values for data absent don't have obvious choices for "insufficient specimen." It would help to have an "official" recommendation of best practice in FHIR on how to use observations to report exceptional lab results (specimen not received, inadequate specimen, etc.). One challenge when working with an external lab system, will be knowing when to mark an order as completed. For example, a provider orders "FULL HEMOGRAM" and it is assigned order number #123. We sent this order to the lab (including the order number). Over the next 8 hours, we receive to lab results that reference order number #123: one is HEMOGLOBIN and the other is PLATELET COUNT. Do we consider the FULL HEMOGRAM order complete? Or will more results come later? The answer may be known by the lab system, but we may not be able to reliably get this information from the lab system, so we may need to come up with a business rule as a compromise (e.g., LabSet with any result received & 24 hours after order placed is considered completed). Phlebotomy Status: Drawn? Label Printing? Where someone needs to add #'s like Reference #, Sample #, Accession #? In general, humans shouldn't have to transcribe these (they should be auto-generated and sent between systems). When there are paper-based workflows, humans may need to transcribe them from a paper requisition into the system. Status page: rejections of samples by lab. Critical results, alert worthy? Certainly on the status page, but do you want to bug the ordering doc as well? I just wanted to add this so I don’t forget when we run out of time. |
All Patients: Order Status |
| (In Lieu of a bigger Lab Info System; similar to Dispensing App) | |
Results Entry |
|
| |
Results Viewing |
| No Order relationship yet... "Orderable" vs "Viewable": Filter to exclude stuff you don't need to see in the Order view, (want to see "Blood Cultures" in orders, but not the sub-tests for each strain of resistance), PIH has driven through "Orderable Labs ConvSet" that tend to be different per country | |
Result Alerts Inbox | None; lab-specific results | Future |
Peoples' Needs:
UCSF: 4-week Sprint starts tomorrow; want something w/ labs
PIH: Not a top priority for MCOE project but want to be involved
MSF: Critical for first pilot in a few months from now; want to align requirements
DIGI: OpenELIS-OMRS fhir-based connection for O3 for Cote d'Ivoire; currently just for VL but want for all lab tests (interested in statuses)
General Support: (assisted by Mekom/Brown (Brandon/Ian)): Implemented Lab Order form in Order Basket; Test Search functionality. Next:
Major Overlaps: Status; Requirements