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

Topic revision: 24 Aug 2008, JamesBusser
 
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