FHIR Chat · Laboratory order results flow

Stream: implementers

Topic: Laboratory order results flow

Andrii Bilyi (Oct 03 2018 at 14:23):

Hi there. We want to use FHIR 3 as standart for comunication with a laboratory. Maybe someone can hint me what resources or whatever I should use for this flow. I mean flow like some external organization or practitioner make an order to our laboratory for some patien for some tests. This external system should be able to recieve status of this order and retrieve results as soon as they ready. I found some examples but seems it is dstu2. If any for version 3 exists?

Thnx alot.

Lloyd McKenzie (Oct 03 2018 at 14:25):

Look at the workflow section and consider whether you need Task. You'll also be using ProcedureRequest, Observation, DiagnosticReport and possibly Specimen.

Andrii Bilyi (Oct 03 2018 at 14:28):

Look at the workflow section and consider whether you need Task. You'll also be using ProcedureRequest, Observation, DiagnosticReport and possibly Specimen.

Thanks alot. I'll take a look.

Andrii Bilyi (Oct 04 2018 at 07:29):

Am I right that first External system must set some ProcedureRequest and then create Task with referrence on this ProcedureRequest?

Lloyd McKenzie (Oct 04 2018 at 11:06):

That's certainly one way - and in my opinion a more preferable way than some of the alternatives (e.g. Messaging, bare ProcedureRequest with a tag)

Andrii Bilyi (Oct 04 2018 at 12:16):

Thx you for your reply. But now I am confused :). Is any standart sequence of Resources must be passed for this flow (pass order to lab with patient and practitioner data and tests and then return test results), or we must work on our own implementation using FHIR just as recomendation or framework for that?

Lloyd McKenzie (Oct 04 2018 at 13:00):

The core specification can't standardize something like this because capabilities, workflows and regulation vary from jurisdiction to jurisdiction. This is something that will need to be nailed down in jurisdiction-specific implementation guides (and in some cases might vary between human, veterinary and environmental lab scenarios.

In a pure REST scenario, a the Patient, ProcedureRequest and other resources would be on the placer's server or possibly some intermediary. The Task would be posted into some location where the lab would be aware of it (either because it's posted directly to their system or posted to a system they monitor. The lab would then update the Task to indicate whether the request had been received, accepted, rejected, etc. However you could also make things work in a traditional messaging approach where you package up a whole bunch of resources and transfer them at once.

Andrii Bilyi (Oct 04 2018 at 14:34):

Thx alot.

René Spronk (Oct 05 2018 at 06:44):

To add to Lloyds comments: you'd need an implementation guide to define a) the workflow and b) the rules how in the context of that workflow the resources should be used. IHE has attempted this for common laboratory workflows (the current guidance is for Hl7 v2, not for FHIR), but uptake unfortunately has been relatively low - which probably means they won't be really motivated to "port" the implementation guide to use FHIR resources.

René Spronk (Oct 05 2018 at 06:45):

Should you be in attendance at the FHIR DevDays in Amsterdam - I'll be presenting a session on this topic so that would be an opportunity to chat about the subject.

Andrii Bilyi (Oct 05 2018 at 06:58):