Lab Conf Minutes 15April2014

Attendees

1) Technical discussion on LAW change proposals in preparation (Ed)

OBR-13:

Lab technical framework in Vol 2: clinical information should be provided through the use of dedicated OBXes;
Beckman Coulter only needed a string at this time, but no objections to using OBX;
Where would the OBX be? Under the OBR, because it relates to the test and its interpretation - used as part of the decision rules ; and
Consider pre-adopting new feature of 2.8.1 to indicate if Result, Ask at Order Entry (AOE) answer or other clinical information. Link to the approved CR <a href="http://wiki.hl7.org/index.php?title=OO_CR128-749_-_Supporting_Clinical_Information">http://wiki.hl7.org/index.php?title=OO_CR128-749_-_Supporting_Clinical_Information</a>

OBR-16:

Consider using assigning authority for all identifiers – to avoid collisions with outside organizations, and
If it is just inside the same organization, may not be needed - consider making it optional for now.

OBR-18:

Order created at the analyzer- send requisition ID from instrument to analyzer manager – in AOE category. Consider creating an IHELAW code for these categories, if more folks would be needing this, but not likely at this point, and
Additional OBXes along with the result – may be unsolicited AWOS, without IDs – would have to look how we handle OBX-29 and what fields in the OBX we’d need to support for those.

OBR-20:

Manual edit will send up exception – cancel original order and send the results as unsolicited AWOS;
Send the information along in OBXes as additional information

OBR-21: Send in OBXes as additional information.

OBR-22:

Not really needed for LAW – more important for outside organization exchanges, and
Ordering of replicates – see other CP will not be using OBR-46.

TCD/TQ1 proposals- Possible additional use cases for LAW:

Analyzer manager to order number of replicate testing –single AWOS per replicate vs allowing group of replicate. There are benefits in having individual AWOS for replicates when referencing individual results. Siemens – needs replicates testing, too – they are wanting to use TQ1 for communicating;
Suggest in LAW: Use single AWOS per replicate – allows for individual cancelation of replicates – next step to cycle back in discussion group for feedback – Dmytro to do;
Pooling of specimen allowed or not and max number of pooled specimen – if we want to support, need to request new fields in TCD – consider for face to face discussion.

Dilution protocol name vs Dilution factors:

Do we want to add as CWE?– need to clarify relationship to TCD-2 dilution factor;
TCD-11 would be ‘O’ in the base standard – same as TCD-2 – NOTE: TCD-2 and TCD-11 should not contradict each other;
Result aspects came from Siemens – created new wiki section for this discussion.
Bill Williams commented: have not multiple qual and quant, but may have screening and have numeric value (for example the threshold) and qual interpretations – currently using multiple OBXes;
Need to see real world examples from Siemens. ACTION: Discuss further at face to face;
LRI is currently looking at best practice for use of OBX-4, will bring back to this group; and
May set up a meeting on Patient demographic issues – if not further discuss at face to face.

2) Face to Face meeting agenda (Francois)

LCC- would be nice to have high level use cases as introduction to newcomers;
Presentation of the two new work items – need gap analysis of standard and what the new items cover, that is not covered at the moment by the LAB TF;
LDA Update: Ed will work with John on presentation;
Goal during the meeting is to decide on the work to allocate for each proposal; and
NOTE: Please RSVP on goggle group () if you will attend.
Send feedback on agenda to Francois (<a href="mailto:francois.macary@sante.gouv.fr">francois.macary@sante.gouv.fr</a>) and Riki (<a href="mailto:rikimerrick@gmail.com">rikimerrick@gmail.com</a>)

Call adjourned 12:03 PM ET

Face to Face Meeting, May 12-14, 2014, Paris France