ihe lcsd profile – laboratory code set distribution

Feb. 9, 2005 IHE Educational Meeting

1

IHE LCSD Profile –IHE LCSD Profile –Laboratory Code Set DistributionLaboratory Code Set Distribution

Based on HL7 version 2.x, Chapter 8

Jean-Christophe Cauvin, FranceRené Spronk, Ringholm GmbH

IHE Laboratory Planning and Technical Committee

Feb. 9, 2005 IHE Educational Meeting2

Laboratory IHE Integration ProfilesLaboratory IHE Integration Profiles

Laboratory Device Automation (LDA)

In Process –TI Nov 2004In Process –TI Nov 2004

Pre-analytic process, analysis and post-analytical treatment

Laboratory Scheduled Workflow (LSWF)Completed in 2003Completed in 2003

Tests performed by a laboratory for an identified

inpatient or outpatient

Laboratory Information Reconciliation (LIR) In ProcessIn Process

Tests performed on an unidentified or misidentified patient

Laboratory Code Set Distribution (LCSD)

Sharing the batteries and tests code sets throughout the enterprise

Laboratory Point Of Care Testing (LPOCT) In Process –TI Nov 2004In Process –TI Nov 2004

Tests performed on point of care or patient’s bedside


LSWF:LSWF: Workflow Workflow

ADT

Order FillerOrder Placer

RAD-1. Pt registrationRAD-12. Pt Update

LAB-1. Placer Order Mgmt

Automation Manager

LAB-4. Work Order Mgmt

Order Result Tracker

LAB-2. Filler Order Mgmt

LAB-3. Order Results Mgmt

LAB-5. Test Results Mgmt

Laboratory



Technicalvalidation

Clinicalvalidation

Selected standard: HL7 version 2.5


The Laboratory The Laboratory Technical FrameworkTechnical Framework

Laboratory Code Set Distribution


Laboratory Code Set DistributionLaboratory Code Set Distribution

The goal of this profile is to simplify the configuration of the systems involved in the Laboratory Scheduled Workflow.

The Laboratory Code Set Distribution Profile offers the means to share the same set of test/observation codes between different actors.

Other information can be also exchanged like presentation of results, laboratory codes (in which lab a test is performed), units …


Laboratory Code Set Distribution Laboratory Code Set Distribution Actors/TransactionActors/Transaction

Laboratory Code Set Master

LAB-xx: Laboratory Code Set Management

Laboratory Code Set Consumer

Order FillerEnterprise Common Repository…

Order PlacerOrder Result TrackerAutomation ManagerOrder Filler…


Replaces Observation/Test/Battery Code SetsReplaces Observation/Test/Battery Code Sets

All Observation, Test and Battery code sets of the Consumer are replaced by the code sets sent by the Master. This Use Case is used both for initialization as well as periodic (weekly, monthly) update.

Laboratory Code Set Distribution Laboratory Code Set Distribution Use Case 1Use Case 1



Creates observation/test/battery codes

Laboratory Code Set Management

(REP)


Laboratory Code Set Distribution Laboratory Code Set Distribution Use Case 2 (out of scope for this year)Use Case 2 (out of scope for this year)



Updates observation/test/battery codes


(UPD)

Updates Observation/Test/Battery Code SetsUpdates Observation/Test/Battery Code Sets

Observation, Test and Battery codes of the Consumer are updated by codes sent by the Master. Updates are at the record level : add record(s), delete record(s), update record(s).


Laboratory Code Set Distribution Laboratory Code Set Distribution Use Case 3 (out of scope for this year)Use Case 3 (out of scope for this year)



Unknown / Expired observation/test/battery codes


Query for Observation/Test/Battery Code SetsQuery for Observation/Test/Battery Code Sets

The Laboratory Code Set consumer either periodically queries for the entire codeset, or it queries for the details of specific Observation, Test and Battery codes. The query responses are used to update the code set are at the record level : add record(s), delete record(s), update record(s).

Query for Laboratory Code Set


Laboratory Code Set Distribution StandardLaboratory Code Set Distribution Standard

Interactions based on HL7 V2.5, Master Files (chapter 8).

Advantages of using HL7 V2.5:

• HL7 is already implemented on laboratory systems; no need to implement a new protocol• Master Files are already adopted by some vendors.• Messages are rich enough to transport other information than just observation/test/battery codes :

• presentation of the results• laboratory codes• units of measure


HL7 Master FilesHL7 Master Files

Master files are a set of common reference files used by one or more application systems. Some common examples of master files in the healthcare environment include:

staff and health practitioner master file

location (census and clinic) master file

lab test definition file

exam code (lab, radiology) definition file


Generic MFN – Abstract MessageGeneric MFN – Abstract Message

MSH

MFI Master File Identification

{ MFE Master File Entry

[ <other resource

related segments, e.g. LOC > ]

}MFI MFE LOC

1..n 0..n


Generic MFN – Location ExampleGeneric MFN – Location Example

MSH|^~\&|MyHIS||PhysioApp||200211221003||MFN^M05|31|P|2.4||AL|NE

MFI|LOC|EH_Locations|UPD|||ER

MFE|MDL|M226||Aqua1^^Êastern Hospital^^^Physio^BÂqua therapy room 1|PLLOC|Aqua1^^Êastern Hospital^^^Physio^BÂqua therapy room 1||L

MFE|MUP|M227||Aqua2^^Êastern Hospital^^^Physio^BÂqua therapy room 2|PLLOC|Aqua2^^Êastern Hospital^^^Physio^BÂqua therapy room 2|Aqua therapy room 2|L|Eastern Hospital|LDP| Aqua2^^Êastern Hospital^^^Physio^BÂqua therapy room 2|PHY^Physiotherapy||REH~PRE|D~O|


Generic MFN Event CodesGeneric MFN Event Codes

MFI – File Level Event Codes

REP: Replace current version of this master file with the

version contained in this message.

UPD: Change file records as defined in the record-level

event codes for each record that follows.

(out of scope for this year)

MFE – Record Level Event Codes

MAD: Add record to master file.

MDL: Delete record from master file.

MUP: Update record for master file.

MDC: Deactivate: discontinue using record in master file,

but do not delete from database.

MAC: Reactivate deactivated record.


Generic MFK – AcknowledgmentGeneric MFK – Acknowledgment

MSH

MSA Message Acknowledgement

[ERR]

MFI Master File Identification

{ [MFA] Master File Acknowledgement

}MFI MFA

0..n

MFI MFE LOC1..n 0..n

Only in case of errors in related

MFE/LOC


Generic MFK Ack, Location ExampleGeneric MFK Ack, Location Example

MSH|^~\&|FysioApp||MyZIS||200211221004||MFK^M05|31|P|2.4||AL|NE

MFI|LOC|EH_Locations|UPD|||NE

MFA|MDL|M226||U^Location not present| Aqua1^^Êastern Hospital^^^Physio^BÂqua therapy room 1|PL

(NOTE: successful changes are NOT acknowledged)

MFA|MUP|M227||S|Aqua2^^Êastern Hospital^^^Physio^BÂqua therapy room 2|PL


Laboratory Code Set Distribution Laboratory Code Set Distribution LAB-XXX Message StructuresLAB-XXX Message Structures

MFN^M08 – Master File Notification – Test/Observation (Numeric)

MSH Message Header [1..1] chap. 2MFI Master File Identification [1..1] chap. 8{ [1..*] MFE Master File Entry [1..1] chap. 8 OM1 General Segment [1..1] chap. 8 [OM2] Numeric Observation Segment [0..1] chap. 8 }

MFN^M09 – Master File Notification – Test/Observation (Categorical)

MFN^M10 – Master File Notification – Batteries

MFN^M11 – Master File Notification – Test/Calculated Observation

[OM3] Categorical Test/Obs. Segment [0..1] chap. 8

[OM5] Observation Batteries [0..1] chap. 8

[OM6 Obs. calculated from other Obs. [0..1] chap. 8 OM2] Numeric Observation Segment [0..1] chap. 8


OM1-2 Producer’s Service/Test/Observation IDOM1-4 Specimen requiredOM1-5 Producer IDOM1-18 Nature of Service/Test/Observation:

P battery, A atomic, S super-set of batteries, C single observation calculated

OM1-19 Report sub-headerOM1-20 Report display order

OM2-2 Units of MeasureOM2-3 Range of Decimal Precision


OM1 – General SegmentOM1 – General Segment

OM2 – Numeric Observation SegmentOM2 – Numeric Observation Segment


OM3-2 Preferred Coding SystemOM3-3 Valid Coded answers

OM3 – Categorical Service/Test/Observation SegmentOM3 – Categorical Service/Test/Observation Segment


OM5 –Observation Batteries SegmentOM5 –Observation Batteries Segment

OM5-2 Tests/observations included within Battery

OM6 –Observation that are Calculated OM6 –Observation that are Calculated

OM6-2 Derivation Rule


Atomic Tests, Numeric ResultsAtomic Tests, Numeric Results

MSH|^~\&|OF|LabSystem|OP||20050205094510||MFN^M08|2106|2.5|||NLD|8859/1|NL|

MFI|OMA|OF_OMA_NL_20050205|REP|||ER|

MFE|MAD|1846||1846^CREABL/Creatinine^L|CE|

OM1|1|1846^CREABL/Creatinine^L|NM|Y|K231^Klinisch Chemisch Laboratorium^?|||Creatinine||||||||||A|

OM2|1|umol/l|6.0||

OM4|1||stolbuis rode dop4||ml|^volbloed|

MFE|MAD|1848||1848^CREAUV/Creatinine^L|CE|

OM1|2|1848^CREAUV/Creatinine^L|NM|Y|K231^Klinisch Chemisch Laboratorium^?|||Creatinine||||||||||A|

OM2|2|mmol/l|6.0||

OM4|2||24-uurs bokaal|||^urine verzamel|


Test with derived resultTest with derived result

MSH|^~\&|OF|LabSystem|OP||20050205094520||MFN^M11|2107|2.5|||NLD|8859/1|NL|

MFI|OMD|OF_OMD_NL_20050205|REP|||ER|

MFE|MAD|1849||1849^CLEA/Creatinine clearance^L|CE

OM1|1|1849^CLEA/Creatinine clearance^L|NM|Y|K231^Klinisch Chemisch Laboratorium^?|||Creatinine clearance||||||||||C|

OM6|1|(CREAUV * HOEV) / (CREASE * 1440)

OM2|1|ml/min|4.0||


Thank you for your attention…

ihe lcsd profile – laboratory code set distribution

Documents

set of testobservation

set of common reference

laboratory systems

update records

master files chapter

hl7 version

hl7 v2

new protocol master