Difference between revisions of "Inter Laboratory Workflow"

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'''Use cases:'''<br/>
 
'''Use cases:'''<br/>
The LTW Integration Profile covers three major use cases:
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The ILW Integration Profile covers three major use cases:
* Order placed with specimens collected and identified by the orderer
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* Cooperation between a hospital and a specialized private laboratory
* Order placed with specimens collected by a third party, then identified and labeled by the laboratory information system
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* Specific tests subcontracted to a national reference laboratory
* Order generated by the laboratory and notified to the ordering system to obtain an order number.
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* Distributed process in a cooperative group of laboratories
  
 
'''Transactions:'''<br/>
 
'''Transactions:'''<br/>
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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ILW Integration Profile defines 2 Transactions: LAB-35 "Sub-order management" and LAB-36 "Sub-order results delivery". Both transactions are based on HL7 release 2.5.1 messaging standard. LAB-35 is implementing an OML/ORL message pair. LAB-36 is implementing an ORU/ACK message pair.
 
 
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.
 
 
 
'''Units of work:'''<br/>
 
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==

Revision as of 05:44, 17 December 2009

Inter Laboratory Workflow (ILW) supports the workflow of orders and results of in vitro diagnostic tests between a requesting laboratory and a subcontracting laboratory.



Summary

The Inter-Laboratory Workflow Profile covers the workflow of orders and results beween a requesting lab providing the specimens and the orders and a subcontracting lab performing the tests and reporting the results to the former one. This workflow is able to carry the payors information along with the order (patient insurances, guarantor, ...). The structured results may be accompanied by a pdf copy of the performing lab report.

Ihe lab ilw proc.jpg


Benefits

Improves Throughput in Care Process

Details

The Inter-Laboratory Workflow (ITW) Integration Profile is bound to in vitro diagnostic testing. The specimen is always provided by the requesting lab. The subcontracting lab does not see the patient. This profile supports all laboratory specialties but anatomic pathology.

Use cases:
The ILW Integration Profile covers three major use cases:

  • Cooperation between a hospital and a specialized private laboratory
  • Specific tests subcontracted to a national reference laboratory
  • Distributed process in a cooperative group of laboratories

Transactions:
ILW Integration Profile defines 2 Transactions: LAB-35 "Sub-order management" and LAB-36 "Sub-order results delivery". Both transactions are based on HL7 release 2.5.1 messaging standard. LAB-35 is implementing an OML/ORL message pair. LAB-36 is implementing an ORU/ACK message pair.

Systems Affected

Systems involved in this profile are:

  • 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.
  • 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.
  • 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.


Actors & Transactions:

Ltw-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