Difference between revisions of "Anatomic Pathology Workflow"

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(New page: '''Pathology Workflow (PWF)''' integrates the pathology department in the healthcare institution, and covers these specialties: surgical pathology, clinical autopsy, cytopathology. __TOC...)
 
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==Details==
 
==Details==
  
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The '''''Pathology Workflow (PWF) Integration Profile''''' is bound to in vitro diagnostic testing (tests performed on in vitro specimen collected from a patient). It supports all laboratory specialties but anatomic pathology.
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The scope of this profile includes surgical pathology, biopsies pathology, cytopathology, autopsies, and related techniques (immunohistochemistry, molecular pathology, etc).
  
 
'''Use cases:'''<br/>
 
'''Use cases:'''<br/>
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The LTW Integration Profile covers three major use cases:
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This profile supports 5major use cases:
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* Order placed with specimens collected and identified by the orderer
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* Use case 1: Surgical pathology – Operative specimen
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* Order placed with specimens collected by a third party, then identified and labeled by the laboratory information system
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* Use case 2: Surgical pathology – Biopsies
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* Order generated by the laboratory and notified to the ordering system to obtain an order number.
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* Use case 3: Cytology
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* Use case 4: Autopsy
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* Use case 5: Tissue Micro Array (more than one specimen from more than one patient per container)
  
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'''Transactions:'''<br/>
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This profile leverages IT Infrastructure profiles [PAM] for sharing up to date patient and encounter data, and [ATNA] and [CT] for security.
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LTW Integration Profile defines 5 Transactions, all of which based on HL7 release 2.5 or 2.5.1 messaging standard. Each transaction selects a subset of HL7 message structures (based on OML, ORL, ORU and OUL) and specifies a set of constraints applying to each message structure, as well as the responsibilities of the sender and receiver.
 
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This profile leverages IT Infrastructure profiles [PAM] or [PDQ] for up to date patient and encounter data, and IT Infrastructure profiles [ATNA] and [CT] for security.
 
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'''Units of work:'''<br/>
 
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A laboratory request ordered by a physician for a patient is frequently composed of multiple tests and panels placed to a laboratory. Such a '''laboratory request''' containing several orders is called an '''Order Group''' in the HL7 standard, and uniquely identified by the ordering CIS with a '''Placer Group Number'''. Each of the orders is in turn uniquely identified by the CIS with a '''Placer Order Number'''. Each order accepted by the laboratory as well as each reflex order generated by the laboratory is uniquely identified by the LIS with a '''Filler Order Number'''.<br/>
 
  
 
==Systems Affected==
 
==Systems Affected==
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Systems involved in this profile are:
 
Systems involved in this profile are:
  
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* One or more Clinical Information Systems ('''CIS'''). Each of these systems is operated by a clinical facility and provides a number of features such as order entry, order placing, placer order management and follow-up, order result tracking, management of patient biologic history, specimen calculation, specimen identification... A CIS usually implements the Actors Order Placer and Order Result Tracker.
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* The hospital Clinical Information System
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* One or more Laboratory Information Systems ('''LIS'''). Each of these systems is operated by a number of clinical laboratories inside the institution. The LIS offers features such as order reception, specimen calculation, specimen identification or specimen acceptance, order check, scheduling, filler order management, production of worklists, result manual entry for non connected-tests, clinical validation and interpretation of results, result reporting. Each LIS implements an Order Filler Actor.
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* The system of the pathology laboratory
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* One or more Laboratory Automation Systems ('''LAS''') operated in each laboratory. A LAS manages a set of automated laboratory devices (pre-analytical devices, analyzers, post-analytical devices). The LAS receives Work Orders related to a specimen and processes the various steps of a WSork Order on its set of devices, to eventually get the test results, perform the technical validation thereof, and upload them back to the LIS.<br/>
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* Imaging modalities
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* Multimodalities
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'''Actors & Transactions:'''
 
'''Actors & Transactions:'''
  
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<center>[[Image:ltw-actor-transaction.JPG]]</center>
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<center>[[Image:pwf-actor-transaction.JPG]]</center>
 
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Revision as of 05:34, 12 June 2008

Pathology Workflow (PWF) integrates the pathology department in the healthcare institution, and covers these specialties: surgical pathology, clinical autopsy, cytopathology.



Summary

The Pathology Workflow Integration Profile establishes the continuity and integrity of basic pathology data acquired during examinations ordered for an identified inpatient or outpatient. This profile covers three main aspects of the workflow:

  • The ordering aspects of the workflow - The PWF profile specifies a number of transactions to maintain the consistency of ordering information and specimen management information.
  • The reporting aspects of the workflow - The PWF profile specifies a number of transactions to create and store observations and reports outside the Pathology department and to maintain the consistency of these results.
  • The imaging aspects of the workflow - The PWF profile specifies a number of transactions to create and store images and to maintain the consistency of these images. Worklists for image acquisition is generated and can be queried. This Integration Profile also describes evidence creation.
Ihe pat pwf ip last.jpg


Benefits

Reduces Errors and Enhances Patient Care

  • Prevents manual data entry errors by ensuring that each piece of information is entered only once, by the person closest to the source of this information, and from there, made available in due time to any system who needs it.


Details

The scope of this profile includes surgical pathology, biopsies pathology, cytopathology, autopsies, and related techniques (immunohistochemistry, molecular pathology, etc).

Use cases:
This profile supports 5major use cases:

  • Use case 1: Surgical pathology – Operative specimen
  • Use case 2: Surgical pathology – Biopsies
  • Use case 3: Cytology
  • Use case 4: Autopsy
  • Use case 5: Tissue Micro Array (more than one specimen from more than one patient per container)

This profile leverages IT Infrastructure profiles [PAM] for sharing up to date patient and encounter data, and [ATNA] and [CT] for security.

Systems Affected

Systems involved in this profile are:

  • The hospital Clinical Information System
  • The system of the pathology laboratory
  • Imaging modalities
  • Multimodalities


Actors & Transactions:

Pwf-actor-transaction.JPG


Specification

Profile Status: Trial Implementation

Documents: IHE Laboratory Technical Framework:

  • Vol. 1 - Section 4 (LTW profile overview)
  • Vol. 2 - Sections 4 through 8 (LTW transactions descriptions)

Underlying Standards:

See Also

Related Profiles

  • Integration Profiles LTW depends on
  • Patient Administration Management (PAM) and/or Patient Demographics Query (PDQ) provide accurate patient demographics used by LTW: An application implementing one of the Actors Order Placer, Order Result Tracker, Order Filler shall also implement the Actors Patient Demographics Consumer and Patient Encounter Consumer from either PAM or PDQ Profile or both.
  • Audit_Trail_and_Node_Authentication (ATNA) to audit creation and access to patient data during LTW. An application implementing one of the Actors Order Placer, Order Result Tracker, Order Filler shall also implement the Actor Secure Node from ATNA.
  • Consistent_Time (CT) to ensure timestamps in LTW data and audit messages are accurate.
  • Integration Profiles depending upon LTW
  • Laboratory_Device_Automation (LDA) from the Laboratory Technical Framework: The Actor Automation Manager from the LDA Profile must also be an Automation Manager in the LTW Profile.
  • Laboratory_Point_Of_Care_Testing (LPOCT) from the Laboratory Technical Framework: The Actor Order Filler from the Laboratory LPOCT Profile must also be an Order Filler in the LTW Profile.
  • Laboratory_Barcode_Labeling (LBL) from the Laboratory Technical Framework: The Label Information Provider Actor of the LBL profile shall be grouped with either the Order Filler or the Order Placer from the LTW profile.

Consumer Information

This page is based on the Profile Template

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