Pathology/Lab results handling - Implementation plan

Needed Parts

• retriever
  • external to the client
  • retrieves data into files
  • can trigger importer run after completion of retrieval

• importer
  • works across patients
  • external to the client
  • imports from files into database
  • imports ALL data, some of which will go into clin.incoming_data_unmatched
  • a thread on patient matching is here
  • candidate FLOSS software includes
    • Mirth
      • may be able to integrate retrieval and import
    • HAPI
      • parsing HL7 for import
    • FEBRL
      • a framework for matching

• viewer
  • works on active patient
  • integrated with the client
  • serves the clinician in evaluating lab results
  • allows signing off results
  • allows marking whether technically abnormal and whether clinically relevant

• manager
  • works across patients
  • integrated with the client
  • associate patients with request IDs
  • manage test types
  • view outstanding requests
  • view and match unmatched and previously thought-to-be unmatchable data
  • create patient from lab results
  • declare data unmatchable

First iteration

Manual data entry

• edit area based data entry

Display

• view complete details in grid-based viewer
  • sign-off of results
  • deletion of result
  • editing of individual results
• integrate summary display with EMR journal

Second iteration

• mostly hinges on external work creating a first importer

Importer

• auto-matches, and puts data into patients' backend tables, based on any of:
  • date of birth AND surname AND firstname AND (if sex is provided) sex
  • pk AND is_pending AND (date of birth OR surname OR firstname)
  • pk AND is_pending AND (null or blank person identifiers i.e an anonymous patient)
• puts anything that was not auto-matched into clin.incoming_data_unmatched

Manager

• enables manual matching from clin.incoming_data_unmatched, and calls importer on such data
• enables declaring data unmatchable

Later iterations

Importer

• PIT path files, def
• HL7
• LDT, partial importer exists
• AU pathology request codes
• LOINC
• matching on:
  • • lab_request_id AND is_pending AND (date of birth OR surname OR firstname)
    • lab_request_id AND is_pending AND (null or blank person identifiers i.e an anonymous patient)

Manager

• soft-matching to candidate patients based on any of:
  • lab_request_id AND (date of birth OR surname OR firstname) AND NOT is_pending
  • lab_request_id AND (null or blank person identifiers i.e anonymous patient) AND NOT is_pending
  • date of birth AND first two characters of surname (reference)
  • ...

• initially demographics widget could be reused for request ID association

Viewer

• virtual grid based

Documentation

• manual: begun at LabModule