Stream: implementers
Topic: Laboratory compendium design
Guillermo Rdguez Glez (Mar 02 2020 at 19:28):
Hello, need help on modeling Quest lab compendium. Quest laboratory has orderable panel and tests, each panel has single or many associated tests. Also both panels and tests specify some specimen condition/temperature/handling requirement and requisition management specification, which in turn will affect how orders are split up before be placed in lab. We taken some desitions on modeling compendium based on Composition+CatalogEntry+ActivityDefinition+ObservationDefinition.
- Composition.section.single().entry ---[0..*]---> Reference(CatalogEntry)
Single section for all orderable items, each entry is a CatalogEntry, referencing either an ObservationDefinition(for test) of ActivityDefinition(for panel)
- CatalogEntry.referencedItem ---[0..1]---> Reference(ActivityDefinition | ObservationDefinition)
ReferencedItem should be either ActivityDefinition for panels, or ObservationDefinition for tests. Also additional CatalogEntry should exists for each non orderable test. That is, tests referenced from panels and which can not be requested as standalone, only in addition to other tests/observations.
- ActivityDefinition.observationResultRequirement ---[0..*]---> Reference(ObservationDefinition)
Each ActivityDefinition(panel) will reference related tests. Non standalone/orderable tests, should be modeled as orphan CatalogEntries referencing ObservationDefinition where the observation definition is an observationResultRequirement of any of the ActivityDefinitions.
We are considering include SpecimenDefinition for storing specimen handling/temperature information. ActivityDefinition support SpecimenDefinition via its specimenRequirement property. The issue is we are modiling only panels as ActivityDefinitions, but Quest also describes orderable/standalone tests with specimen handling/temperature/requirements which also need to be stored in any place. So we thought modeling everyting orderable, either panel or test, as an ActivityDefinition, and for standalone tests, only one ObservationDefinition will be associated with ActivityDefinition. We also need advise on finding an accurrate place for storing requisition special handling, like PAP flag specified by quest, which indicates whether the requisition should be split between AP and Clinical. Is this model compliant with the idea behing ActivityDefinition/ObservationDefinition/SpecimenDefinition and Composition/CatalogEntry design? Do you recommend to modify our actual model in any way?
Eric Haas (Mar 02 2020 at 21:26):
@François Macary @Lorraine Constable ??
Rob Hausam (Mar 03 2020 at 04:02):
@Guillermo Rdguez Glez This is exactly what we're preparing to ballot in the Order Catalog project. I can't tell for sure from the description above if you've already looked at the IG, but I expect that it should be able to meet most of the needs. It will be great to have your input (particularly if you have some needs that aren't yet being addressed).
François Macary (Mar 03 2020 at 06:39):
The order-catalog FHIR IG is approaching completeness on the laboratory service compendium part. As @Rob Hausam says, we'll ballot this part as a STU ballot.
@Guillermo Rdguez Glez you are most welcome to check it out and contribute. The choice of resources has evolved after a long discussion with the FHIR Management Group, and CatalogEntry is no longer used. A lab service is represented externally as a PlanDefinition, and internally as one or more ActivityDefinition + a number of ObservationDefinition, SpecimenDefinition, and optionnaly ChargeItemDefinition.
Order catalog calls are every Friday, noon EST, except for the coming Friday, which will be skipped. The project has a dedicated listserv: ordercatalog@lists.hl7.org. Not sure whether you are talking of the same Quest, but there are contributors from Quest to this IG, as you'll see.
Looking forward to your input on this project.
Guillermo Rdguez Glez (Mar 03 2020 at 14:41):
Thank you very much @Rob Hausam & @François Macary , I will study laboratory service compendium part to adjust my design and let you know if I still don't find a place to store all required information. Thanks for providing the link.
François Macary (Mar 03 2020 at 19:35):
Great! @Guillermo Rdguez Glez Please also check the set of examples.
Last updated: Apr 12 2022 at 19:14 UTC
