Difference between revisions of "Sharing Laboratory Reports"

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''' Sharing Laboratory Reports (XD-LAB)''' describes the laboratory report as an electronic content to be shared among a community of healthcare settings and care providers relying on a document sharing infrastructure.
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{| style="color: blue;"
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| '''This profile is part of the Pathology and Laboratory Medicine (PaLM) domain, which merged the former AP and LAB domains since 2016, January 4th.'''
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|}
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''' Sharing Laboratory Reports (XD-LAB)''' addresses the sharing of laboratory reports  among a community of healthcare settings and care providers.
  
  
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==Summary==
 
==Summary==
  
This Content Integration Profile describes a clinical laboratory report as an electronic document to be published towards a document sharing resource such as an Electronic Health Record (EHR) or in Personal Health Record (PHR) shared by a community of care providers, using one of the document sharing profiles defined in ITI-TF. Such an electronic document contains the set of releasable results produced by a clinical laboratory in fulfillment of one or more test Orders for a patient. The report is shared in a human-readable format. In addition, this electronic laboratory report SHALL contain test results in a machine-readable format, to facilitate the integration of these observations in the database of a consumer system. <br/>
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This Content Integration Profile describes a clinical laboratory report as an electronic document to be published towards a document sharing resource such as an Electronic Health Record (EHR) or a Personal Health Record (PHR) shared by a community of care providers, using one of the document sharing profiles defined in ITI-TF. Such an electronic document contains the set of releasable results produced by a clinical laboratory in fulfillment of one or more test Orders for a patient. <br/>
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The report is both human-readable and importable in the consumer systems so as to consolidate their patient medical records. <br/>
 
The scope of this profile covers all laboratory specialties except anatomic pathology. <br/>
 
The scope of this profile covers all laboratory specialties except anatomic pathology. <br/>
This profile leverages IT Infrastructure profiles [ATNA] and [CT] for security, and [XDS], [XDM], [XDR] for document sharing.<br/>
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This profile leverages the [Clinical Document Architecture Release 2] (CDAr2) standard from [[http://www.hl7.org HL7]]
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<center>[[Image:ihe_lab_xd-lab_ip.jpg]]</center>
 
<center>[[Image:ihe_lab_xd-lab_ip.jpg]]</center>
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'''Facilitates Patient Care Coordination'''
 
'''Facilitates Patient Care Coordination'''
* Enables the caregiver to obtain at once the laboratory reports produced during previous episodes of care.
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* Enables the caregiver to obtain at once the laboratory reports produced during previous episodes of care, which enhances continuity of care.
* Reduce over-ordering and over blood sampling from the patient by sharing the last laboratory reports among the various physicians attending the patient.
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* Reduces over-ordering and over blood sampling from the patient by sharing the last laboratory reports among the various physicians attending the patient.
 
* Enables the physician to consolidate their patient biological history by importing into their EHR the structured and coded data embedded in the electronic laboratory report.
 
* Enables the physician to consolidate their patient biological history by importing into their EHR the structured and coded data embedded in the electronic laboratory report.
 
* Allows a public health laboratory to share broadly its reports related to a suspected outbreak
 
* Allows a public health laboratory to share broadly its reports related to a suspected outbreak
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==Details==
 
==Details==
  
The '''''Sharing Laboratory Reports (XD-LAB) Integration Profile''''' describes a laboratory report as an electronic document to be shared between various care providers within a document sharing resource. This electronic document has a human-readable format for visualization on screen or print out and embedds each of its reported results as structured and coded data, machine-readable, that can be imported in the database of any consumer of the document.<br/>
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The '''''Sharing Laboratory Reports (XD-LAB) Integration Profile''''' provides an electronic format for the laboratory report, to make this report:
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* human-readable: displayed on screen or printed out, with a proper and clear layout and presentation.
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* machine-readable: Each observation displayed in the report is also represented in the document as a set of structured and coded data that can be imported in the database of any consumer of the document.<br/>
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This double capacity is achieved by leverageing the [Clinical Document Architecture Release 2] (CDAr2) standard from [[http://www.hl7.org HL7]]<br/>
 
The XD-LAB Integration Profile covers six major use cases:
 
The XD-LAB Integration Profile covers six major use cases:
 
* At discharge time, a hospital physician publishing a summary laboratory report with the most significant results obtained during the patient stay.
 
* At discharge time, a hospital physician publishing a summary laboratory report with the most significant results obtained during the patient stay.
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* A healthcare institution produces a cumulative report of all laboratory tests performed for the patient during the encounter.
 
* A healthcare institution produces a cumulative report of all laboratory tests performed for the patient during the encounter.
 
* A public health laboratory shares its reports into a regional repository.
 
* A public health laboratory shares its reports into a regional repository.
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<br/>
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The standard CDAr2 leveraged by XD-LAB enables to share reports embedding images and charts, which are faithfully rendered by a web browser supporting RFC 2397:<br/>
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<center>[[Image:ihe_lab_xd-lab_example.jpg]]</center>
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<br/>
  
 
==Systems Affected==
 
==Systems Affected==
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Systems involved in this profile are:
 
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.
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* A system owning a laboratory report and willing to publish it into a document sharing infrastructure. Depending upon the use cases, this can be the system of a clinical laboratory (LIS), the EHR of an ambulatory physician, the EMR of a care setting, the system of a public health laboratory. Each of these systems can play the role of Content Creator.
* 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 operated by a professional caregiver who wants to view a laboratory report, and may want to import its structured and coded results into its own database. This system plays the role of Content Consumer.
* 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/>
 
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/>
 
  
 
'''Actors & Transactions:'''
 
'''Actors & Transactions:'''
  
[[Image:ltw-actor-transaction.JPG]]
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<center>[[Image:xd-lab_actor_transaction.JPG]]</center>
 
<br/>
 
<br/>
'''Other requirements for systems implementing LTW (dependencies towards IT Infrastructure Profiles):'''
 
* 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.
 
* An application implementing one of the Actors Order Placer, Order Result Tracker, Order Filler shall also implement the Actor Secure Node from the '''ATNA''' Profile, as well as the Actor Time Client from the '''CT''' Profile.
 
  
 
==Specification==
 
==Specification==
  
'''Profile Status:''' [[Comments| Trial Implementation]]   
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'''Profile Status:''' [[Comments| Final Text]]   
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'''Documents:''' [https://www.ihe.net/resources/technical_frameworks/#PaLM IHE Laboratory Technical Framework:]
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:* [https://www.ihe.net/uploadedFiles/Documents/PaLM/IHE_PaLM_TF_Vol1.pdf Vol. 1] - XD-LAB profile overview
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:* [https://www.ihe.net/uploadedFiles/Documents/PaLM/IHE_PaLM_TF_Vol3.pdf Vol. 3] - Content
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'''Computable specification:'''
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:* [https://art-decor.ihe-europe.net/art-decor/decor-project--XDLAB- XD-LAB specified in Art-Decor on ihe-europe.net] - templates and value sets
  
'''Documents:'''
 
:* [http://www.ihe.net/Technical_Framework/index.cfm#laboratory IHE Laboratory Technical Framework:]
 
 
'''Underlying Standards:'''
 
'''Underlying Standards:'''
:* [http://www.hl7.org HL7]
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:* [http://www.hl7.org HL7 CDA Release 2]
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:* [http://www.regenstrief.org/medinformatics/loinc LOINC (Logical Observation Identifiers Names and Codes)]
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:* [http://unitsofmeasure.org/trac The Unified Code for Units of Measure (UCUM)]
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:* RFC 2397
  
 
==See Also==
 
==See Also==
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'''Related Profiles'''
 
'''Related Profiles'''
  
* '''Integration Profiles LTW depends on'''
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* '''Integration Profiles XD-LAB depends on'''
:* [[Patient_Administration_Management]] (PAM) or [[Patient_Demographics_Query]] (PDQ) from ITI Technical Framework: The Actors Order Placer, Order Filler, Order Result Tracker shall be grouped with Actors from PAM or PDQ or both.
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:* [[Cross Enterprise Document Sharing]] (XDS) or [[Cross_Enterprise_Document_Media_Interchange]] (XDM) or [[Cross_Enterprise_Document_Reliable_Interchange]] (XDR) from the ITI Technical Framework. Each of these three profiles provides an infrastructure for the sharing of medical documents between the creators and the consumers.
:* [[Audit_Trail_and_Node_Authentication]] (ATNA) and [[Consistent_Time]] (CT) from ITI Technical Framework: The Actors Order Placer, Order Filler, Order Result Tracker shall be grouped with the Actors "Secure Node" from ATNA and "Time Client" from ATNA.
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:* [[Audit Trail and Node Authentication]] (ATNA) from the ITI Technical Framework, to authenticate and audit the document-sharing transactions: Document storage and registration, document query and retrieval.
* '''Integration Profiles depending upon LTW'''
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:* [[Consistent Time]] (CT) from the ITI Technical Framework, to ensure accuracy of the time stamps in the shared documents and in the associated metadata.
:* [[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.
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:* [[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_Specimen_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'''
 
'''Consumer Information'''
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[[Category:Profiles]]
 
[[Category:Profiles]]
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[[Category:PaLM Profile]]
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[[Category:DocShare]]
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[[Category:CDA]]

Latest revision as of 09:45, 14 April 2020

This profile is part of the Pathology and Laboratory Medicine (PaLM) domain, which merged the former AP and LAB domains since 2016, January 4th.

Sharing Laboratory Reports (XD-LAB) addresses the sharing of laboratory reports among a community of healthcare settings and care providers.



Summary

This Content Integration Profile describes a clinical laboratory report as an electronic document to be published towards a document sharing resource such as an Electronic Health Record (EHR) or a Personal Health Record (PHR) shared by a community of care providers, using one of the document sharing profiles defined in ITI-TF. Such an electronic document contains the set of releasable results produced by a clinical laboratory in fulfillment of one or more test Orders for a patient.
The report is both human-readable and importable in the consumer systems so as to consolidate their patient medical records.
The scope of this profile covers all laboratory specialties except anatomic pathology.


Ihe lab xd-lab ip.jpg


Benefits

Facilitates Patient Care Coordination

  • Enables the caregiver to obtain at once the laboratory reports produced during previous episodes of care, which enhances continuity of care.
  • Reduces over-ordering and over blood sampling from the patient by sharing the last laboratory reports among the various physicians attending the patient.
  • Enables the physician to consolidate their patient biological history by importing into their EHR the structured and coded data embedded in the electronic laboratory report.
  • Allows a public health laboratory to share broadly its reports related to a suspected outbreak

Details

The Sharing Laboratory Reports (XD-LAB) Integration Profile provides an electronic format for the laboratory report, to make this report:

  • human-readable: displayed on screen or printed out, with a proper and clear layout and presentation.
  • machine-readable: Each observation displayed in the report is also represented in the document as a set of structured and coded data that can be imported in the database of any consumer of the document.

This double capacity is achieved by leverageing the [Clinical Document Architecture Release 2] (CDAr2) standard from [HL7]
The XD-LAB Integration Profile covers six major use cases:

  • At discharge time, a hospital physician publishing a summary laboratory report with the most significant results obtained during the patient stay.
  • The bio-medical scientist of a private laboratory publishes a report for a patient into the regional Patient Health Record.
  • An ambulatory physician shares a laboratory report obtained from a laboratory.
  • A private or public laboratory publishes automatically all its reports in a shared document repository.
  • A healthcare institution produces a cumulative report of all laboratory tests performed for the patient during the encounter.
  • A public health laboratory shares its reports into a regional repository.


The standard CDAr2 leveraged by XD-LAB enables to share reports embedding images and charts, which are faithfully rendered by a web browser supporting RFC 2397:

Ihe lab xd-lab example.jpg


Systems Affected

Systems involved in this profile are:

  • A system owning a laboratory report and willing to publish it into a document sharing infrastructure. Depending upon the use cases, this can be the system of a clinical laboratory (LIS), the EHR of an ambulatory physician, the EMR of a care setting, the system of a public health laboratory. Each of these systems can play the role of Content Creator.
  • The system operated by a professional caregiver who wants to view a laboratory report, and may want to import its structured and coded results into its own database. This system plays the role of Content Consumer.

Actors & Transactions:

Xd-lab actor transaction.JPG


Specification

Profile Status: Final Text

Documents: IHE Laboratory Technical Framework:

Computable specification:

Underlying Standards:

See Also

Related Profiles

  • Integration Profiles XD-LAB depends on


Consumer Information

This page is based on the Profile Template