laboratory system interface - mayo · pdf fileby the mml laboratory system interface team,...

Mayo Medical LaboratoriesA Division within Mayo Reference Services

LaboratorySystemInterface

Introduction

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Mayo Medical Laboratories 200 First Street SW Rochester, Minnesota 55905 800-533-1710 Dear Colleague: Mayo Medical Laboratories has always recognized the value of information system integration between community laboratories and their reference laboratory. MML used its extensive expertise in developing system interfaces to be one of the first reference laboratories in the world to implement a standard method for transferring laboratory data between any two computer systems. MML has developed communications protocols designed for reliability, transmission speed, and data security. As with all projects of this scope, they require a dedicated team of people with strong project management and technical skills. Commitment is needed on the part of everyone involved in developing and setting up new interfaces. To help with this endeavor, MML has developed a detailed work plan and project schedule describing the effort required from all participants. In addition, MML assigns appropriate IT staff for the duration of the project, to facilitate the implementation of your interface. This interface manual documents all aspects of the interface project, including those tasks to be completed by the MML Laboratory System Interface Team, you, our Client, and your laboratory information system vendor. Please take the time to review all the tasks assigned to each of the specific resources prior to the start of your project’s implementation. Any suggestions for change are welcome. It is vital for a successful project that everyone involved completes his or her assignments in a timely manner. Please refer to the Overview of MML Interface Projects for more details. As always, if there are questions or concerns, please do not hesitate to give us a call. Our Laboratory System Interface Team is ready to help you successfully implement your interface project with Mayo Medical Laboratories. If you have any questions or comments, please call Kathryn Finnerty, Unit Head, Laboratory Systems Interface Unit at (978) 988-0504. We look forward to working with you! Sincerely,

Robert M. Kisabeth, M.D. Medical Director

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Table of Contents

General Information Project Participants ………………………………………………………………………………………………………. 6 MML Interface Timeline Summary………………………………………………………………………………………. 8 Overview of a Mayo Medical Laboratories Interface Project ……………………………………………………………. 9

Initiation Phase………………………………………………………………………………………………………... 9 Definition Phase………………………………………………………………………………………………………. 10 Development Phase …………………………………………………………………………………………………... 10 Testing Phase…………………………………………………………………………………………………………. 11 Implementation Phase………………………………………………………………………………………………… 12 Maintenance………………………………………………………………………………………………………….... 13

Packing and Shipping of Specimens…………………………………………………………………………………….... 14 Fields Required on Packing List………………………………………………………………………………………. 15 Sample Packing List…………………………………………………………………………………………………... 17 Fields Required on Specimen Labels…………………………………………………………………………………. 18 Sample Specimen Labels……………………………………………………………………………………………… 19

MML System Options and Parameters …………..………………………………………………………………………. 20 Formatted Text…………………………..………..………………………………………………………………………. 20 Generic Orderable………………………………………………………………………………………………………… 20 Special Procedures ……………………………………………………………………………………………………….. 21

Add-On/Cancellations ………...……………………………………………………………………………………… 21 Miscellaneous (WILD) Tests .…..…………………………………………………………………………………….. 21

MML Contact Information…………………………………………………………………………………………….…. 22

Technical Information Interface Models ………...……………………………………………………………………………………………….. 24

Direct LSI Diagram ………………………………………………..………………………………………………… 25 2-Way MayoNet LSI Diagram………………………………..………………………………………………………. 26 4-Way MayoNet LSI Diagram..………………………………………………………………………………………. 27

VPN Diagram……………………………………………………………………………………………………………... 28 VPN Frequently Asked Questions………………………………………………………………………………………... 29 MML VPN Request Form………………………………………………………………………………………………... 31 UUNet Value Added Network …………………………………………………………………………………………… 32 Unit Dial-In Script……………………………………………………………………………………………………….. 33

Example of Xmodem Communication Session ………………………………………………………………………. 34 Connection Requirements…………………………………………………………………………………………….. 36 Miscellaneous Notes ………………………………………………………………………………………………….. 36 MML Networking Protocol…………………………………………………………………………………………... 36 Basic Command Format ……………………………………………………………………………………………… 36 Overview ……………………………………………………………………………………………………………... 37 File Format……………………………………………………………………………………………………………. 37 Valid Responses ….….……………………………………………………………………………………………….. 38 MML Mailbox System Command Definitions ……………………………………………………………………….. 38

Message Formatting…………………………………………………………………………………………………….… 39 MML's Use of HL7 2.3 …………………………………………………………………………………………………... 40

Message Structure …………………………………………………………………………………………………….. 40 Message Format ………………………………………………………………………………………………………. 41 Data Communications………………………………………………………………………………………………… 51 Examples of HL7 Messages…………………………………………………………………………………………... 53

MML Use of the ASTM E-1238-88 ……………………………………………………………………………………... 56 Examples of ASTM E-1238-88 Messages ……………………………………………………………...……………. 63

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Appendix File Definition ……………………………………………………………………………………………………………. 67

Implementation Notices……………………………………………………………………………………………….. 68 Sample Implementation Notice……………………………………………………………………………………….. 69 Age-Specific File Definition………………………………………………………………………………………….. 71 AP File Definition…………………………………………………………………………………………………….. 77 Coagulation Consult File Definition ………………………………………………………………………………….. 79 Drug -Level File Definition ………..…………………………………………………………………………………. 87 Microbiology File Definition …………………………………………………………………………………………. 89 Profile Test File Definition …………………………………………………………………………………………… 91 Sex-Specific File Definition ………………………………………………………………………………………….. 96 Single Result Code File Definition …………………………………………………………………………………… 100

Index Index ……………………………………………………………………………………………………………………... 101

General Information

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Project Participants

* Indicates this resource attends conference calls on a regular basis v Client

LIS Manager* § The LIS Manager is responsible for the Laboratory Information System and is usually the

resident expert in system functionality and Client-specific issues.

IS representatives* § The number of IS representatives who work on the project varies. Some sites have several

(networks, communications, interface engine, etc.), while others do not have any IS representatives join the project. Site complexity and requirements of internal systems dictate who should attend. These participants may or may not attend each conference call.

File Definition Specialist* § This individual, usually from the Laboratory, will do the actual hands-on file and table building

and testing for the project. Sites generally build from 100-500 tests for the project. This person will work closely with MML Telecommunications for file definition advice. During the testing phase, this individual will continue to work with MML Telecommunications for validation testing.

Lab Manager or Administrative Director

Pathologist

Other § At multiple-facility sites, each institution may send one of each of the above team members.

v LIS Software Vendor

Application Analyst § The Application Analyst helps the Client with file definition, patient report formatting, and other

functionality that is specific to the main Laboratory Information System.

Interface Analyst* § The Interface Analyst builds the interface, works with the Client and MML to establish

connectivity, confirms file formatting, answers interface module-specific questions, and assists in testing and troubleshooting.

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v Mayo Medical Laboratories

MML Regional Manager The Regional Manager is responsible for the Client account. He or she acts as a liaison, a Client advocate, or a facilitator, as necessary, to help resolve issues.

MML Interface Developer* § The MML Interface Developer builds the interface, defines communication, and sets rules and

parameters on other MML systems that affect the LSI. The MML Interface developer will create translates and/or scripts on MML's interface engine and confirm and monitor communication and file format. Other responsibilities of the MML Interface Developer include handling issues with the Vendor Interface Analyst and the Client tester throughout the testing phase, moving the site to production, and supporting the site during the 30-day post-live phase.

MML Telecommunications* § The MML Telecommunications Specialist works with the Client to facilitate file building and

testing. MML Telecommunications also serves as the main MML Client contact for other interface-related issues after implementation. Telecommunications supplies the Client with file definition from MML’s Lab system, handles questions about how to define Lab tests, develops and helps execute the QA plan, and assists in troubleshooting. Telecommunications is the first level of support (24 x 7) for all MML Clients, interfaced and not.

MML Project Manager* § The primary responsibility of the MML Project Manager is to keep the project on track. Acting

as the facilitator, the Project Manager resolves issues or assigns the appropriate resource, works with the Client and/or developer to resolve issues between the Client’s LIS and MML’s Laboratory Information System, and can help solve issues the interface may present. The MML Project Manager assists with testing, reviews QA testing, ensures all project activities are on course, works with the Vendor, and arranges extra calls as needed. The Project Manager is also responsible for delivery of all documentation for the project (agendas, specifications, project notebook, minutes).

MML LSI Facilitator § The LSI Facilitator works with the Client and Regional Manager during the Initiation Phase to

help prepare the site for start date confirmation. Responsibilities include arranging the Informational Call, handling the LSI Agreement, and, when applicable, gathering needed documents for vendor interface license fee reimbursement. The LSI Facilitator monitors and tracks the Client's milestones until start date is scheduled.

Not on the conference calls, but also involved: § Mayo Networks Group § Mayo Unix Team § MML ADCS Team (MayoLink/Net) § MML Lab Liaison § MML Billing Office § MML Accessioning

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MML Interface Timeline Summary

A traditional project duration is approximately 6 weeks, and begins once connectivity has been established. It encompasses QA testing and Top 25 database testing, and concludes with successful transmission of a live order through production system. MML recognizes that LIS vendors may also have a proposed timeline and may have specific database testing requirements. The MML PM assigned to the project can work with the client and vendor to create a mutually acceptable timeline. If you would like a detailed copy of MML’s 6-week timeline, please contact the project manager assigned to your project or your regional manager.

Timeline MML 6 week project plan Percentage of client work VPN shipped & installed

Pre Project Work VPN connectivity tested

MML creates interface Week 1 Vendor creates interface

20% of entire project

Week 2 Application connectivity established 1% of entire project Week 3 QA testing 1% of entire project Week 4 QA testing 31% of entire project

Client prep for implementation Top 10 tests available MML moves interface to production

Week 5

Vendor moves interface to production

23% of entire project

Week 6 GO LIVE 24% of entire project Week 7, 8, 9, 10 Database testing

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Overview of a Mayo Medical Laboratories Interface Project

This section will provide an overview of the Mayo Medical Laboratories (MML) Laboratory System Interface (LSI) products, either directly to MML, or through MayoNet. It describes the various functions of the system, and details the responsibilities for creating and managing those functions. This interface manual also provides information needed to transmit orders and results through a Laboratory System Interface with MML. Agreeing to undertake an Interface Project with MML represents commitment by all stakeholders to dedicate the resources, time, and any necessary equipment to meet these time estimates. All project participants will receive a project schedule to document the steps and total duration of time estimated to be involved in completing the project. This project timeline is based on historical experience with similar Interface Projects and/or all information known at the time of creation. All parties will be asked to indicate agreement with these timelines in writing. Project stakeholders will be notified in writing (slippage reports) by the MML Project Manager each time a change in the project timeline has been made that affects the target date of a milestone for the interface. MML reserves the right to suspend activity on any project that remains inactive for a period of at least two weeks. Once project activity is suspended it is the responsibility of the Client to notify their MML Regional Manager when they are ready to resume activity. Once notification is received, a restart date will be assigned based on MML, Client, and Vendor resource availability. It will be the Client's responsibility to coordinate the stop and restart dates with Vendor. i. Initiation Phase

To initiate an Interface project with MML, the Regional Manager works with the Client and LSI Facilitator to complete the LSI Request Form. An informational call between the Client and an MML Project Manager can be arranged to explain MML’s interface process and the time and effort involved in an Interface project. Process requirements and availability of resources differ with each LIS vendor. Certain vendors require overlays/updates to the LIS within six months of starting an interface project. Vendors may also require the Client to fill out an informational questionnaire before resources will be scheduled. Additional considerations include ensuring both test and live systems are up to date on Client LIS and placing a request for interface software with the vendor prior to the start of the project. Please contact your vendor for pre-project requirements and coordination of resources. If applicable, reimbursement toward the vendor interface license fee can be arranged once an LSI Agreement has been signed, dated and returned to the LSI Facilitator along with a copy of the vendor invoice and the site’s Federal Tax ID. The project will be assigned a start date by the Regional Manager and Sales Administration.

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ii. Definition Phase In this phase, the Client assigns his/her resources for the project and attends the initial conference call. The Vendor and members of the MML Interface team will also attend the initial conference call, coordinated by the MML Project Manager assigned to the project. The Client will be responsible for coordinating vendor activities (software and hardware installation, vendor documentation, and interface training on the LIS). MML will provide an Interface Developer, Telecommunications Specialist, and a Project Manager. The Vendor will also assign an Interface Developer for this project, in addition to providing the Client with interface software, documentation, and training. The MML Project Manager will create a project plan, outlining the project schedule, as well as a project notebook, summarizing the project.

iii. Development Phase

During this phase, the Client, Vendor, and members of the MML Interface team will continue to attend weekly conference calls, coordinated by the MML Project Manager.

Test Setup

Development of the interface and testing of files begins in this phase. Client responsibilities include completion of file definition and software definition (translation tables, cross-reference tables, schedules, etc.) for tests comprising the QA plan and the client’s top 10-25 tests. An MML Telecommunications Specialist will send the Client test set-up information, and is available to answer questions. Examples of MML test set-up can be found in the Appendix of this manual.

Packing List and Specimen Labels The Client will also work with the Vendor to create a packing list and labels for all MML specimens. A sample packing list can be found on page 17. Sample labels can be found on page19. Each shipment of specimens must be accompanied by a packing list. The packing list itemizes the specimens in the shipment, and includes sufficient information so that orders could be manually entered from this list, if necessary. MML looks for the client’s labels to contain the patient name, Mayo test # or test mnemonics and client accession #. The specimens should be packaged, labeled, and shipped in the manner specified by MML.

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Communications

Connectivity and data communications will be established and tested during this phase. Several communication options are available. Preferably, a socket connection or file transfer over the Internet, using a VPN and the Client’s existing Internet Service Provider (ISP). In any case, MML is concerned for the security and confidentiality of patient data. The necessary and related parameters are defined and configured to allow authorized connectivity with authentication, and the secure transfer of electronic orders and results. A VPN solution includes encryption and authentication to ensure patient confidentiality. From time to time as technology matures, MML will test and develop communications protocols that will improve reliability, transmission speeds, and most importantly data security. More detailed information about the available communications solutions can be found in the Technical Information section of this manual.

Orders

Preparation of orders into ASTM or HL7 transactions will be the responsibility of the Client and their vendor. MML will assist in identifying preferred methods to queue order transactions. Order transactions should be transmitted promptly and be available for MML use prior to arrival of the associated specimens. After receipt of the order by MML, order transactions will be processed into actual pending orders. Processing will occur automatically on a schedule, prior to the anticipated arrival of specimens. MML will check the number of pending orders prior to specimen arrival to detect possible problems with order transmissions. Packing lists must accompany all specimens sent to MML.

Note: MML preferred data format is HL7 2.3

Results

Test results will be reported promptly on release from the performing laboratory. Re-transmission of results is available by calling MML Telecommunications (800-533-1710). Transaction formats and approved communication protocols are discussed in detail in the Technical Information Section. Note: MML preferred data format is HL7 2.3

iv. Testing Phase

Testing during an MML LSI project is divided into two phases. In each phase, the Client will create test batches and fax packing lists to the MML Telecommunications Specialist for result entry. The Client will work primarily with MML Telecommunications during testing to ensure proper transmission of each order and result. The MML Project Manager, MML Interface Developer, and Vendor Interface Developer will also be available to assist in issue resolution. All phases of testing must be successfully completed before the interface can be moved into production.

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The testing phases consist of:

Sample Testing The Client will select 5-6 tests to order, taking a sampling from the tests built for the QA test scenarios. This phase is used to verify connectivity as well as ensure proper file building.

Quality Assurance (QA) Testing In this phase, MML Telecommunications will create a test plan

consisting of an MML-defined set of test variables. The test plan consists of test scenarios that are typically encountered in a production environment. Client LIS reports generated during this phase will be evaluated not only for QA parameters, but also for clinical content and interpretation of results. Complete documentation will be provided to the Client following successful completion of the test plan.

To ensure proper formatting of orders and results into the Client LIS, MML requires that each Client site maintain a parallel printer (teleprinter), supplied by MML. This printer will generate MML hard copy reports of each resulted accession, through a modem connection to MML’s LIS, allowing for direct comparison to each Client LIS-generated report. The parallel printer must remain on site for the duration of the interface project, as well as for 30 days post-implementation. At that time, the Client has the option of returning the parallel printer to MML. During the testing and development phase, both MML and the Client must be able to prevent test transactions from affecting the production area of the system. Both parties must coordinate transition from test environment to production environment

v. Implementation Phase In this phase, the Clients’ Top 10 to 25 high volume tests will be tested, the client and vendor will finish preparation for go live and the interfaces’ will be moved into the production system. To initiate this phase, the Client must submit the go-live request form to the MML Project Manager one week prior to implementation to ensure the move of the Interface from test to production. The Client, along with their Vendor, will make any necessary changes in their LIS production environment before go-live. On go-live day, before transitioning to production, one “test order” will be sent through the production system. Following successful transmission and resulting of the test order, subsequent orders will be placed and resulted in the production/live system. The Client will also closely monitor the system error and pending logs during the post go-live period. This phase of the project ends with the transition of the Client to MML routine support (30 days post-go-live) and the completion of an MML Customer Survey.

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vi. Maintenance

Continued maintenance is required for a Laboratory System Interface to function properly. The Client and MML need to promptly and clearly inform each other of changes that may affect the interface. The following cases require maintenance:

• The Client adds a test(s) to the Laboratory System Interface • File definition changes by MML • Interface software failures or procedure conflicts between the Client’s system and MML • Client LIS Upgrade and/or overlay

When an interfaced Client wishes to add a new reference test to the interface, they must contact the MML Telecommunications staff to obtain the required setup information, as well as work with MML Telecommunications to test the ordering and resulting processes within the test areas on both computer systems. After testing is completed, the test(s) may be ordered within the production area. For maintenance of the results cross-reference, MML Telecommunications will notify the Client of file changes that will affect results processing. Notification of appropriate updated test setup information prior to the effective date of the change(s) will be sent to each Client via email or fax. Please see the appendix for a sample notification. If the Client wishes to test the impact of the change(s), they may do so within the test environments of each computer system. If the interface software malfunctions, the problem must be clearly documented. MML will work with the Client and vendor personnel to determine where the problem may be. MML’s LSI Unit will support the software within its control. This does not include software on the Client’s computer system. The Client’s software vendor must be promptly informed of problems in the interface software at the Client’s end of the interface. The Client must work with their software vendor to resolve such problems. If a client’s LIS receives an upgrade after an interface implementation, or receives an upgrade/change to an ancillary system (i.e. upgrade is planned), the client must check with their LIS vendor to discuss the impact of the upgrade on the interface. If a software change is required, please contact your MML Regional Manager as soon as possible. As with any project, MML requires adequate lead-time to schedule your project and assign an MML project team to assist with the changes to the reference laboratory interface.

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Packing and Shipping of Specimens

In order to further enhance the handling of interfaced specimens once they have arrived at MML, we will supply each Client with temperature bags. These will be used for the specimens being sent to Mayo. The specimens should be placed in the corresponding temperature bag with the packing list that matches the samples in the bag. We ask that you place a check mark by the patient’s name as you place the sample in the bag. We also ask if multiple vials are to be sent for one accession number, please rubber band the vials together. This will ensure the samples are processed in a timely manner. When the samples are received at MML, the first line of data from the packing list will be used to verify receipt of the samples and generate labels. These labels will be affixed to the specimens, prior to being sent to performing laboratories. The packing list data will be used to manually enter the order if for some reason the electronic orders are not received from the interface. In order for this to be done in a timely fashion, it is necessary for the samples to be matched up with the packing list. Once a packing list has been generated, cancellation of any orders/batches must also be called into MML. Any samples on the packing list not sent to MML, or canceled, should be crossed off the packing list. The packing list, on the next page(s), provides an example of acceptable format and necessary information that needs to accompany all samples sent to MML. It must contain all the information needed for a manual entry of specimens, in the event of a failure of the electronic transfer of the orders. Patient information and tests on packing lists should match all samples sent. We ask that you only send one packing list per bag, with all samples listed on the sheet. If the Client packs a box, samples must be packed in styros matching temperature on the bags. Frozen styro: Dry ice should always be placed on the top and the bottom of the shipping styros with the samples placed between the layers of dry ice. During the summer months, make sure there is an appropriate amount of dry ice to sustain the appropriate temperature during shipping. Refrigerated styro: During the summer months, a frozen cold pack should be used in the bottom of the styro. In the winter months, a refrigerated cold pack should be used in the bottom of the styro. After the specimens are packed into the temperature-specific styros, the styros should then be placed into MML-labeled shipping boxes to be sent to Mayo. If the courier packs the styro, specimens should be packed into appropriate temperature bags, and stored in the freezer or refrigerator. If samples are to be sent ambient, they should be placed in a designated area for courier pickup. The courier will then pack the specimens into the correct temperature styro and place them in the MML shipping boxes to be sent to Mayo.

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Fields Required on Packing List

At top of page: • Include Client name and MML Client number • Note that this is a packing list for a Reference Lab Interface • Include date of shipment • List number of page if there are multiple pages

At end of packing list:

• Note total number of specimens on packing list For each specimen order:

• Label the data fields at the top of columns Data Possible Field Description Values/Comments Patient ID: Client Assigned Patient Identification Required Patient Name: Last, First, MI Required Age/DOB: Age in Years (default) Age optional if Date of Birth given Date of birth (DOB) MM/DD/YY M (Months), W (Weeks), or D (Days) Sex: M (Male) or F (Female) Sample ID: Client-Assigned Sample Identified Required Sample Identifier Test ID: Client Test Identifier Required Print the Mayo Unit Code, as sent via the interface. If multiple tests are ordered per accession, they should be listed one per line. If a test orders multiple orderable units, that should be noted along with showing the member test IDs and names.

Test Name Client Test Name Required Print the Mayo Unit Code, as sent via the interface. If multiple tests are ordered per accession, they should be listed one per line. If a test orders multiple orderable units, that should be noted along with showing the member test IDs and names.

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Collection Date specimen collected MM/DD/YY Date/Time: Time specimen collected HHMM in military 24 hour clock Volume/Weight Total volume of As needed; 999_99_Hours format Specimen: "Weight__Hours" Physician: Referring Physician Optional Additional Any Other Pertinent Information As needed Information: Results sent with order* In many cases, information will be sent as results for individual tests. This will allow flexibility in passing a variety of information sometimes needed for proper performance of specific tests. Information that may be passed this way includes:

• Urine volume and collection duration • Microbiology source • Drug dosage information, etc.

When such information is sent, indicate:

• Which ordered test the information applies to • What the individual test name is • What the result information is • Units of the measurement, if applicable

*Please check with your LIS vendor for specific information regarding results sent with orders.

Sample Specimen Packing List

MAYO MEDICAL LABORATORIES Date of Shipment

200 First Street SW Rochester, MN 55905

(MML Client Account Number) (Client Name) (Temperature) 1. Patient

Sid # 2. Patient

Name 3. Sex 4. DOB/Age 5. Lab Pt. # 6a. MML

Test # 6b. Test Name 7. Requesting

Physician 8. Collection

Date/time 9. Source/ Total Volume

10. Additional Info (if needed)

B1234567 SMITH, JANE

F 07/15/81 17Y

6222a 8804 C-Peptide, Serum

HACKLE 08/01/98 1215

Serum 1 HR POST DOSE

97651 DURAND, HAROLD

M 03/04/89 6M

5520a 8513 Creatinine, Urine

JOHNSON 08/02/98 0815

Urine 1230 24 Hours

30 Minutes

A0006501 CALAHAN, AMY T.

F 99D 44444 8202 Brucella Culture

JONES 09/31/98 2210

CSF

Data Field Description/Entry Values 1. Patient ID Number Assigned patient identifier for CLIENT NAME Required 2. Patient Name Enter as LAST NAME, FIRST NAME MI (UPPER CASE) Required 3. Sex Enter as M (male) or F (female) Test driven 4. Date of Birth/Age Enter as MM/DD/YY Required 5. Lab Patient Number Another patient identifier Optional 6a. Test Code Number Enter MML’s assigned test code number(s) Required 6b. Test Code Name Enter MML’s assigned test name Required 7. Requesting Physician Enter Doctor’s name(s) Optional 8. Collection Date/Time Enter date, MM/DD/YY, Time HHMM in Military time Required 9. Source/Total Volume Enter source of specimen when prompted Required Enter total volume for urine/stool test when prompted Required 10. Additional Information (if needed) Enter (i.e.) dosage information, (i.e.) draw times, and any pertinent information As needed # of total specimens on each packing list

Page Number

Required Fields on Labels Data Field Description Possible Values/Comments Accession: Client-assigned Accession Number Required Patient Name: Last, First, MI Required

Age/DOB: Age in Years (default) Age optional if Date of Birth given Date of birth (DOB) MM/DD/YY M (Months), W (Weeks), or D (Days) Sex: M (Male) or F (Female) Required Test Name: Test Identifier Required Print the Mayo Unit Code or Test Name of each orderable test, as sent via the interface. Collection Date specimen collected MM/DD/YY As needed Date/Time: Time specimen collected HHMM in military 24 hour clock Volume/Weight Total volume of As needed; 999_99_Hours format Specimen: "Weight__Hours" Source: Specimen Source As needed Primarily for Micro Specimens

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Sample Specimen Labels Please Note: Labels have been enlarged to show detail

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MML System Options and Parameters

During the development phase of the Interface project, the MML Project Manager will arrange an Interface Parameter and Options call. On this call the Project Manager will review with the Client specific settings that have been designed to customize the interface, in an effort to best meet our Clients’ needs. In addition, the Project Manager will review limitations of the Mayo Laboratory Information System, as well as options known to MML, regarding the specific Vendor LIS. ** The following features, Formatted Text and Generic Orderable, are available based on LSI configuration and vendor support. For more information, contact the MML Project Manager assigned to your project or your MML Regional Manager. The information contained herein is subject to change, as needed, without notice.

MML Formatted Text Formatted Text (FT), or Image Reports, is an optional LSI feature offered by Mayo Medical Laboratories. Implemented on the Cloverleaf interface engine, it modifies outbound result messages in such a way as to minimize the client’s file definition and file maintenance efforts. Formatted Text (FT) produces a single formatted textual result to replace multiple coded results and comments for any given test (orderable). It allows clients to build tests with one generic resultable instead of multiple specific resultables and it allows Mayo to standardize the report format. For a client meeting specific requirements, FT can be enabled for all tests or on a per-test basis

MML Generic Orderable Generic Orderable (GO) is an optional LSI feature offered by Mayo Medical Laboratories. "Generic" tests enable a client site to order MML tests that have not been defined in their database. At the time of order entry, test-specific information is entered in the form of ask-at-order tests or prompt tests. Implemented on the Cloverleaf interface engine, it modifies inbound order and outbound result messages in such a way as to minimize the client’s file definition and file maintenance efforts. Order message modification is based on the client providing the actual MML unit code as either an order comment or prompt result. The GO uses Formatted Text (FT) for formatting of the GO result. FT produces a single formatted textual result to replace multiple coded results and comments for any given test (orderable).

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Special Procedures

Add-On/Cancellation Procedure To add or cancel tests, after placing them through the LSI and generating a packing list, the Client must call Mayo Lab Inquiry (MLI) at (800-533-1710) for assistance.

Ordering Miscellaneous (WILD) Tests Miscellaneous (WILD) tests cannot be ordered through the Interface. These tests must be ordered through MayoLink, MayoNet, or manually.

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Mayo Medical Laboratories Contact Information

MML Billing 800-447-6424 MLI/Client Services 800-533-1710 • Add-ons to electronically sent orders • Cancellations of electronically sent orders • Changes in patient demographic information • Supplies requests • Provide additional ask-at-order/result-at-order

information not included on manifest • Verify status of sent orders MML Telecommunications 800-533-1710 (Ask for Telecom) • Electronic resend of results FAX: 507-284-9311 • General interface troubleshooting • Missing results/orders • Request test setup/file definition • Refile accessions after change in patient

demographics • Teleprinter troubleshooting MML Transportation 800-533-1710 (Ask for Transportation) • Transportation/Packing Issues MML Technical Representatives 800-533-1710 (Ask for Technical Representative On-Call) • Laboratory-specific questions • Special testing concerns

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Technical Information

Copyright © 2003 by Mayo Foundation 24 Proprietary and Confidential

Interface Models

Please Note: Some of the interface models described on the following pages are Vendor-dependent. Please consult with your LIS Vendor and MML to discuss available options. The information contained herein is subject to change as needed, without notice.


Direct LSI

A Direct LSI is Mayo’s traditional send-orders receive-results interface. It allows the Client to send orders to Mayo and receive results from Mayo.

Orders

Results

latigid

Mayo Lab3Client LIS- Send orders- Receive results


2-Way MayoNet LSI

A 2-Way MayoNet LSI is similar to a Direct LSI except that it also allows the Client to send orders to other performing labs on its network, and to receive

results from those performing labs, as well as from Mayo. The performing lab within the network must use a 4-Way MayoNet LSI or its MayoNet Kit to

receive network orders and return results.

Orders

Results

latigid

Mayo Lab3Client A LIS- Send orders- Receive results

Data General

Client B LIS

latigid

MayoNet Server


4-Way MayoNet LSI

A 4-Way MayoNet LSI is identical to a 2-Way MayoNet LSI except that it gives the Client the additional ability to receive orders from other network members

and to send results.

latigid

Mayo Lab3Client A LIS- Send orders- Receive results- Receive orders- Send results

Data General

Client B LIS

latigid

MayoNet Server


VPN Diagram

A virtual private network, or VPN, is a standards-based, hardware/software

solution that establishes a secure, managed tunnel through the Internet to enable an electronic trust relationship between business partners for a specific purpose. For LSI’s, a VPN can be pictured as a pipe between the Client’s LIS and Mayo’s Cloverleaf Interface Engine. Nothing is allowed to enter or leave

the pipe, except at the two endpoints. Data is encrypted during the transmission.

Internet

Client LIS Remote VPNServer

Router

Firewall

Antrim Lab3Local VPNServer

Router

Firewall

CloverleafInterface Engine

ISP


Frequently Asked Questions MML Virtual Private Network

Q. What is the standard VPN Solution for an interface with MML? A. MML has selected Nortel’s Contivity 100 as the client site VPN server. Mayo will purchase the VPN hardware, configure it specifically for each client’s network, and co-manage it with the client’s Networks team. Q. Why does MML require clients to have registered addresses? A. Each Contivity VPN server has a public interface and a private interface. The public interface must have a registered IP address in order to be “seen” on the Internet. A registered address is required in order to establish a logical connection between Mayo’s and the client’s VPN servers. Q. If there is an existing VPN solution at the client site, is it possible to do a server-to-server connection to MML with the existing solution? A. Yes. Mayo Networks has successfully VPNs with a variety of third party solutions. Mayo Networks is willing to work with clients to make a reasonable attempt to establish a connection with other vendors before deferring to the standard MML VPN solution. Q. Why does it matter to MML what private addresses are being used on the client's internal network? A. Mayo needs to confirm that the client’s private addresses are not already in use at Mayo or by another client or business partner with whom network connectivity has already been established. Q. Is there a solution if a client site is using private address space that conflicts with Mayo or another existing client? A. Yes. Mayo has tested the Nortel Contivity600 using NAT.


Q. Can we lock down specific devices and ports through our firewall for the connection? A. Yes. Only the public IP addresses of the remote and local VPN servers need to be in the rule on the firewall and only the IPSec protocols, UDP500 and port 50 and port 51. Mayo Networks may ask for additional IP addresses and ports to be opened during the installation phase to facilitate access to the VPN server for troubleshooting. Q. How secure is the public interface of the VPN server? A. On the public interface we apply filters that only accept traffic from Mayo's registered Class B network and traffic going to Mayo's Class B network. If you have any further questions, please contact your MML Project Manager to coordinate a meeting with a member of Mayo's Networks staff.


VPN Request Form

MML CONTACT INFORMATION MML Requestor/Project Manager Request Date MML Networks Contact

TECHNICAL CONTACT INFORMATION Client Name/Account Number Contact Name Telephone Email Shipping Address

Shipping Date

GENERAL QUESTIONS Do you have a Firewall Do you have a VPN solution? Who is your VPN Vendor? Would you like to use your existing VPN solution to connect to Mayo?

Please note: Establishing a server-to-server connection using existing solutions depends on the vendor of the existing VPN solution. Mayo Networks is willing to work with clients to make a reasonable attempt to establish a connection with other vendors before deferring to the standard MML VPN solution.

CLIENT ADDRESSING INFORMATION TO BE COMPLETED FOR ALL REQUESTS

Test LIS or Interface Engine Host Name TCP/IP Address Port Production LIS or Interface Engine Host Name TCP/IP Address Port Firewall must allow the following ports between public IP address of VPN servers at site and Mayo.

IPsec Tunnel Encapsulation Protocol 50 (ESP) ISAKMP/IPsec Key Management Port UDP Src 500 & Dst 500


UUNET Value Added Network

UUNET is a network service provider, contracted by MML to handle a portion of the

data communications path between the Client and MML.

The Client's LIS initiates a dial-up connection to UUnet using the public switched network (telephone system). This is a local call if available, toll-free if

not. Access to the UUnet network requires a host (service) name, username, and password. The session is X.25 protocol. The protocol may be X-modem or

HLLP. The Mayo router translates to TCP/ IP and connects to the Interface Engine or Mailbox system on the Mayo network. A second username and

password may be required before the Client is in capture mode.

latigid

D ata General

Terminal Server

Modem

UUnetRouter Firewall

Client LIS InterfaceEngine

Mayo Lab3

PSN X.25 TCP/ IPLAT or

TCP/ IP


UUnet Dial-In Script

The following outline is an example of a connection to the MML Mailbox System to upload orders and download results using XMODEM protocol for data transmission. A. Connect to the UUNet network 1. Dial the data network number provided by MML and establish a modem connection. 2. Send a carriage return, which is the wakeup string for the UUNet network. B. Logon to the UUNet Network and connect to the MML Mailbox System 1. Receive the “Host Name:” prompt, enter a “+”, then a carriage return, then the host name given to you by MML and a carriage return. The “+” will force the UUNet modem to 8 data bits, no parity, 1 stop bit, which should make the “Host Name:” prompt readable in all cases. 2. Receive the “UIC:” prompt and enter the UIC given to you by MML. 3. Receive the “Password:” prompt and enter the password given to you by MML. C. Logon to the MML Mailbox System

1. Receive the “Username:” prompt and enter the MML Mailbox System username given to you by MML.

2. Receive the “Password:” prompt and enter the MML Mailbox System password given to you by MML.

3. You are now communicating with the MML Mailbox System. D. Upload an order to the MML Mailbox System 1. Send “UPLOAD TO: Ö SUBJECT: Ö” 2. Check for ready (%%%UPLD-S-BGN) 3. Upload (transfer control to the XMODEM upload module) 4. Check for acknowledgment (%%%UPLD-S-XFEROK) E. Request and download results from the MML Mailbox System 1. Request next message (DOWNLOAD %NEXT) 2. Check for ready (%%%DWNLD-S-BGN) 3. Receive messages (transfer control to XMODEM receive module) 4. Acknowledge receipt (%%%DWNLD-S-XFEROK) F. Logoff the MML Mailbox System

1. Send “BYE” to logoff the MML Mailbox System.

G. Disconnect from UUNet 1. Send “OFF” at the “Host Name:” prompt to disconnect.


Example of X-Modem Communications Session A. Connect to the UUNet network Dial the local or 800 UUNet number provided by MML RECEIVE SEND COMMENT CONNECT <cr> The carriage return is the wake up string for the UUNet network.

0055ROY UUNet PAD information (text is variable). Host Name: +<cr>MMLxxx<cr> Enter the UUNet host name provided by MML. Entering a “+”

followed by a carriage return before the host name will force the UUNet modem to 8 data bits, no parity, and 1 stop bit.

UIC: xxxxxxxx<cr> Enter the UUNet user identifier provided by MML. Password: xxxxxxxx<cr> Enter the UUNet password provided by MML.

Connected to 0108 Mayo_Foundation_1 Connection established to MML Mailbox System Trying 129.176.136.218…Open (text is variable) -------------------------- transition from Data Network Provider to MML Mailbox System ------------------------------ B. Communication session once connected to the MML Mailbox System RECEIVE SEND COMMENT System LPCOMA - VAX/VMS V5.5 MML Mailbox System welcome (text is variable). Username: xxxxxx<cr> Enter MML Mailbox System username assigned by MML.

Password: xxxxxx<cr> Enter MML Mailbox System password assigned by MML. %%%PARSR-I-RDY, Ready UPLOAD %TO:"yyy" %SUBJECT:"yyyymmdd_messagetype"<cr>.

Upload an order to the MML Mailbox System where yyy is MML” for production or “MMLTEST” for testing.The subject is the date plus a message type, which is “ASTMO” for an ASTM order.

%%%UPLD-S-BGN, Begin transfer Call the XMODEM upload function on your system

EOT<CR> Send these characters when upload is complete.

%%%UPLD-S-XFEROK, Transferred Successful upload response from the MML Mailbox System

Successfully log the upload on your system. UPLOAD %TO:"yyy" %SUBJECT:"yyyymmdd_messagetype"<cr>. Upload an order to the MML Mailbox System.

%%%UPLD-S-BGN, Begin transfer Call the XMODEM upload function on your system

EOT<cr> Send these characters when upload is complete.


RECEIVE SEND COMMENT %%%UPLD-S-XFEROK, Transferred Successful upload response from the MML Mailbox System

Successfully log the upload on your system.

DOWNLOAD %NEXT<cr> Request download of next message from the MML Mailbox System. %%%DWNLD-S-BGN, Begin transfer call the XMODEM download function on your system %%%DWNLD-S-XFEROK, Transferred

Successfully ACCEPT<cr> Receipt of message acknowledgment.

DOWNLOAD %NEXT<cr> Request download of next message from the MML Mailbox System.

%%%DWNLD-S-BGN, Begin transfer call XMODEM download function on your system %%%DWNLD-F-XFERFAIL, Transfer failed Failure encountered.

DOWNLOAD %NEXT<cr> Try again (we allow 2 failures of this type before exiting). %%%DWNLD-S-BGN, Begin transfer call XMODEM download function on your system %%%DWNLD-S-XFEROK Transferred successfully.

ACCEPT<cr> Receipt of message acknowledgment.

DOWNLOAD %NEXT<cr> Request download of next message.

%%%DWNLD-W-NOMSG <cr> MML Mailbox System has no more messages for you. %%PARSR-I-RDY, Ready BYE<cr> Disconnect from the MML Mailbox System.

-------------------------- transition from MML Mailbox System to Data Network Provider ------------------------------

Host Name: OFF<cr> Enter “OFF” to disconnect from UUNet. You may be

disconnected from UUNet immediately after you disconnect from the MML Mailbox System, if not, this will disconnect you completely.


Connection Requirements Hardware requirements include a modem capable of accessing a data communications network. Transmission characteristics supported are: 8 baud rate 2400 to 28800 bps 8 communications parameters 8 Data Bits, No Parity, One Stop Bit

Miscellaneous Notes There are times when data network connections may be abnormally interrupted while in the process of sending or receiving files. Treat any incomplete transactions as unsent and queue them for retransmission. Also, discard any incomplete reads as the MML Mailbox System treats these as unsent messages.

MML Networking Protocol

The direct interface to the MML Mailbox System is designed to be a simple mail interface. Its features make it better suited for machine-to-machine communications than commercial mail systems. The interface makes control messages extremely simple and provides self-checking features where possible to avoid problems that can occur when control messages are garbled in transmission. It uses standard modem protocols for the actual data transfer operations.

The XMODEM protocol will be one of the protocols supported for data transfer. The control signaling will be command oriented. The Client computer will initiate a connection to the MML Mailbox System and issue a sequence of commands to control the process of information transfer. The primary commands are the upload and download commands, but additional commands are provided to control the course of the connection to the MML Mailbox System.

Basic Command Format

The protocol is based on a general syntax of the form verb [switch[:value] ...] VERB command, for example UPLOAD, DOWNLOAD, or BYE. SWITCH command modifier and by convention begins with a percent sign. VALUE associated number, key word, string, or list of values within parentheses.

A typical command is: UPLOAD %TO:yyy %SUBJECT:yyyymmdd_messagetype Where yyy is either “MML” if in production or “MMLTEST” if in testing. The subject is the date concatenated with a message type. This message Type is “ASTMO” for ASTM orders and “ASTMR” for ASTM results.


Overview The following outline summarizes the verbs and associated option switches. SET %ECHO:value ON OFF %PROTOCOL:type XMODEM DOWNLOAD [switch:value [switch:value ...]] %NEXT ACCEPT REJECT %CODE:reason_code %INFO:reason_text UPLOAD [switch:value [switch:value ...]] %TO:recipient %SUBJECT:subject_string BYE

File Format Control lines begin with a single period and are as follows: .To: destination_name .From: source_name .Subject: subject_string The above lines constitute a message header and precede any data lines. There are currently no other control line formats defined. If a data line begins with a period, there must be an additional period prefixed to it in order to avoid being interpreted as a control line. Applications must perform this prefixing operation upon file creation and must strip off the additional period when reading any line that begins with two periods.


Valid Responses-Download Command To the DOWNLOAD COMMAND: %%%DWNLD-S-BGN Begin transfer %%%DWNLD-S-XFEROK Transferred successfully %%%DWNLD-F-XFERFAIL Transfer failed %%%DWNLD-F-REJECT "Reject" command received %%%DWNLD-S-ACCEPT Download completed and "accept" received To the UPLOAD COMMAND: %%%UPLD-S-XFEROK Transferred successfully %%%UPLD-S-BGN Begin transfer %%%UPLD-F-XFERFAIL Transfer failed To BYE COMMAND: %%%BYCMD-S-DSCON Bye command received, disconnecting

MML Mailbox System Command Definitions Prompt: Comments: %%%PARSR-I-RDY MML Mailbox System ready for command %%%UPLD-S-BGN Signals that the MML Mailbox System is ready to

receive via XMODEM %%%DWNLD-S-BGN Signals that the MML Mailbox System is ready to

send via XMODEM %%%UPLD-S-XFEROK Signals that the MML Mailbox System successfully

received the file %%%DWNLD-S-XFEROK Signals that the MML Mailbox System received

acknowledgment of transfer %%%DWNLD-W-NOMSG Signals that there are no more messages available for

download %%%DWNLD-F-XFERFAIL Signals that the XMODEM file transfer to the Client

system failed %%%UPLD-F-XFERFAIL Signals that the XMODEM file transfer to the MML

Mailbox System failed %%%DWNLD-F-REJECT Signals that the Client system rejected file transfer %%%UPLD-F-REJECT Signals that the MML Mailbox System rejected file

transfer %%%DWNLD-S-ACCEPT Signals MML Mailbox System acknowledgment of

the Client system accepting file transfer %%%UPLD-S-ACCEPT Signals MML Mailbox System acknowledgment of

file transfer

Valid Responses-Upload Command UPLOAD %TO:to %SUBJECT:yyyymmdd_messagetype %PROTOCOL:protocol DOWNLOAD %NEXT


Message Formatting Note: These definitions apply to both ASTM and HL7. In most instances Mayo can accommodate vendor specifications that may deviate from this standard. For non-standard message formatting, Mayo and the LIS vendor must arrange a conference call to review interface specifications. Data Segment A data segment is an intermediate unit of information in a transaction. The data segment is a variable length record of logically related data elements in a defined sequence including a predetermined segment identifier and one or more data elements. The segment identifier is a one-character (ASTM) or three-character (HL7) label that is not considered a data element. Each data element is preceded by a data element separator or delimiter. A segment terminator closes each segment. Data Message A data message is the larger unit of information in a transaction, encompassing the header, patient, order, result, and comment records or segments. Delimiters A delimiter is a character used to separate two data elements or sub-elements. They are specified message header segment, MSH in HL7 or H in ASTM, immediately following the segment identifier. Once specified in the header segment, the delimiters are not to be used in a data element value elsewhere in the message, i.e. they should be used only as delimiters. Segment Terminator A segment terminator is used to mark the end of a segment. Carriage return (ASCII-13) and line feed (ASCII-10) serve as the segment terminator for X-modem transfer. For stream-based messages, e.g. socket connections, a single carriage return (ASCII-13) is the preferred segment terminator.


MML Use of HL7 2.3

Purpose The following information describes Mayo’s Laboratory System Interface (LSI) for orders and results. Specifically, it details the HL7 2.3 message structure and syntax to which Mayo normalizes orders and results transactions as they’re processed through its LSI 2000 interface software, and reflects the requirements and limitations of Mayo’s Lab3 Laboratory Information System (LIS) with respect to HL7. This information can also be used externally in the absence of a suitable HL7 specification from a client’s LIS vendor.

Disclaimer The following is accurate and complete to the best of our knowledge as of this writing. The information contained herein is subject to change or correction, as needed, without notice.

Message Structure ORM – Orders to Mayo MSH PID [ PV1 ] { [ NTE ] } ORC { OBR { [ NTE ] } { [ OBX ] { [ NTE ] } } }

ORU – Results from Mayo MSH PID ORC { OBR { [ NTE ] } { [ OBX ] { [ NTE ] } } }

“[“ and “]” indicate optional segments; “{“ and “}” indicate repeating segments.


Message Format The following sections detail the HL7 message segments relevant to Mayo Laboratory System Interfaces, as required by Mayo’s Lab3 Laboratory Information System or accommodated by LSI 2000. MSH for Orders – Message Header Segment SEQ FIELD TITLE ITEM HL7

LEN REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Field separator 1 1 REQ ST 1 Usually |

2 Encoding characters 2 4 REQ ST 4 Usually ^~\& 3 Sending application 3 180 REQ ST 15 Client ID 4 Sending facility 4 180 OPT ST 20 Sub-client ID 5 Receiving application 5 180 REQ ST 30 MML, MMLTEST, or

MayoNet ID

6 Receiving facility 6 180 NS ST 180 Not used 7 Date/time of message 7 26 REQ TS 12 CCYYMMDDHHM

M

8 Security 8 40 NS ST 40 Not used 9 Message type 9 7 REQ CM 7 ORM 10 Message control ID 10 20 OPT ST 20 11 Processing ID 11 3 REQ ID 1 D,P,T = debug,

production, test

12 Version ID 12 8 REQ ID 8 2.3 13 Sequence number 13 15 NS NM 15 Not used 14 Continuation pointer 14 180 NS ST 180 Not used 15 Accept acknowledgement

type 15 2 NS ID 2 Not used

16 Application acknowledgement type

16 2 NS ID 2 Not used

17 Country code 17 2 NS ID 2 Not used 18 Character Set 692 6 NS ID 6 Not used 19 Principal Language of

Message 693 60 NS CE 60 Not used


MSH for Results – Message Header Segment SEQ FIELD TITLE ITEM HL7

LEN REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Field separator 1 1 REQ ST 1 Usually |

2 Encoding characters 2 4 REQ ST 4 Usually ^~\& 3 Sending application 3 180 REQ ST 15 MML, MMLTEST, or

MayoNet ID

4 Sending facility 4 180 NS ST 20 Not used 5 Receiving application 5 180 REQ ST 30 Client ID 6 Receiving facility 6 180 OPT ST 30 Sub-client ID 7 Date/time of message 7 26 REQ TS 12 CCYYMMDDHHM

M

8 Security 8 40 OPT ST 40 Sub-client ID 9 Message type 9 7 REQ CM 7 ORU 10 Message control ID 10 20 REQ ST 20 "R" or serial number 11 Processing ID 11 3 REQ ID 1 D,P,T = debug,

production, test

12 Version ID 12 8 REQ ID 8 2.3 13 Sequence number 13 15 NS NM 15 Not used 14 Continuation pointer 14 180 NS ST 180 Not used 15 Accept acknowledgement

type 15 2 NS ID 2 Not used

16 Application acknowledgement type

16 2 NS ID 2 Not used

17 Country code 17 2 NS ID 2 Not used 18 Character Set 692 6 NS ID 6 Not used 19 Principal Language of

Message 693 60 NS CE 60 Not used

MSA – Message Acknowledgement Segment SEQ FIELD TITLE ITEM HL7

LEN REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Acknowledgement Code 18 2 REQ ID 2 AA (acceptance) 2 Message Control ID 10 20 REQ ST 20 From MSH-10 3 Text Message 20 80 OPT ST 80 4 Expected Sequence Number 21 15 OPT NM 15 5 Delayed Acknowledgement

Type 22 1 B ID 1

6 Error Condition 23 100 OPT CE 100


PID – Patient Identification Segment SEQ FIELD TITLE ITEM HL7

LEN REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - Patient ID 104 4 OPT SI 4 2 Patient ID (External ID) 105 20 REQ CK 20 3 3 Patient ID (Internal ID) 106 20 OPT CM 20 4 4 Alternate Patient ID 107 20 OPT ST 12 5 Patient Name - last first

middle suffix prefix degree 108 48 REQ PN 48 MAYO^PATIENT^TH

REE

6 Mother's Maiden Name 109 48 OPT ST 30 Not used 7 Date of Birth 110 26 C1 TS 8 CCYYMMDD 8 Sex 111 1 C1 ID 1 LSI-M, F, U

MAYONET-M, F, NULL

9 Patient Alias 112 48 OPT PN 48 Not used 10 Race 113 1 OPT ID 1 (O) NS (R) Not used 11 Patient Address 114 106 OPT AD 106 (O) NS (R) Not used 12 County code 115 4 NS ID 4 Not used 13 Phone Number - Home 116 40 OPT TN 40 (O) NS (R) Not used 14 Phone Number - Business 117 40 NS TN 40 Not used 15 Language - Patient 118 60 NS ST 25 Not used 16 Marital Status 119 1 NS ID 1 Not used 17 Religion 120 3 NS ID 3 Not used 18 Patient Account Number 121 20 NS CK 20 Not used 19 SSN Number - Patient 122 16 NS ST 16 Not used 20 Driver's Lic Num - Patient 123 25 NS CM 25 Not used 21 Mother's Identifier 124 20 NS CK 20 Not used 22 Ethnic Group 125 3 NS ID 1 Not used 23 Birth Place 126 60 NS ST 25 Not used 24 Multiple Birth Indicator 127 2 NS ID 2 Not used 25 Birth Order 128 2 NS NM 2 Not used 26 Citizenship 129 4 NS ID 3 Not used 27 Veterans Military Status 130 60 NS CE 60 Not used 28 Nationality 739 80 NS CE 80 Not used 29 Patient Death Date and

Time 740 26 NS TS 26 Not used

30 Patient Death Indicator 741 1 NS ID 1 Not used 1 Complete normal flagging requires these fields


PV1 for Orders – Patient Visit Segment SEQ FIELD TITLE ITEM HL7

LEN REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - Patient Visit 131 4 NS SI 4 Not used 2 Patient Class 132 1 NS ID 1 Not used 3 Assigned Patient Location 133 80 OPT CM 30 4 Admission Type 134 2 NS ID 2 Not used 5 Pre-admit Number 135 20 NS ST 20 Not used 6 Prior Patient Location 136 80 NS CM 12 Not used 7 Attending Doctor - id last

first middle suffix prefix degree

137 60 OPT CN 60

8 Referring Doctor 138 60 NS CN 60 Not used 9 Consulting Doctor 139 60 OPT CN 60 10 Hospital Service 140 3 NS ID 3 Not used 11 Temporary Location 141 80 NS CM 12 Not used 12 Pre-admit Test Indicator 142 2 NS ID 2 Not used 13 Readmission indicator 143 2 NS ID 2 Not used 14 Admit Source 144 3 NS ID 3 Not used 15 Ambulatory Status 145 2 NS ID 2 Not used 16 VIP Indicator 146 2 NS ID 2 Not used 17 Admitting Doctor 147 60 NS CN 60 Not used 18 Patient type 148 2 NS ID 2 Not used 19 Visit Number 149 20 NS NM 15 Not used 20 Financial Class 150 50 NS CM 50 Not used 21 Charge Price Indicator 151 2 NS ID 2 Not used 22 Courtesy Code 152 2 NS ID 2 Not used 23 Credit Rating 153 2 NS ID 2 Not used 24 Contract Code 153 2 NS ID 2 Not used 25 Contract Effective Date 155 8 NS DT 8 Not used 26 Contract Amount 156 12 NS NM 12 Not used 27 Contract Period 157 3 NS NM 3 Not used 28 Interest Code 158 2 NS ID 2 Not used 29 Transfer to Bad Debt Code 159 1 NS ID 1 Not used 30 Transfer to Bad Debt Date 160 8 NS DT 8 Not used 31 Bad Debt Agency Code 161 10 NS ID 10 Not used 32 Bad Debt Transfer Amount 162 12 NS NM 12 Not used 33 Bad Debt Recovery Amount 163 12 NS NM 12 Not used 34 Delete Account Indicator 164 1 NS ID 1 Not used 35 Delete Account Date 165 8 NS DT 8 Not used 36 Discharge Disposition 166 3 NS ID 3 Not used 37 Discharged to Location 167 25 NS CM 25 Not used 38 Diet Type 168 2 NS ID 2 Not used 39 Servicing Facility 169 2 NS ID 2 Not used 40 Bed Status 170 1 NS ID 1 Not used 41 Account Status 171 2 NS ID 2 Not used 42 Pending Location 172 80 NS CM 12 Not used 43 Prior Temporary Location 173 80 NS CM 12 Not used 44 Admit Date/time 174 26 NS TS 12 Not used 45 Discharge Date/time 175 26 NS TS 12 Not used 46 Current Patient Balance 176 12 NS NM 12 Not used 47 Total Charges 177 12 NS NM 12 Not used


48 Total Adjustments 178 12 NS NM 12 Not used 49 Total Payments 179 12 NS NM 12 Not used 50 Alternate Visit ID 180 20 NS CM 20 Not used 51 Visit Indicator 1226 1 NS IS 1 Not used 52 Other Healthcare Provider 1224 60 NS XCN 60 Not used

NTE – Notes and Comments Segment SEQ FIELD TITLE ITEM HL7

LEN REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - NTE 96 4 OPT SI 4 2 Source of Comment 97 8 NS ID 8 (O) Not used REQ (R) See below 2.1 Comment Type 1 OPT 1 6 2.2 Message Code 6 OPT 6 3 Comment 98 64K OPT FT 60 or 72 APS, MGS, Lab3 A &

C - 60 byte max; Lab3 F, Micro - 72 byte max


ORC – Common Order Segment SEQ

FIELD TITLE ITEM

HL7 LEN

REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Order Control 215 2 REQ 215 2 (O) NW (R) RE 2 Placer Order Number 216 22 C 216 15 (O) Mayo accn number REQ (R) Mayo accn number 3 Filler Order Number 217 22 NS 217 75 Not used 4 Placer Group Number 218 22 NS 218 75 Not used 5 Order Status 219 2 NS 219 2 Not used 6 Response Flag 220 1 NS 220 1 Not used 7 Quantity/Timing 221 200 NS 221 200 Not used 8 Parent 222 200 NS 222 200 Not used 9 Date/time of Transaction 223 26 NS 223 12 Not used 10 Entered By 224 120 NS 224 80 Not used 11 Verified By 225 120 NS 225 80 Not used 12 Ordering Provider 226 120 NS 226 80 Not used 13 Enterer's Location 227 80 NS 227 80 Not used 14 Call Back Phone No 228 40 NS 228 40 Not used 15 Order Effective Date/time 229 26 NS 229 12 Not used 16 Order Control Code Reason 230 200 NS 230 200 Not used 17 Entering Organization 231 60 NS 231 60 Not used 18 Entering Device 232 60 NS 232 60 Not used 19 Action by 233 120 NS 233 80 Not used


OBR for Orders – Observation Request Segment SEQ

FIELD TITLE ITEM

HL7 LEN

REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - Observation Request

237 4 OPT SI 4

2 Placer Order Number1 216 22 REQ CM 15 Client accn number 8 3 Filler Order Number2 217 22 C CM 15 Mayo accn number 4 Universal Service ID 238 200 REQ CE 200 MML Unit Code 5 Priority 239 2 NS ID 2 Not used 6 Requested Date/time 240 26 OPT TS 26 11 7 Observation Date/time 241 26 OPT3 TS 12 CCYYMMDDHHMM 8 Observation End Date/time 242 26 NS TS 12 Not used 9 Collection Volume1 243 20 NS CQ 20 Not used 10 Collector Identifier1 244 60 NS CN 60 Not used 11 Specimen Action Code1, 2 245 1 NS ID 1 Not used 12 Danger Code 246 60 NS CE 60 Not used 13 Relevant Clinical Info. 247 300 OPT ST 300 Preserved by Lab3 at

accession level

14 Specimen Rcvd Date/time1, 2 248 26 OPT TS 12 CCYYMMDDHHMM 15 Specimen Source1,4 249 300 OPT CM 300 16 Ordering Provider - id last


226 80 OPT CN 80

17 Order Callback Phone No 250 40 NS TN 40 Not used 18 Placer field 1 251 60 OPT ST 60 Preserved by Lab3 at

accession level 9

19 Placer field 2 252 60 NS ST 60 Not used 20 Filler Field 1 253 60 NS ST 60 Not used 21 Filler Field 2 254 60 OPT ST 60 Preserved by Lab3 at

order level

22 Results Report/Status Change - Date/time

255 26 NS TS 12 Not used

23 Charge to Practice1, 2 256 40 OPT CM 40 C,P,M = client, patient, Medicare

24 Diagnostic Service Sect ID 257 10 NS ID 10 Not used 25 Result Status 258 1 OPT ID 1 26 Parent Result 259 400 NS CM 200 Not used 27 Quantity/Timing 221 200 OPT TQ 200 28 Result Copies To 260 150 OPT CN 150 29 Parent Number 261 150 NS CM 150 Not used 30 Transportation Mode 262 20 NS ID 20 Not used 31 Reason for Study 263 300 OPT CE 300 32 Principal Result Interpreter 264 200 NS CM 60 Not used 33 Assistant Result Interpreter 265 200 NS CM 60 Not used 34 Technician 266 200 NS CM 60 Not used 35 Transcriptionist 267 200 NS CM 60 Not used 36 Scheduled Date/time 268 26 OPT TS 12 Request Date 37 Number of Sample

Containers 1028 4 NS NM 4 Not used

38 Transport Logistics of Collected Sample

1029 60 NS CE 60 Not used

39 Collector’s Comment 1030 200 NS CE 200 Not used


40 Transport Arrangement Responsibility


41 Transport Arranged 1032 30 NS ID 30 Not used 42 Escort Required 1033 1 NS ID 1 Not used 43 Planned Patient Transport

Comment 1034 200 NS CE 200 Not used

1 Known by application placing order 2 Known by application filling the order

3 Required by many Urinalysis tests 4 Required by most Microbiology tests

OBR for Results – Observation Request Segment SEQ

FIELD TITLE ITEM HL7 LEN

REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - Observation Request

237 4 OPT SI 4

2 Placer Order Number1 216 22 REQ CM 15 Client accn number 8 3 Filler Order Number2 217 22 REQ CM 15 Mayo accn number 4 Universal Service ID 238 200 REQ CE 200 MML Unit Code 5 Priority 239 2 NS ID 2 Not used 6 Requested Date/time 240 26 NS TS 26 Not used 7 Observation Date/time 241 26 OPT3 TS 12 8 Observation End Date/time 242 26 NS TS 12 Not used 9 Collection Volume1 243 20 NS CQ 20 Not used 10 Collector Identifier1 244 60 OPT CN 60 11 Specimen Action Code1, 2 245 1 REQ ID 1 N (new) 12 Danger Code 246 60 OPT CE 60 Not used 13 Relevant Clinical Info. 247 300 OPT ST 300 Preserved by Lab3 at

accession level

14 Specimen Rcvd Date/time1, 2 248 26 OPT TS 12 15 Specimen Source1,4 249 300 NS CM 300 Not used 16 Ordering Provider - id last


226 80 OPT CN 80

17 Order Callback Phone No 250 40 OPT TN 40 18 Placer field 1 251 60 OPT ST 60 Preserved by Lab3 at

accession level 9

19 Placer field 2 252 60 NS ST 60 Not used 20 Filler Field 1 253 60 OPT ST 60 21 Filler Field 2 254 60 OPT ST 60 Preserved by Lab3 at

order level

22 Results Report/Status Change - Date/time

255 26 OPT TS 12

23 Charge to Practice1, 2 256 40 OPT CM 40 C,P,M = client, patient, Medicare

24 Diagnostic Service Sect ID 257 10 OPT ID 10 25 Result Status 258 1 REQ ID 1 F 26 Parent Result 259 400 NS CM 200 Not used 27 Quantity/Timing 221 200 OPT TQ 200 28 Result Copies To 260 150 NS CN 150 Not used 29 Parent Number 261 150 NS CM 150 Not used 30 Transportation Mode 262 20 NS ID 20 Not used 31 Reason for Study 263 300 NS CE 300 Not used 32 Principal Result Interpreter 264 200 NS CM 60 Not used


33 Assistant Result Interpreter 265 200 NS CM 60 Not used 34 Technician 266 200 NS CM 60 Not used 35 Transcriptionist 267 200 NS CM 60 Not used 36 Scheduled Date/time 268 26 NS TS 12 Not used 37 Number of Sample

Containers 1028 4 NS NM 4 Not used

38 Transport Logistics of Collected Sample


39 Collector’s Comment 1030 200 NS CE 200 Not used 40 Transport Arrangement

Responsibility 1031 60 NS CE 60 Not used

41 Transport Arranged 1032 30 NS ID 30 Not used 42 Escort Required 1033 1 NS ID 1 Not used 43 Planned Patient Transport

Comment 1034 200 NS CE 200 Not used

1 Known by application placing order 2 Known by application filling the order

3 Required by many Urinalysis tests 4 Required by most Microbiology tests


OBX for Orders – Observation Result Segment SEQ


REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - Observational Simple

569 10 OPT SI 4

2 Value Type 570 2 NS ID 2 Not used 3 Observation Identifier 571 590 REQ CE 80 MML Test Code 4 Observation Sub-ID 572 20 NS ST 20 Not used 5 Observation Value 573 64K OPT ST 80 6 Units 574 60 NS CE 60 Not used 7 References Range 575 10 NS ST 60 Not used 8 Abnormal Flags 576 5 NS ID 10 Not used 9 Probability 577 5 NS NM 5 Not used 10 Nature of Abnormal Test 578 2 NS ID 5 Not used 11 Observation Result Status 579 1 NS ID 2 Not used 12 Date Last Observation

Normal Values 580 26 NS TS 26 Not used

13 User Defined Access Checks

581 20 NS ST 20 Not used

14 Date/time of the Observation


15 Producer's ID 583 60 NS CE 60 Not used 16 Responsible Observer 584 80 NS XCN 80 Not used 17 Observation Method 936 60 NS CE 60 Not used

OBX for Results – Observation Result Segment SEQ


REQ/ OPT

TYPE LAB3 LEN

MAYO USE LSI

1 Set ID - Observational Simple

569 10 OPT SI 4

2 Value Type 570 2 OPT ID 2 ST 3 Observation Identifier 571 590 REQ CE 80 4 Observation Sub-ID 572 20 NS ST 20 Not used 5 Observation Value 573 64K REQ ST 80 6 Units 574 60 OPT CE 60 Value returned 7 References Range 575 10 OPT ST 60 8 Abnormal Flags 576 5 OPT ID 5 HH, LL, h, l, N 9 Probability 577 5 NS NM 5 Not used 10 Nature of Abnormal Test 578 2 NS ID 5 Not used 11 Observation Result Status 579 1 REQ ID 2 C, F 12 Date Last Observation

Normal Values 580 26 REQ TS 26

13 User Defined Access Checks

581 20 NS ST 20 Not used

14 Date/time of the Observation


15 Producer's ID 583 60 OPT CE 60 16 Responsible Observer 584 80 NS XCN 80 Not used 17 Observation Method 936 60 NS CE 60 Not used


Data Communications Communications protocols, data framing, and acknowledgements are described in this section. Mayo offers dial-up connectivity via UUnet services and network connectivity via the Internet and Virtual Private Network (VPN) technology.

HLLP – Hybrid Lower Layer Protocol Dial-up connectivity uses the Hybrid Lower Layer Protocol. HLLP defines data blocks and Nak blocks. Each HL7 message is transmitted in a data block, whereas Nak blocks are used to signal transmission errors. Both use the format: <SB>tvv<CR>ddddcccccxxx<EB><CR> where…

<SB> is the start block character (X0B) t is “D” for data or “N” for NAK vv is “23” <CR> is carriage return (X0D) dddd is the HL7 message or a one-character reason code ccccc is block size (length of data plus 5) xxxx is checksum <EB> is the end block character (X1C) <CR> is a carriage return

For inbound data, Mayo will validate the structure of the data frame, check its length, calculate its checksum, and accept or reject the message accordingly. Rejected messages will generate a Nak. Clients should perform similar checks on messages received from Mayo. If an outbound message is Nak’ed three times, Mayo will set it aside and try it again later.

MLLP – Minimal Lower Layer Protocol Network connectivity uses the Minimal Lower Layer Protocol. Because MLLP depends on TCP/IP for data integrity (transmission errors, timeouts, etc.), it defines only data blocks of the format: <SB>dddd<EB><CR> where…

<SB> is the start block character (X0B) dddd is the HL7 message <EB> is the end block character (X1C) <CR> is a carriage return (X0D)

For a more thorough discussion of HLLP and MLLP, refer to Appendix C of the HL7 2.3 Manual. Whether HLLP or MLLP, inbound messages that pass the above integrity checks will be compared with the previous message. If Mayo detects three consecutive identical messages, the second and subsequent messages will be disregarded. For outbound network connections (MLLP) initiated by Mayo, the standard configuration uses a recovery database to guarantee delivery. It also establishes a maximum number of retries (typically three to five) and a timeout value (typically 30 seconds). When Mayo sends a results message and the client acknowledges receipt with an Ack, the transaction is completed. If the client returns a negative acknowledgement (Nak), Mayo will resend up to the maximum number of retries. If the maximum retries is exceeded, the message is written to an error database and processing continues. If Mayo sends a message and gets no response within the timeout period,


the message is resent. This standard configuration is based on MSA-1, Acknowledgement Code, of AA (application accept) or CA (commit accept).

Mayo will acknowledge inbound messages in a similar way and can return a message control id in MSA-2 if provided in MSH-10.


Sample HL7 Messages

Orders Messages MSH|^~\&|C7012345|SUBCLIENT|MML||20020722101000||ORM|2686.2|P|2.3 PID|1|CLIENTPATIENTID||M00111449567|LASTNAME^FIRSTNAME M||19840324|M||C|STREET1^^CITY^STATE^ZIPCODE|||||S PV1||I|PARC^067^01^PBMC|E|||ATTENDING||||||||||ADMITTING|IN||BC|||||||||||||||||||||AD ORC|NW|197654^LAB||0721:RR00005U||N|^^^^^R||20020721225900.0000-0500 OBR|1|0721:RR00005U||505325^DRUG OF ABUSE, CLINICAL^L|||20020721223000.0000-0500|||||||20020721223900.0000-0500||ORDERING||197654^LAB||||||LAB|||^^^^^R MSH|^~\&|C7012345|SUBCLIENT|MML||20020722124300.0000-0500||ORM|2689.2|P|2.3 PID|1|CLIENTPATIENTID||M00111452132|LASTNAME^FIRSTNAME M||19170304|M||C|STREET1^^CITY^STATE^ZIPCODE|||||W|||SSN PV1||O|LAB^^^PBMC|S|||ATTENDING|||||||||||RE||MCRA|||||||||||||||||||||RE ORC|NW|198041^LAB||0722:RR00011R||N|^^^^^R||20020722121200.0000-0500 OBR|1|0722:RR00011R||82587^TISSUE TRANSGLUTAMINASE AB^L|||20020722082000.0000-0500|||||||20020722121300.0000-0500||ORDERING||198041^LAB||||||LAB|||^^^^^R MSH|^~\&|C7012345|SUBCLIENT|MML||200207221244||ORM|2690.2|P|2.3 PID|1|CLIENTPATIENTID||M00111451118|LASTNAME^FIRSTNAME M||19760603|M||C|STREET1^^CITY^STATE^ZIPCODE|||||M|||SSN PV1||O|LAB^^^PBMC|S|||ATTENDING|||||||||||CL||BC|||||||||||||||||||||RE ORC|NW|197928^LAB||0722:RR00007R||N|^^^^^R||20020722104100.0000-0500 OBR|1|0722:RR00007R||200133^TESTOSTERONE, TOTAL ONLY^L|||20020722110800.0000-0500|||||||20020722110800.0000-0500||ORDERING||197928^LAB||||||LAB|||^^^^^R MSH|^~\&|C7012345|SUBCLIENT|MML||20020722101000.0000-0500||ORM|2686.5|P|2.3 PID|1|CLIENTPATIENTID||M00111450292|LASTNAME^FIRSTNAME M||19601209|F||C|STREET1^^CITY^STATE^ZIPCODE|||||M|||SSN PV1||O|LAB^^^PBMC|S|||ATTENDING|REFERRING||||||||||CL||BC|||||||||||||||||||||RE ORC|NW|197814^LAB||0722:RR00004R||N|^^^^^R||20020722090000.0000-0500 OBR|1|0722:RR00004R||200177^FREE T3^L|||20020722090600.0000-0500|||||||20020722090600.0000-0500||ORDERING||197814^LAB||||||LAB|||^^^^^R


Results Messages MSH|^~\&|MML||C7012345|SUBCLIENT|20020723150239|SUBCLIENT|ORU|R|P|2.3 PID||CLIENTPATIENTID|MAYOPATIENTID||LASTNAME^FIRSTNAME M||19840324|M||||||||||M00111449567 ORC|RE|K8158381 OBR||197654^LAB|K8158381|505325^Drug of Abuse, Clin, DAU9*C, U|R||200207212230|||C7012345^Community Hospital^800-123-4567|N|||200207222100||ORDERING||0721:RR00005U|LAB|||200207231502|C|CH|F OBX||L|11161^Cocaine Metabolite^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 300 ng/mL^N OBX||L|11162^Tetrahydrocannabinols^ROCLIS||Positive||||||F|19990617 NTE||L|Cutoff: 50 ng/mL^N OBX||L|11570Ôpiates^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 300 ng/mL^N OBX||L|11301^Barbiturates^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 300 ng/mL^N OBX||L|11572^Benzodiazepines^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 300 ng/mL^N OBX||L|11573^Phencyclidine^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 25 ng/mL^N OBX||L|11164Âmphetamines^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 1000 ng/mL^N OBX||L|11165^Methadone^ROCLIS||Negative||||||F|19990617 NTE||L|Cutoff: 300 ng/mL^N OBX||L|11166^Propoxyphene^ROCLIS||Negative||||||F|19990617 NTE||L|CUTOFF: 300 ng/mL^N OBX||L|11163^ ^ROCLIS||||||||F|19990617 NTE||L|Results confirmed by mass spectroscopy.^C^MS NTE||A^ZMMLNE|This report is intended for clinical monitoring andÂ^ZMMLNENEW NTE||A^ZMMLNE|management of patients. It is not intended for use inÂ^ZMMLNENEW NTE||A^ZMMLNE|employment-related drug testing.Â^ZMMLNENEW NTE||A^ZMMLNE| Â^ZMMLNENEW NTE||A^ZMMLNE|Test Performed by: Mayo Medical Laboratories New England Â^ZMMLNENEW NTE||A^ZMMLNE|265 Ballardvale Street, Wilmington, MA 01887 CLIA 22D0072372 Â^ZMMLNENEW NTE||A^ZMMLNE|Laboratory Director: Charles J. Przyjemski, M.D.Â^ZMMLNENEW MSH|^~\&|MML||C7012345|SUBCLIENT|20020723150552|SUBCLIENT|ORU|R|P|2.3 PID||CLIENTPATIENTID|MAYOPATIENTID||LASTNAME^FIRSTNAME M||19170304|M||||||||||M00111452132 ORC|RE|K8160368 OBR||198041^LAB|K8160368|82587^Tissue Transglutaminase Ab, S (IgA)|R||200207220820|||C7012345^Community Hospital^800-123-4567|N|||200207230627||ORDERING||0722:RR00011R|LAB|||200207231504|C|CH|F OBX||L|82587^Tissue Transglutaminase(tTG) AB, S^ROCLIS||7.7|U|||||F|20020318 NTE||L|<20 (Negative)^NC^N82587 NTE||L|20-30 (Weakly positive)^NC^N82587


NTE||L|>30 (Positive)^NC^N82587 MSH|^~\&|MML||C7012345|SUBCLIENT|20020723043942|SUBCLIENT|ORU|R|P|2.3 PID||CLIENTPATIENTID|MAYOPATIENTID||LASTNAME^FIRSTNAME M||19760603|M||||||||||M00111451118 ORC|RE|K8160376 OBR||197928^LAB|K8160376|200133^Testosterone, Total Only, S|R||200207221108|||C7012345^Community Hospital^800-123-4567|N|||200207222103||ORDERING||0722:RR00007R|LAB|||200207230438|C|CH|F OBX||L|11963^Testosterone, Total Only, S^ROCLIS||552|ng/dL|300-950|N|||F|20010423 NTE||A^ZMMLNE| Â^ZMMLNENN NTE||A^ZMMLNE|Test Performed by: Mayo Medical Laboratories New EnglandÂ^ZMMLNENN NTE||A^ZMMLNE|265 Ballardvale Street, Wilmington, MA 01887 CLIA 22D0072372Â^ZMMLNENN NTE||A^ZMMLNE|Laboratory Director: Charles J. Przyjemski, M.D.Â^ZMMLNENN MSH|^~\&|MML||C7012345|SUBCLIENT|20020723044722|SUBCLIENT|ORU|R|P|2.3 PID||CLIENTPATIENTID|MAYOPATIENTID||LASTNAME^FIRSTNAME M||19601209|F||||||||||M00111450292 ORC|RE|K8158390 OBR||197814^LAB|K8158390|200177^T3 (Triiodothyronine), Free, S|R||200207220906|||C7012345^Community Hospital^800-123-4567|N|||200207222058||ORDERING||0722:RR00004R|LAB|||200207230445|C|CH|F OBX||L|12177^T3 (Triiodothyronine), Free, S^ROCLIS||2.9|pg/mL|2.3-4.2|N|||F|20011015 NTE||A^ZMMLNE| Â^ZMMLNENN NTE||A^ZMMLNE|Test Performed by: Mayo Medical Laboratories New EnglandÂ^ZMMLNENN NTE||A^ZMMLNE|265 Ballardvale Street, Wilmington, MA 01887 CLIA 22D0072372Â^ZMMLNENN NTE||A^ZMMLNE|Laboratory Director: Charles J. Przyjemski, M.D.Â^ZMMLNENN


MML Use of the ASTM E-1238-88 Standard

Please refer to the ASTM "Standard Specification E 1238-88 For Transferring Clinical Laboratory Data Messages Between Independent Computer Systems." This document will not attempt to describe that standard, but rather will specify how MML will use that standard. In this document the numbers next to each of the field descriptions correspond to those used in the ASTM standard specification. I. General

There are several types of records defined in the standard. MML will use some, but not all of these types. If record types not used by MML are received, they will be ignored. Note that sequence numbers are not required since the communication method specified by MML is designed to deal with problems of lost or mis-sequenced messages.

Code Transaction Type H Message header Optional P Patient ID record O Test Order record R Result record E Error checking record NOT USED C Comment record Q Request results record NOT USED L Message terminator Optional S Scientific record NOT USED A Addenda record II. Control Records

The Message header and Message terminator records are desirable. If one is used the other should also be present. These records are useful for control and audit of interface flow. If orders from multiple accounts are to be sent from one laboratory system, the message header and terminator records are required. There may be multiple "H" and "L" records per mail message.


A. For the Header record, the fields used are:

7.1.1 Record type ID 7.1.2 Delimiter definition MML limits the possible delimiters to the following set of characters: ^ ASCII 94 \ ASCII 92 | ASCII 124 ~ ASCII 126 ` ASCII 96 7.1.5 Sender name or ID This will be the MML Client ID number, or "MML" depending on

destination 7.1.9 Subclient ID, if used

7.1.10 Receiver ID This will be the MML Client ID number, or "MML" depending on

destination 7.1.12 Processing ID Processing code "P" may be used for testing and production since our

testing will be within a test environment. Processing codes of "T" or "D" will only be parsed and are useful for only the most preliminary testing.

7.1.14 Date and time of message If the sender does not use "H" records there can only be one MML Client

account per sending system. Also, the default delimiters will be used. The default delimiters are:

^ ASCII 94 - field \ ASCII 92 - sub-field | ASCII 124 - sub-sub-field B. For the Terminator record, both standard fields will be used, but the sequence

number will be optional. III. Orders

An order for a specimen will include type P and type O records. Comment records and result records, types C and R, may be included to contain certain additional information. If order records do not contain the required fields then they will be handled manually as exceptions. Extra fields that are not processed by the MML computer system may be useful for transmitting other information needed for proper handling of certain orders. If the extra required information is sent as part of the ASTM order transactions, then we may be able to eliminate the need for paper forms or phone calls to obtain the additional information needed in these special cases. All data sent by the Client will be available for use by MML personnel.


A. For the Patient ID record, required fields are:

8.1.1 Record type ID 8.1.3 Practice (Client) assigned Patient ID MML limits to 15 characters; error if longer. 8.1.6 Patient Name MML limits to 20 characters; will truncate. Names of format

LAST|FIRST ETC will be valid as well as those following the more strict ASTM format. All patient names will be converted into uppercase for storage in the MML computer system, and when the "P" record is returned with results the name will be all uppercase. Note that the delimiter between parts of the name is the sub-subfield delimiter.

8.1.8 Birthdate Age will be accepted as the second subfield and may be up to two digits

followed by one letter where Y=years, M=months, W=weeks, and D=days. If the letter for age units is omitted, then years will be assumed. Birthdate and/or age is sometimes required for proper interpretation of test results. Birthdate is preferred over only age.

8.1.9 Sex Please note that complete normals flagging will not be possible if birthdate/age and sex are not

provided. B. For the Test Order record, required fields are: 9.4.1 Record type ID 9.4.3 Practice (Client) Specimen ID MML limits to 15 characters. Does not need to include a date, but does

need to be unique to a single specimen for at least the time that MML and the Client may refer to that specimen.

9.4.5 (Universal) Battery ID This will be the Client's identifier for the ordered unit. If the Client

wishes, they may alternatively send MML codes for the ordered units. In either case, there will be a cross-reference table somewhere to convert Client order codes to MML order codes. Note that there must be a one-to-one relation between Client order codes and MML order codes. This will have two sub subfields. The first sub subfield will contain the battery ID. The second sub subfield is optional and may contain the name of the ordered test. This second sub subfield is provided especially for tests, which MML may not normally be offered in the catalog, but which may be available, by special arrangement. MML will limit the first sub subfield to 12 characters; longer will be an exception to be handled manually. The total field length must not exceed 80 characters, as specified by the ASTM standard. If a comprehensive universal system for coding of orderable units is developed, we will consider use of such a system.

9.4.12 Action code Only “N” will be supported. C, A, P, L are not supported. 9.4.24 Charge-to code This field will be used on orders to state the type of billing desired by the


Client. The only valid charge-to code is: C Bill Client If other than Client billing is to be used, this must be arranged in advance

with your Regional Manager. 9.4.26 Report types Only "O" will be used on orders.

The optional fields which are used by MML are: 9.4.6 Priority The values accepted by MML are "R" for routine, "C" for callback, and

"A" for priority plus callback. MML looks only at the first character of the priority so that any word starting with one of the valid priority codes will be treated as being that priority. Any other character is invalid.

9.4.8 Specimen Collection date and time This information is required for performance of certain tests. 9.4.10 Collection volume This field will be required for many urinalysis tests. This information

may be alternatively sent as a result to a test. 9.4.16 Source of specimen This field is required for most Microbiology tests. 9.4.17 Ordering physician MML limits to 35 characters; will truncate as needed. C. Comment type records can be used with orders to contain: 12.1.1 Record type ID 12.1.4 Comment text This will be limited to 70 characters each. This text must be common to

all tests on the specimen, but does not need to be sent with all test order records per specimen.

It will be used for MML's "Internal Notes."


IV. Results

Under normal circumstances, each test result will be sent only once. The receiver of results should, however, be able to deal with corrections, retransmitted results, and other unusual cases. All data sent by MML should be made available to a human end-user, whether or not it is stored in the Client's computer database. Results transmission will include record types P (Patient), O (Order), R (Result), and possibly C (Comment).

A. Patient records sent back to the Client as part of results transmission will contain only the first six fields. The additional field 8.1.4, "Laboratory Assigned Patient ID," will be included.

B. Order records sent back to the Client as part of results transmission will be as for

orders, but will contain the following additional fields: 9.4.4 Laboratory specimen ID MML will send seven to eight characters. 9.4.15 Date and time of specimen receipt in laboratory 9.4.21 Laboratory field 1 Will be common to all tests on this specimen. It will correspond to

MML's "Report Notes," which is currently printed on MML's reports in the "Specimen Information" box. It will be limited to 70 characters.

9.4.23 Date and time results reported or status changed 9.4.26 Report types Types C, P, and F will be used. NOTE: for field 5, "Universal Battery ID," MML returns the MML

battery code and battery name unless a universal coding scheme is developed.

C. Result records will contain the following fields: 10.1.1 Record type ID 10.1.3 Test ID This will be the MML test ID unless a universal coding scheme is

developed that is adequate to deal with the wide range of tests offered by MML. A second sub subfield will contain the test name. Note that a test may exist under multiple orderable units. For this reason, it is advisable that the cross-reference for resultable tests include both the ordered unit and the resultable unit as keys.


10.1.4 Result "Short" text or numeric results will be identified here. Free text and

coded results will be placed in Comment records to follow the respective "R" record. Note that MML will send some results that have special meaning. They are "DNR" and a single space.

˚ DNR (= "Do Not Report") means that this test has no reportable

result and does not need to be reported. ˚ A result of a single space is used to force a test to be reported even

though there may be no result. 10.1.5 Units MML units may be up to 15 characters; this is longer than the ASTM

specified maximum of eight. 10.1.6 Reference ranges Brief range descriptions may be included here. Long text range

descriptions will be in comment records. 10.1.7 Result abnormal flags MML will provide no trend flagging, so flag types U, D, B, and W will

not be sent. 10.1.8 Nature of abnormality testing 10.1.9 Result status Types C, P, and F will be used. 10.1.10 Date of last change of laboratory normal values or units This will refer to date change made to any member of this battery. D. Comment records may be used as part of results transmission. Free text and coded results will be handled in comment records, which follow the

respective "R" record. Comment records MAY follow "R" result records if there are results in the "R" record. If there are NO results in the "R" record (the field is null), there WILL be following "C" records. In some cases, there may be a very large number of comment records for a single test. Text normals and coded text normals will also be sent in comment records, as will coded messages always sent with certain tests. To differentiate the different information to be found in the comment records with results, MML will provide three subfields for field 12.1.4 "Comment Text." The first subfield will be the text, the second subfield will be a code identifying which type of information is being sent in the first subfield, and the third subfield will be the MML code for the text, if applicable. The codes for the types of information will be:

C Coded message results (may be multiple codes) F Free text results N Text normals NC Coded normals A Coded message always sent with this test


E. Checking of units, and normals will always be needed if the "date of last change" is

changed. V. Record Length Limit

Addenda records (5.1.3 of ASTM E 1238-88) will be used to carry overflow of an immediately preceding record that exceeds the maximum allowable size of 200 characters. This record type will begin with a field of "A" followed by whatever fields remain from the preceding record.


Sample ASTM-88 Order Transactions H^\|^^^C7012345^^^^^MML^^P^1^19911219174500 P^^1111111^^^PATIENT|TEST A|^^19070607^F O^^913530347^^0088653|MYELP|L^R^19911219092700^19911219095500^^^^N^^^^^00228^^^^^^^Ô^ O^^913530347^^0088285|ACE|L^R^19911219092700^19911219095500^^^^N^^^^^00228^^^^^^^Ô^ O^^913530347^^0089052|CRYO QUAN|L^R^19911219092700^19911219095500^^^^N^^^^^00228^^^^^^^Ô^ O^^913530347^^0089029|FTA ABS|L^R^19911219092700^19911219095500^^^^N^^^^^00228^^^^^^^Ô^ O^^913530347^^0080150|ANNA|L^R^19911219092700^19911219095500^^^^N^^^^^00228^^^^^^^Ô^ O^^913530347^^0088774|HEXO SERUM|L^R^19911219092700^19911219095500^^^^N^^^^^00228^^^^^^^Ô^ P^^1234567^^1231234^TEST|PATIENT A|^^19560830^F O^^913550284^^0088374|STOOL NA|L^R^19911221190000^19911218190000^^^^N^^^^^20529^^^^^^^Ô^ O^^913550284^^0088375|STOOL K|L^R^19911221183300^19911218183300^^^^N^^^^^20529^^^^^^^Ô^ R^^913550284^^0082592|WEIGHT|L^115^GMS^^^^F^ P^^776655^^1234567^PATIENT TEST|^^19360701^M O^^913580330^^0088364|Ceruloplasmin|L^R^19911219133000^19911224135000^^^^N^^^^^20329^^^^^^^Ô^ L H^~`^14002^^C0002345^^^^^MML^^PÂ.1^199112201911 P^1^111111^^^PATIENT`TEST^^19590303^F^^^^^^^^^^^^^^^^^^^^^^^ O^1^W00000^^8596^~~^^199112201152^^^^N^^^199112201152^^518`JONES, BOB.^^^^^^^C^Ô^~^ R^1^2438^KIDNEY^^~~^Â~S^^ P^2^444444^^^PATIENT`TEST2^^19340421^F^^^^^^^^^^^^^^^^^^^^^^^ O^1^T00000^^80190^~~^^199112191810^^^^N^^^199112191840^^1083`SMITH, J.^^^^^^^C^Ô^~^ P^3ÔS-32100^^^PATIENT`TESTÒNE^^19390826^F^^^^^^^^^^^^^^^^^^^^^^^ O^1^F11111^^8529^~~^^199112201030^^^^N^^^199112201030^^311`JONES, JOHN^^^^^^^C^Ô^~^ C^1^^SENT TO MAYO 12/20/91 LD.~T~~ R^1^691^24^HRS^~~^Â~S^^ R^2^692^1131^ML^~~^Â~S^^ P^4^456789^^^PATIENT`TEST3^^19040811^F^^^^^^^^^^^^^^^^^^^^^^^ O^1^T12121^^9029^~~^^199112240045^^^^N^^^199112200059^^670`JONES, JOHN^^^^^^^C^Ô^~^ C^1^ÔRDERED BY LABORATORY~T~OBL~ L^1 H^~`^MAYO-SO.1.9^^T7012345^^^^^MMLTEST^^DÂ.1^200010270902 P^^M0000000^^H000000000^PATIENT`TEST^^19251005^F O^^0101:R00001R^^9168``L^^^200010270900^^^^N^^^200010270900^^SMITH,J.^^L2 85~LAB O^^0101:R00002R^^8413``L^^^200010270900^^^^N^^^200010270900^^SMITH, J ^^L2 85~LAB O^^0101:R00003R^^8665``L^^^200010270900^^^^N^^^200010270900^^SMITH,J ^^L2 85~LAB L^1


Sample ASTM-88 Result Transactions H^~`^^^MML^^^^^C7001234^R^PÂ.1^199112271140 P^^111111^H000000^^PATIENT`TEST O^^W00000^H000000^8596`Stone Analysis^^^^^^^^^^199112270333^^^^^^^^19911227^^^F R^^8596`Stone Analysis^ ^^^^^F^19850129 C^^L^Quantitative Report~N R^^2438`Source:^Kidney^^^^^F^19850129 R^^2439`Weight:^0.004^grams^^^^F^19850129 R^^2440`1st Constituent:^100% Calcium oxalate dihydrate^^^^^F^19850129 R^^2441`2nd Constituent:^DNR^^^^^F^19850129 R^^2442`3rd Constituent^DNR^^^^^F^19850129 R^^2443`Nidus (Major):^DNR^^^^^F^19850129 R^^2444`Nidus (Minor):^DNR^^^^^F^19850129 R^^2445`Shell (Major):^DNR^^^^^F^19850129 R^^2446`Shell (Minor):^DNR^^^^^F^19850129 R^^2447`Comment:^DNR^^^^^F^19850129 L H^~`^^^MML^^^^^C7012345^R^PÂ.1^199112271005 P^^123123^H111111^^PATIENT`TEST O^^1234567^H111111^8374`Sodium, Quantitative, Feces^^^^^^^^^^199112240626^^^^^^^^19911227^^^F R^^8374`Sodium, Quantitative, Feces^27^mEq/Kg^10-20^h^^F^19910101 R^^2177`Total Weight of Specimen^115^grams/spec^^^^F^19910101 O^^1234567^H111111^8375`Potassium, Quantitative, Feces^^^^^^^^^^199112240626^^^^^^^^19911227^^^F R^^8375`Potassium, Quantitative, Feces^49^mEq/Kg^5-20^h^^F^19910101 R^^2592`Total Weight of Specimen^115^grams/spec^^^^F^19910101 L H^~`^^^MML^^^^^C7001234^R^PÂ.1^199112211312 P^ÔS-123456^H987654^^PATIENT`TEST O^^F98765^H987654^8529Ùric Acid, Urine^^^^^^^^^^199112201620^^^^^^^^19911221^^^P R^^8529Ùric Acid, Urine^656^mg/24 Hrs^0-749^N^^F^19850130 C^^L^<750 (Diet-dependent)~N R^^691`Collection Duration^24^hours^^^^F^19850130 R^^692Ùrine Volume^1131^mL^^^^F^19850130 R^^2152`Concentration^58^mg/dL^^^^F^19850130 L H^~`^^^MML^^^^^C7001234^R^PÂ.1^199112271338 P^^333333^H567890^^PATIENT`TEST O^^T99999^H567890^80190`Hepatitis C Antibody (Anti-HCV), Serum^^^^^^^^^^199112270417^^^^^^^^19911227^^^F R^^80190`Hepatitis C Antibody (Anti-HCV), Serum^Negative^^^^^F^19901231 C^^L^Negative (reported as negative~NC~NHEP C^^Lôr positive)~NC~NHEP C^^LÎnterpretation depends on~NC~NHEP C^^L^clinical setting. Additional~NC~NHEP C^^Lînformation is present in the~NC~NHEP C^^L^'Special Instructions' section~NC~NHEP C^^Lôf the Mayo Medical Laboratories~NC~NHEP C^^L^test catalog.~NC~NHEP L


Sample ASTM-88 Result Transactions H^~`^^^MML^^^^^C7012345^R^PÂ.1^199112271132 P^^776655^H55555^^TEST`MR. PATIENT O^^1234567^H55555^8364`Ceruloplasmin, Serum^^^^^^^^^^199112270327^^^^^^^^19911227^^^F R^^8364`Ceruloplasmin, Serum^35.8^mg/dL^22.9-43.1^N^^F^19910510 C^^L^PLEASE NOTE: Addition of pediatric literature normal values have been made~A~Z8364 C^^Lêffective May 10, 1991. These appear below on pediatric age patients.~A~Z8364 L H^~`^^^MML^^^^^C7001234^R^PÂ.1^199112271611 P^^456789^H111111^^TEST`PATIENT O^^T12121^H111111^9029`Fluorescent Treponemal Antibody, Absorbed (FTA-ABS), Serum^^^^^^^^^^199112270333^^^^^^^^ 19911227^^^P R^^9029`Fluorescent Treponemal Antibody, Absorbed (FTA-ABS), Serum^^^^^^P^19900412 C^^L^ Nonreactive~N C^^L^TEST BEING REPEATED:~C~SR1 C^^L^report in 1 day~C~SR1 L H^~`^^^MML^^^^^C7121212^R^Â.1^199107121030 P^^000^Y000000^^TEST`PATIENT O^^000^Y000000^9033~Fluorescent Treponemal Antibody, Absorbed (FTA-ABS), Spinal Fluid^^^^^^^^^^199107121022^^^^^^ See hP R^^9033~Fluorescent Treponemal Antibody, Absorbed (FTA-ABS), Spinal Fluid^PRELIM^^^^^P^19900412 C^^L^ Nonreactive~N L H^~`^^^MML^^^^^C7123456^R^PÂ.1^199202201511 P^^10000000^X123456^^TEST`PATIENT7 O^^101010101^X123456^8236`Fungal Serology Survey, Serum^^^^^^^^^^199204201353^^^^^^^^19920420^^^F R^^5998`Specimen Source^SERUM^^^^^F^19920326 R^^5999`Special Information^DNR^^^^^F^19920326 R^^8236`Fungal Serology Survey^^^^^^F^19920326 C^^L^ HISTOPLASMA-MYCELIAL by Complement Fixation, NEGATIVE~F C^^L^ HISTOPLASMA-YEAST by Complement Fixation,~F C^^L^ NEGATIVE~F C^^L^ HISTOPLASMA-IMMUNODIFFUSION, NEGATIVE~F C^^L^ COCCIDIOIDES ANTIBODY by Complement Fixation,~F C^^L^ NEGATIVE~F C^^L^ BLASTOMYCES ANTIBODY by Complement Fixation,~F C^^L^ NEGATIVE~F C^^L^ BLASTOMYCES ANTIBODY by Immunodiffusion,~F C^^L^ NEGATIVE~F C^^L^ CRYPTOCOCCUS ANTIGEN, NEGATIVE~F C^^L^-- EXPECTED VALUES --~NC~ C^^L^Report will indicate~NC~N8236 C^^L^significant titers.~NC~N8236 R^^6000`Report Status^FINAL 042092^^^^^F^19920326 L H^~`^^^MML^^^^^C7123456^R^PÂ.1^199202201511 P^^454545454^X111111^^TEST`PATIENT4 O^^999999999^X111111^8152~Adenovirus Antibodies, Serum^^^^^^^^^^199204201353^^^^^^^^19920420^^^F R^^5947~Specimen Source^SERUM^^^^^F^19920326 R^^5948~Special Information^Test performed by Complement Fixation^^^^^F^19920326 R^^8152~Adenovirus Antibodies^< 1:2^^^^^F^19920326 C^^L^-- EXPECTED VALUES --~NC~ C^^L^< 1:2~NC~N8152E C^^LÂ fourfold or greater rise in~NC~N8152E C^^L^paried sera titer indicates~NC~N8152E C^^L^recent infection.~NC~N8152E R^^5949~Report Status^FINAL 041692^^^^^F^19920326 L


Appendix


File Definition


Implementation Notices Periodically, MML will make additions, substitutions, or deletions from the current test catalog, as well as modify the current test set-up (i.e. change in units or methodology). Communication of any changes to MML test set-up will be communicated to our clients through implementation or file definition change notices. A sample notification can be found on page 69. Notifications can be sent to Clients via fax or e-mail, through the MML Telecommunications office. It is the Client's responsibility to contact MML Telecommunications (800-533-1710) for the updated test set-up, if the change affects a test currently ordered through the interface. MML makes every effort to notify clients 30 to 60 days prior to implementing a change in the production system. However, some circumstances may require a shorter notification period. To facilitate testing for our clients, changes to the test set-up are effective in MML's testing environment when the notice is sent out. Changes to the production system will not occur until the effective date listed on the notification.


Mayo Medical Laboratories Stabile Building 150 Third Street SW Rochester, Minnesota 55902

800-533-1710

Implementation Notice: Test Change

Date: June 29, 2001 Title: Thyroglobulin (HTG), Serum Test Code#: 9039 Effective Date: August 28, 2001 Explanation of Change: There will be a method change and a reference range change for thyroglobulin. The method will change from the Nichols method to the Beckman Access Sandwich Immunoenzymatic Assay. The new method has excellent correlation with the current method and is less susceptible to hook effect problems. It also shows improved linearity, requires a smaller sample volume, and a quicker turnaround time. The diagnostic criteria for athyrotic patients (<5ng/mL) is not changing, however, the normal range is changing from <59.4 ng/mL to <33 ng/mL. Method: Sandwich Immunoenzymatic Assay. Reference Values: < 33 ng/mL Cautions: Thyroid autoantibodies may interfere with the measurement of HTG. All specimens are pre-screened for antibodies and a comment appended to the report if they are present. Undetectable levels of HTG should be interpreted with caution if anti-HTG is present. Specimens with thyroglobulin concentrations greater than 250,000 ng/mL may “hook” and appear to have markedly lower levels.

Specimen Required: Draw blood in a plain, red-top tube or an SST tube(s). Spin down and send 1.0 mL of serum refrigerated.

Analytic Time: 1 day

Contact MML Telecommunications for test setup information.

Questions: Contact your Regional Manager Henry A. Homburger, M.D., Laboratory Consultant Dennis J. O’Kane, Ph.D., Laboratory Consultant William Reilly, Laboratory Supervisor Steve Monson, MML Technical Support


AGE SPECIFIC FILE DEFINITION EXAMPLE


AGE SPECIFIC FILE DEFINITION Note: If no Date of Birth/Age noted, the NO AGE reference range will be used

ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 8340 7/15/2002 Alkaline Phosphatase, S Transport temp : Refrig\Frozen OK\Ambient NO Worklist : ECHEM 8340 Alkaline Phosphatase, S Units: U/L NO SEX No age : ; #N8340C0N 1D to 3Y : ; Not established (0-3 yea) 4Y to 4Y : ; #N8340C4 5Y to 5Y : ; #N8340C5 6Y to 6Y : ; #N8340C6 7Y to 7Y : ; #N8340C7 8Y to 8Y : ; #N8340C8 9Y to 9Y : ; #N8340C9 10Y to 10Y : ; #N8340C10 11Y to 11Y : ; #N8340C11 12Y to 12Y : ; #N8340C12 13Y to 13Y : ; #N8340C13 14Y to 14Y : ; #N8340C14 15Y to 15Y : ; #N8340C15 16Y to 16Y : ; #N8340C16 17Y to 17Y : ; #N8340C17 18Y to 18Y : ; #N8340C18 19Y to 23Y : ; #N8340C23 24Y to 45Y : ; #N8340C45 46Y to 50Y : ; #N8340C50 51Y to 55Y : ; #N8340C55 56Y to 60Y : ; #N8340C60 61Y to 65Y : ; #N8340C65 66Y to 150Y : ; #N8340C150 MALE No age : ; #N8340CM 1D to 3Y : ; Not established (0-3 yea) 4Y to 4Y : 324-803 ; 324-803 (4 years) 5Y to 5Y : 389-904 ; 389-904 (5 years) 6Y to 6Y : 390-906 ; 390-906 (6 years) 7Y to 7Y : 374-881 ; 374-881 (7 years) 8Y to 8Y : 367-871 ; 367-871 (8 years) 9Y to 9Y : 381-893 ; 381-893 (9 years) 10Y to 10Y : 415-945 ; 415-945 (10 years) 11Y to 11Y : 402-1103 ; 402-1103 (11 years) 12Y to 12Y : 403-1222 ; 403-1222 (12 years) 13Y to 13Y : 395-1276 ; 395-1276 (13 years) 14Y to 14Y : 361-1241 ; 361-1241 (14 years) 15Y to 15Y : 299-1110 ; 299-1110 (15 years) 16Y to 16Y : 221-906 ; 221-906 (16 years) 17Y to 17Y : 151-677 ; 151-677 (17 years) 18Y to 18Y : 113-482 ; 113-482 (18 years) 19Y to 150Y : 98-251 ; 98-251 (> or = 19 years)

(continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded)

FEMALE 8340 (continued) 8340 Alkaline Phosphatase, S (continued) No age : ; #N8340CF 1D to 3Y : ; Not established (0-3 yea) 4Y to 4Y : 368-809 ; 368-809 (4 years) 5Y to 5Y : 352-772 ; 352-772 (5 years) 6Y to 6Y : 367-805 ; 367-805 (6 years) 7Y to 7Y : 398-875 ; 398-875 (7 years) 8Y to 8Y : 433-956 ; 433-956 (8 years) 9Y to 9Y : 461-1018 ; 461-1018 (9 years) 10Y to 10Y : 468-1034 ; 468-1034 (10 years) 11Y to 11Y : 388-1144 ; 388-1144 (11 years) 12Y to 12Y : 290-1055 ; 290-1055 (12 years) 13Y to 13Y : 260-976 ; 260-976 (13 years) 14Y to 14Y : 333-787 ; 333-787 (14 years) 15Y to 15Y : 163-595 ; 163-595 (15 years) 16Y to 16Y : 133-573 ; 133-573 (16 years) 17Y to 23Y : 114-312 ; 114-312 (17-23 years) 24Y to 45Y : 81-213 ; 81-213 (24-45 years) 46Y to 50Y : 84-218 ; 84-218 (46-50 years) 51Y to 55Y : 90-234 ; 90-234 (51-55 years) 56Y to 60Y : 99-257 ; 99-257 (56-60 years) 61Y to 65Y : 108-282 ; 108-282 (61-65 years) 66Y to 150Y : 119-309 ; 119-309 (> or = 66 years)


MML Messages used as normals CODE TEXT N8340C0N Males Not established (0-3 years) 324-803 (4 years) 389-904 (5 years) 390-906 (6 years) 374-881 (7 years) 367-871 (8 years) 381-893 (9 years) 415-945 (10 years) 402-1103 (11 years) 403-1222 (12 years) 395-1276 (13 years) 361-1241 (14 years) 299-1110 (15 years) 221-906 (16 years) 151-677 (17 years) 113-482 (18 years) 98-251 (> or = 19 years) Females Not established (0-3 years) 368-809 (4 years) 352-772 (5 years) 367-805 (6 years) 398-875 (7 years) 433-956 (8 years) 461-1018 (9 years) 468-1034 (10 years) 388-1144 (11 years) 290-1055 (12 years) 260-976 (13 years) 333-787 (14 years) 163-595 (15 years) 133-573 (16 years) 114-312 (17-23 years) 81-213 (24-45 years) 84-218 (46-50 years) 90-234 (51-55 years) 99-257 (56-60 years) 108-282 (61-65 years) 119-309 (> or = 66 years) -------- N8340C10 415-945 (Males 10 years) 468-1034 (Females 10 years) -------- N8340C11 402-1103 (Males 11 years) 388-1144 (Females 11 years) -------- N8340C12 403-1222 (Males 12 years) 290-1055 (Females 12 years) -------- N8340C13 395-1276 (Males 13 years) 260- 976 (Females 13 years) --------


CODE TEXT N8340C14 361-1241 (Males 14 years) 333- 787 (Females 14 years) -------- N8340C15 299-1110 (Males 15 years) 163- 595 (Females 15 years) -------- N8340C150 98-251 (Males > or = 19 years) 119-309 (Females > or = 66 years) -------- N8340C16 221-906 (Males 16 years) 133-573 (Females 16 years) -------- N8340C17 151-677 (Males 17 years) 114-312 (Females 17-23 years) -------- N8340C18 113-482 (Males 18 years) 114-312 (Females 17-23 years) -------- N8340C23 98-251 (Males > or = 19 years) 114-312 (Females 17-23 years) -------- N8340C4 324-803 (Males 4 years) 368-809 (Females 4 years) -------- N8340C45 98-251 (Males > or = 19 years) 81-213 (Females 24-45 years) -------- N8340C5 389-904 (Males 5 years) 352-772 (Females 5 years) -------- N8340C50 98-251 (Males > or = 19 years) 84-218 (Females 46-50 years) -------- N8340C55 98-251 (Males > or = 19 years) 90-234 (Females 51-55 years) -------- N8340C6 390-906 (Males 6 years) 367-805 (Females 6 years) -------- N8340C60 98-251 (Males > or = 19 years) 99-257 (Females (56-60 years) -------- N8340C65 98-251 (Males > or = 19 years) 108-282 (Females 61-65 years) -------- N8340C7 374-881 (Males 7 years) 398-875 (Females 7 years) -------- N8340C8 367-871 (Males 8 years) 433-956 (Females 8 years) -------- N8340C9 381-893 (Males 9 years) 461-1018 (Females 9 years) --------


CODE TEXT N8340CF Females Not established (0-3 years) 368-809 (4 years) 352-772 (5 years) 367-805 (6 years) 398-875 (7 years) 433-956 (8 years) 461-1018 (9 years) 468-1034 (10 years) 388-1144 (11 years) 290-1055 (12 years) 260- 976 (13 years) 333- 787 (14 years) 163- 595 (15 years) 133- 573 (16 years) 114- 312 (17-23 years) 81- 213 (24-45 years) 84- 218 (46-50 years) 90- 234 (51-55 years) 99- 257 (56-60 years) 108- 282 (61-65 years) 119- 309 (> or = 66 years) -------- N8340CM Males Not established (0-3 years) 324-803 (4 years) 389-904 (5 years) 390-906 (6 years) 374-881 (7 years) 367-871 (8 years) 381-893 (9 years) 415-945 (10 years) 402-1103 (11 years) 403-1222 (12 years) 395-1276 (13 years) 361-1241 (14 years) 299-1110 (15 years) 151-677 (17 years) 113-482 (18 years) 98-251 (> or = 19 years) --------


AP FILE DEFINITION EXAMPLE


AP FILE DEFINITION ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 3287 8/25/1999 Leukemia/Lymphoma, Phenotype Transport temp : Ambient\Refrig OK\Frozen NO - blood, bone marrow, serous effusion fluid Refrig\Frozen NO\Ambient NO - csf Worklist : LIFC 18245 Accession Number - - - - - 18246 Referring Pathologist/Physician - - - - - 18247 Ref. Path Address - - - - - 18248 Material - - - - - 18249 Bone Marrow Differential - - - - - 18250 Peripheral Blood: - - - - - 18251 Aspirate: - - - - - 18252 Biopsy - - - - - 18253 Microscopic Description - - - - - 18254 Special Studies: - - - - - 18255 Final Diagnosis: - - - - - 18256 Comment: - - - - - 18257 Revision Description: - - - - - 18258 Signing Pathologist - - - - - 18259 Special Procedures - - - - - 18260 SP Signing Pathologist - - - - - 18261 *Previous Report Follows* - - - - - 18262 Addendum - - - - - 18263 Addendum Pathologist:

- - - - -


COAGULATION CONSULT FILE DEFINITION EXAMPLE


COAGULATION CONSULT FILE DEFINITION ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 550(profile) Coag Consult, Thrombos/Hyperco, P/B 6599 5/14/2002 Prothrombin Time (PT), P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAS 6599 Prothrombin Time (PT), P Possible result values include : >240 Units: s NO SEX All Ages : 8.4-12.0 ; 8.4-12.0 MALE All Ages : 8.4-12.0 ; 8.4-12.0 FEMALE All Ages : 8.4-12.0 ; 8.4-12.0 - - - - - 7528 INR Possible result values include : >24.0 - - - - - 9053 5/14/2002 PT Mix 1:1 Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAR 9053 PT Mix 1:1 Possible result values include : >240 Units: s - - - - - 6548 5/14/2002 Activated Partial Thrombopl Time, B Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAS 6548 Activated Partial Thrombopl Time, B Possible result values include : >240 Units: s NO SEX No age : ; #N6548C0 1D to 6M : ; #N6548C0 7M to 150Y : 21-33 ; 21-33 (>3-6 months) MALE No age : ; #N6548C0 1D to 6M : ; #N6548C0 7M to 150Y : 21-33 ; 21-33 (>3-6 months) FEMALE No age : ; #N6548C0 1D to 6M : ; #N6548C0 7M to 150Y : 21-33 ; 21-33 (>3-6 months) - - - - - 9118 5/14/2002 APTT Mix 1:1 Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAR 9118 APTT Mix 1:1 Possible result values include : >240 Units: s (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 550 (continued) 8866 5/14/2002 PNP Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAR 8866 PNP - - - - - 7517 PNP Buffer Control Units: s - - - - - 80340 5/14/2002 Dilute Russells Viper Venom Time, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAS 15000 DRVVT Screen Ratio Units: ratio NO SEX No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 MALE No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 FEMALE No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 - - - - - 21557 5/14/2002 DRVVT Mix and Confirmation Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAR 15001 DRVVT Mix Ratio Units: ratio NO SEX No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 MALE No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 FEMALE No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 - - - - - 7134 DRVVT Confirm Ratio Units: ratio NO SEX No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 MALE No age : ; #N80340 1D to 6M : ; #N80340 (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 550 (continued) 7134 DRVVT Confirm Ratio (continued) 7M to 150Y : 0.0-1.1 ; <1.2 FEMALE No age : ; #N80340 1D to 6M : ; #N80340 7M to 150Y : 0.0-1.1 ; <1.2 - - - - - 9059 5/14/2002 Thrombin Time (Bovine), P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAS 9059 Thrombin Time (Bovine), P Possible result values include : >240 Units: s NO SEX All Ages : 16-25 ; 16-25 MALE All Ages : 16-25 ; 16-25 FEMALE All Ages : 16-25 ; 16-25 - - - - - 9078 5/14/2002 Reptilase Time, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAR 9078 Reptilase Time, P Possible result values include : >150 Units: s NO SEX All Ages : 16-22 ; 16-22 MALE All Ages : 16-22 ; 16-22 FEMALE All Ages : 16-22 ; 16-22 - - - - - 6625 5/14/2002 D-Dimer, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : MDAS 21564 D-Dimer, P Units: ng/mL NO SEX All Ages : 0-300 ; <= 300 MALE All Ages : 0-300 ; <= 300 FEMALE All Ages : 0-300 ; <= 300 - - - - - 6625 D-Dimer, Manual Possible result values include : 250-500,500-1000,1000-2000,2000-4000,4000-8000,<250 Units: ng/mL NO SEX All Ages : 0-249 ; <250 (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 550 (continued) 6625 D-Dimer, Manual (continued) MALE All Ages : 0-249 ; <250 FEMALE All Ages : 0-249 ; <250 - - - - - 9339 11/10/1998 Protein C Activity, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : C/FX 9339 Protein C Activity, P Units: % NO SEX No age : ; #N9339C0N 1D to 15Y : ; #N9339C0N 16Y to 150Y : 70-130 ; 70-130 MALE No age : ; #N9339C0N 1D to 15Y : ; #N9339C0N 16Y to 150Y : 70-130 ; 70-130 FEMALE No age : ; #N9339C0N 1D to 15Y : ; #N9339C0N 16Y to 150Y : 70-130 ; 70-130 - - - - - 6359 Comment - - - - - 80338 4/12/2002 Protein S Ag, Free, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : PSTF 2095 Protein S Ag, Free, P Units: % NO SEX No age : ; #N2095C0N 1D to 6M : ; #N2095C0N 7M to 150Y : ; #N2095CA MALE No age : ; #N2095CM 1D to 6M : ; #N2095CM 7M to 150Y : 60-130 ; 60-130 FEMALE No age : ; #N2095CF 1D to 6M : ; #N2095CF 7M to 150Y : 50-120 ; 50-120 - - - - - 80994 4/12/2002 Protein S Ag, Total, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : PSTF 2027 Protein S Ag, Total, P Units: % NO SEX All Ages : ; #N2027C0 (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 550 (continued) 2027 Protein S Ag, Total, P (continued) MALE All Ages : 60-130 ; 60-130 FEMALE All Ages : 50-120 ; 50-120 - - - - - 9030 5/16/2000 Antithrombin III Activity, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : AT3F 9030 Antithrombin III Activity, P Expect results of form : Should be a 2 or 3 digit whole number Possible result values include : DNR,>240,<10 Units: % NO SEX No age : ; #N9030C6M 1D to 6M : ; #N9030C6M 7M to 150Y : 80-120 ; 80-120 MALE No age : ; #N9030C6M 1D to 6M : ; #N9030C6M 7M to 150Y : 80-120 ; 80-120 FEMALE No age : ; #N9030C6M 1D to 6M : ; #N9030C6M 7M to 150Y : 80-120 ; 80-120 - - - - - 6357 Comment - - - - - 9079 11/21/1998 Plasminogen Activity, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : PLGN 9079 Plasminogen Activity, P Expect results of form : Should be a 2 or 3 digit whole number Units: % NO SEX All Ages : 80-123 ; 80-123 MALE All Ages : 80-123 ; 80-123 FEMALE All Ages : 80-123 ; 80-123 - - - - - 81136 11/21/1998 Activated Protein C Resistance, P Transport temp : Frozen\Refrig NO\Ambient NO Worklist : APCR 7773 Baseline APTT Expect results of form : Should be a 2 or 3 digit whole number Possible result values include : >240,>240 Units: s NO SEX All Ages : 26-38 ; 26-38 (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 550 (continued) 7773 Baseline APTT (continued) MALE All Ages : 26-38 ; 26-38 FEMALE All Ages : 26-38 ; 26-38 - - - - - 7774 APTT with APC Expect results of form : Should be a 2 or 3 digit whole number Possible result values include : >240,>240 Units: s NO SEX All Ages : 68-137 ; 68-137 MALE All Ages : 68-137 ; 68-137 FEMALE All Ages : 68-137 ; 68-137 - - - - - 7775 APC-R Ratio Expect results of form : Should be a number between 0.0 and 99.9 Possible result values include : >10.0,>10.0,Indeterminate NO SEX No age : 2.4-4.0 ; #N7775 1D to 6M : 2.4-4.0 ; #N7775 7M to 150Y : 2.4-4.0 ; 2.4-4.0 MALE No age : 2.4-4.0 ; #N7775 1D to 6M : 2.4-4.0 ; #N7775 7M to 150Y : 2.4-4.0 ; 2.4-4.0 FEMALE No age : 2.4-4.0 ; #N7775 1D to 6M : 2.4-4.0 ; #N7775 7M to 150Y : 2.4-4.0 ; 2.4-4.0 - - - - - 7776 Interpretation - - - - - 81419 5/14/2002 Factor V Leiden (R506Q) Mutation, B Transport temp : Ambient\Refrig OK\Frozen NO Worklist : F5DNA 81419 Factor V Leiden (R506Q) Mutation, B Possible result values include : Homozygous,Heterozygous,Negative,Positive NO SEX All Ages : ; Negative MALE All Ages : ; Negative FEMALE All Ages : ; Negative TEST CODE ALWAYS MESSAGE - [ZPCRASR] ZPCRASR This test is performed pursuant to an agreement with Roche Molecular Systems, Inc. "This test was developed and its performance characteristics determined by Laboratory Medicine and Pathology, Mayo Clinic Rochester. It has not been cleared or approved by the U.S. Food and Drug Administration." - - - - - (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) ------ ---- ---- ---------- ---------------- ---------------------- 550 (continued) 15005 Comments Possible result values include : #CFVL1,#CFVL2,#CFVL3,#CFVL4,#CFVL5,#CFVL6,#CFVL7,#CFV8 - - - - - 81742 5/14/2002 Prothrombin G20210A Mutation, B Transport temp : Ambient\Refrig OK\Frozen OK w/note Worklist : PTNT 81742 Prothrombin G20210A Mutation, B Possible result values include : Homozygous,Heterozygous,Negative,Positive NO SEX All Ages : ; Negative MALE All Ages : ; Negative FEMALE All Ages : ; Negative TEST CODE ALWAYS MESSAGE - [ZPCRASR] ZPCRASR This test is performed pursuant to an agreement with Roche Molecular Systems, Inc. "This test was developed and its performance characteristics determined by Laboratory Medicine and Pathology, Mayo Clinic Rochester. It has not been cleared or approved by the U.S. Food and Drug Administration." - - - - - 15252 Comment Possible result values include : #PTNT1,#PTNT2,#PTNT3,#PTNT5,#PTNT9 - - - - - 7525 5/14/2002 Special Coagulation Interpretation Transport temp : Frozen\Refrig NO\Ambient NO Worklist : CCC1 7525 Interpretation - - - - - 7769 Reviewed by: Possible result values include : C.C. Hook, M.D.,D.A. Gastineau, M.D.,G.S. Gilchrist, . - - - - -


DRUG LEVEL FILE DEFINITION EXAMPLE


DRUG LEVEL FILE DEFINITION

ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 81858 11/23/1999 Nortriptyline, P Transport temp : Refrig\Ambient OK\Frozen OK Worklist : TCA 81858 Nortriptyline, P Expect results of form : Should be 2-4 Digit Number Possible result values include : <20 Units: ng/mL NO SEX All Ages : 50-150 ; #N2450 MALE All Ages : 50-150 ; #N2450 FEMALE All Ages : 50-150 ; #N2450 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - MML Messages used as normals CODE TEXT ----- ------------------ N2450 50-150 (Therapeutic concentration) > or = 500 (Toxic concentration, automatic call-back) --------


MICROBIOLOGY FILE DEFINITION EXAMPLE


MICROBIOLOGY FILE DEFINITION ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 80349 2/16/1999 Bacterial Typing Transport temp : Ambient\Refrig OK\Frozen NO Worklist : PFGE 17809 Specimen Source - - - - - 80349 Result - - - - - 17828 Special Information - - - - - 17847 Report Status - - - - -


PROFILE TEST FILE DEFINITION EXAMPLE


PROFILE TEST FILE DEFINITION ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 8508(profile) Testosterone, Total and Free, S 3631 3/20/1996 Testosterone, Free, S Transport temp : Refrig\Frozen OK\Ambient NO Worklist : FTST 8508 Testosterone, Free - - - - - 2874 % Free Testosterone Expect results of form : Should be 1 digit plus 1 decimal place Units: % NO SEX No age : ; #N2874C0 1D to 15Y : ; #N2874C0 16Y to 150Y : ; #N2874A MALE No age : ; 2.0-4.8 (>= 16 y) 1D to 15Y : ; 2.0-4.8 (>= 16 y) 16Y to 150Y : 2.0-4.8 ; 2.0-4.8 FEMALE No age : ; 0.9-3.8 (>= 16 y) 1D to 15Y : ; 0.9-3.8 (>= 16 y) 16Y to 150Y : 0.9-3.8 ; 0.9-3.8 - - - - - 3631 Testosterone, Free, S Expect results of form : Should be 1 or 2 numbers with one decimal place on values <10 Possible result values include : <0.3 Units: ng/dL NO SEX No age : ; #N3631C 1D to 15Y : ; #N3631C 16Y to 150Y : ; #N3631CA MALE No age : ; 9-30 (>= 16 y) 1D to 15Y : ; 9-30 (>= 16 y) 16Y to 150Y : 9-30 ; 9-30 FEMALE No age : ; 0.3-1.9 (>= 16 y) 1D to 15Y : ; 0.3-1.9 (>= 16 y) 16Y to 150Y : 0.3-1.9 ; 0.3-1.9 - - - - - 7742 Free Testosterone Units: pg/mL NO SEX No age : ; #N7742C0 1D to 15Y : ; #N7742C0 16Y to 150Y : ; #N7742CA MALE No age : ; 9-300 (>= 16 y) 1D to 15Y : ; 90-300 (>= 16 y) 16Y to 150Y : 90-300 ; 90-300 FEMALE No age : ; 3-19 (>= 16 y) (continued next page)


ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 8508 (continued) 7742 Free Testosterone (continued) 1D to 15Y : ; 3-19 (>= 16 y) 16Y to 150Y : 3-19 ; 3-19 - - - - - 3632 4/24/2002 Testosterone, Total, S Transport temp : Refrig\Frozen OK\Ambient NO Worklist : TTST 8533 Testosterone, Total, S Possible result values include : <10,#FQNS,#TQNS,#R8533 Units: ng/dL NO SEX No age : ; #N8533CE 1D to 11M : ; Not established 12M to 9Y : 0-39 ; <40 10Y to 11Y : ; #N8533C11N 12Y to 13Y : ; #N8533C13N 14Y to 14Y : ; #N8533C14N 15Y to 16Y : ; #N8533C16N 17Y to 18Y : ; #N8533C18N 19Y to 40Y : ; #N8533C40E 41Y to 150Y : ; #N8533CAE MALE No age : ; #N8533CMNEW 1D to 11M : ; Not established 12M to 9Y : 0-39 ; <40 10Y to 11Y : 0-199 ; <200 12Y to 13Y : 0-799 ; <800 14Y to 14Y : 0-1199 ; <1200 15Y to 16Y : 100-1200 ; 100-1200 17Y to 18Y : 300-1200 ; 300-1200 19Y to 40Y : 300-950 ; 300-950 41Y to 150Y : 240-950 ; 240-950 FEMALE No age : ; #N8533CFE 1D to 11M : ; Not established 12M to 9Y : 0-39 ; <40 10Y to 11Y : 0-74 ; <75 12Y to 16Y : 0-119 ; <120 17Y to 18Y : 20-120 ; 20-120 19Y to 150Y : 12-72 ; 12-72 - - - - -


MML Messages used as normals CODE TEXT ----- ------------------ N2874A 2.0-4.8 (Males) 0.9-3.8 (Females) -------- N2874C0 2.0-4.8 (Males >= 16 y) 0.9-3.8 (Females >= 16 y) -------- N3631C 9-30 (Males >= 16 y) 0.3-1.9 (Females >= 16 y) -------- N3631CA 9-30 (Males) 0.3-1.9 (Females) -------- N7742C0 90-300 (Males >= 16 y) 3-19 (Females >= 16 y) -------- N7742CA 90-300 (Males) 3-19 (Females) -------- N8533C11N <200 (Males) <75 (Females) -------- N8533C13N <800 (Males) <120 (Females) -------- N8533C14N <1200 (Males) <120 (Females) -------- N8533C16N 100-1200 (Males) <120 (Females) -------- N8533C18N 300-1200 (Males) 20-120 (Females) -------- N8533C40E 300-950 (Males) 12-72 (Females) -------- N8533CAE 240-950 (Males) 12-72 (Females) -------- (continued on next page)


CODE TEXT ----- ------------------ N8533CE Males: Not established (<1 y) <40 (1-9 y) <200 (10-11 y) <800 (12-13 y) <1200 (14 y) 100-1200 (15-16 y) 300-1200 (17-18 y) 300-950 (19-40 y) 240-950 (>= 41 y) Females: Not established (<1 y) <40 (1-9 y) <75 (10-11 y) <120 (12-16 y) 20-120 (17-18 y) 12-72 (>= 19 y) -------- N8533CFE Not established (<1 y) <40 (1-9 y) <75 (10-11 y) <120 (12-16 y) 20-120 (17-18 y) 12-72 (>= 19 y) -------- N8533CMNEW Not established (<1 y) <40 (1-9 y) <200 (10-11 y) <800 (12-13 y) <1200 (14 y) 100-1200 (15-16 y) 300-1200 (17-18 y) 300-950 (19-40 y) 240-950 (>= 41 y) --------


SEX SPECIFIC FILE DEFINITION EXAMPLE


SEX SPECIFIC FILE DEFINITION Note: If no sex designation given, the NO SEX reference range will be used

ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 8141 4/6/1998 Progesterone, S Transport temp : Frozen\Refrig <7 days\Ambient NO Worklist : PGSN 8141 Progesterone, S Possible result values include : <0.40 Units: ng/mL NO SEX No age : ; #N8141C0 1D to 23M : ; #N8141C23MN 24M to 9Y : ; #N8141C9N 10Y to 17Y : ; #N8141C17N 18Y to 150Y : ; #N8141CAN MALE No age : ; #N8141CM 1D to 23M : ; #N8141C23MN 24M to 9Y : ; #N8141M9N 10Y to 17Y : ; #N8141M17 18Y to 150Y : 0.0-1.2 ; <= 1.2 FEMALE No age : ; #N8141CF 1D to 23M : ; #N8141C23MN 24M to 9Y : ; #N8141F9N 10Y to 17Y : ; #N8141F17 18Y to 150Y : ; #N8141FAN - - - - -


MML Messages used as normals CODE TEXT N8141C0 Males 569-1107 (cord blood)* 0.87-3.37 (0-23 mo)* 0.12-0.14 (2-9 y)* Adult values attained by puberty.* <= 1.2 (>= 18 y) Females 569-1107 (cord blood)* 0.87-3.37 (0-23 mo)* 0.20-0.24 (2-9 y)* Values increase through puberty and adolescence.* Premenopausal females Follicular phase: <= 1.5 Luteal phase: 2-20 Postmenopausal females: <= 1.1 *Literature value -------- N8141C17N Males: Adult values attained by puberty. * <= 1.2 (Males >= 18 y) Females: Values increase through puberty and adolescence.* Premenopausal females Follicular phase: <= 1.5 Luteal phase: 2-20 Postmenopausal females <= 1.1 *Literature value -------- N8141C23MN 569-1107 (cord blood)* 0.87-3.37 (0-23 mo)* *Literature value -------- N8141C9N 0.12-0.14 (Males)* 0.20-0.24 (Females)* *Literature value -------- N8141CAN Males: <= 1.2 Premenopausal females: Follicular phase: <= 1.5 Luteal phase: 2-20 Postmenopausal females: <= 1.1 --------


MML Messages used as normals CODE TEXT N8141CF 569-1107 (cord blood)* 0.87-3.37 (0-23 mo)* 0.20-0.24 (2-9 y)* Values increase through puberty and adolescence.* Premenopausal Follicular phase: <= 1.5 Luteal phase: 2-20 Postmenopausal: <= 1.1 *Literature value -------- N8141CM 569-1107 (cord blood)* 0.87-3.37 (0-23 mo)* 0.12-0.14 (2-9 y)* Adult values attained by puberty.* <= 1.2 (>= 18 y) *Literature value -------- N8141F17 Values increase through puberty and adolescence.* Premenopausal Follicular phase: <= 1.5 Luteal phase: 2-20 Postmenopausal: <= 1.1 *Literature value -------- N8141F9N 0.20-0.24* *Literature value -------- N8141FAN Premenopausal Follicular phase: <= 1.5 Luteal phase: 2-20 Postmenopausal: <= 1.1 -------- N8141M17 Adult values attained by puberty.* <= 1.2 (>= 18 y) *Literature value -------- N8141M9N 0.12-0.14* *Literature value --------


SINGLE RESULT CODE FILE DEFINITION EXAMPLE


SINGLE RESULT CODE FILE DEFINITION ORDER EFF CODE DATE TC TITLE Checking Normals Print normals (# coded) 9168 7/17/2002 Haptoglobin, S Transport temp : Refrig\Frozen <14 days OK\Ambient <14 days OK Worklist : COM 9168 Haptoglobin, S Possible result values include : <5.8 Units: mg/dL NO SEX All Ages : 30-200 ; 30-200 MALE All Ages : 30-200 ; 30-200 FEMALE All Ages : 30-200 ; 30-200 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -


Index


A

ACK/NAK Processing, 51 Add-On of tests, 21 Age Specific File Definition, 70 - 75 Anatomic Pathology File Definition, 76 - 77 Ask/Result at Order Tests, 16 ASTM88 (MML's Use of), 56 - 62 ASTM88 Orders, 63 ASTM88 Results, 64 - 65

B

Billing, 22

C

Cancellation of tests, 21 Client Services, 22 Coagulation Consult File Definition, 78 - 85 Communications, 11 Contact Information, 22

D

Data Communication, 51 Data Message, 39 Data Segment, 39 Definition Phase, 10 Delimiters, 39 Development Phase, 10 Direct "Straight" LSI, 25 Drug Level File Definition, 86 - 87

F

File Building, 6, 10 File Definition, 67 - 100 File Definition Change, See Implementation Notice Four-Way MayoNet Communications, 27 Formatted Text, 20

G

Generic Orderable, 20

H

Hardware, See Teleprinter, VPN HLLP, 51 HL7 (Mayo's Use Of), 40 HL7 Orders, 53 HL7 Results, 54 - 55 Hold Policy, 9

I

Implementation to Live Phase, 12 Implementation Notices (File Definition), 68 - 69 Initiation Phase, 9 Interface Models, 24 Interface Timeline Summary, 8

L

Labels, Required Fields, 18 Labels, Specimen, 10, 18 - 19

M

Maintenance, 13 Message Formatting, 39, 41 Microbiology File Definition, 88 - 89 Miscellaneous Tests. See WILD Tests MLLP, 51 MML Mailbox System, 33 - 39 MML Telecommunications, 7, 11, 12, 22 MSH, 41 - 42 MSA, 42

N

NTE, 45

O

OBR, 47 - 49 OBX, 49 - 50 ORC, 46 Orders, 11

P

Packaging of Specimens, 14 Packing List, 10, 14 - 17 Packing List Requirements, 15 PID, 43 Pre-Project Requirements, 9 Profile Test File Definition, 90 - 94 Project Participants, 6 PV1, 44 - 45

Q

Quality Assurance (QA) testing, 12 also known as Validation Testing

R

Results, 11 Result at Order Entry, See Ask/Result at Order Tests


S

Sample Testing, 12 Segment Terminator, 39 Sex Specific File Definition, 95 - 98 Single Result Code File Definition, 99 - 100 Shipping of Specimens, 14 Slippage Reports, See Hold Policy System Options and Parameters, 20

T

Technical Support, 22 Teleprinter, 12 Telephone Numbers, See Contact Information Testing Phase, 11 Test Set Up, 10, also see File Definition Transportation, 22 Two-Way MayoNet Communications, 26

U

Unit Dial-In Script, 33 Upgrades, 13 UUNet, 32

V

VPN, 28 - 31 VPN Frequently Asked Questions, 29 - 30 VPN Request Form, 31

W

WILD Tests, 21

X

XMODEM, 34

laboratory system interface - mayo · pdf fileby the mml laboratory system interface team,...

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