CP-LAB-240-TF-LAB1_corrections.docx
IHE Change Proposal
Tracking information:
IHE Domain / LABChange Proposal ID: / 240
Change Proposal Status: / Submitted Completed
Date of last update: / 23-Jan-2015
Person assigned: / Riki Merrick
Change Proposal Summary information:
Define ProfilesFix Discrepancies between IHT LTF in LAB-1 and LAB-3 to Base StandardSubmitter’s Name(s) and e-mail address(es): / Riki Merrick ()
Submission Date: / 23-Jan-2015
Integration Profile(s) affected: / LTF
Actor(s) affected: / Order Placer, Order Filler, Order Result Tracker
IHE Technical Framework or Supplement modified: / LTF
Volume(s) and Section(s) affected: / Volumes 2a, 2x
Rationale for Change:
· Updates/corrections to the sections that are out of line with the base standard.
Vol 2 a
Update the section with the following corrections to bring back in compliance with the base standard.
Section 3.1.5.3 OML^O21 Static Definition
Lines 660 –
1 Patient Visit group – list as RE?, because PV1 cannot be RE, as it is R in the base.
2 Timing_QTY group – list as RE?, because TQ1 cannot be RE, as it is R in the base.
3 NTE/OBR OBX listed a C - Condition predicate for the NTE segment below OBX (Comment of the result): Information that can be coded in OBX segments or OBR segments shall not be sent in a NTE segment. – this is not computable from the message – change to usage O with cardinalty 0..*
4 Container group: listed as C, Condition predicate for the SAC segment: This segment should be used only if it provides information that has no placeholder in the SPM segment. – this is not computable from the message – change to usage O RE with cardinalty 0..*
3.1.5.4 ORL^O22 Static Definition
‘
Is not listing SFT and NTE/MSH in the definition – add as O with cardinality 0..*
3.1.5.9.1 OBR - Observation Request Segment
Lines 765:
1 OBR-7 is “C” in the base with CP: Required in ORU/OUL message, required, when sample has been sent along, which is not computable, so suggest; listing OBR-7 usage as C(R/RE) with cardinality 0..1 for order messages with CP: Required in ORU/OUL message
Line 789: OBR-7, OBR-7 Observation Date/Time (TS), conditional
Definition: This field is the clinically relevant date/time of the observation. In the case of observations taken directly from a subject, it is the actual date and time the observation was obtained. In the case of a specimen-associated study, this field shall represent the date and time the specimen was collected or obtained.
Condition predicate: Required in ORU/OUL message
OBR-8, OBR-12, OBR-14, OBR-15 These fields are not supported. See SPM segment that supersedes them.
2 OBR-28 is “C” Condition predicate: The Order Placer shall fill this field when it sends a new order for which there are persons or care units declared for receiving a copy of the results. – This is not computable – suggest usage be RE with cardinality [0..*]
Lines 831-836: OBR-28 Result Copies To (XCN), conditional required if available.
HL7 Definition: This field identifies the people who are to receive copies of the results. By local convention, either the ID number or the name may be absent.
Condition predicate: The Order Placer shall fill this field when it sends a new order for which there are persons or care units declared for receiving a copy of the results.
3.3.5.2 ORU^R01 Static Definition
Lines 1077:
1 Patient Visit group – list as RE?, because PV1 cannot be RE, as it is R in the base.
2 Timing_QTY group – list as RE,?, because TQ1 cannot be RE, as it is R in the base.
3 Observation group listed as O, but text in lines 1100 – 1102: Unless the Report Status field (OBR-25) of the OBR is valued with an "X" (deleted battery), the OBR segment shall always be followed by one or several SPM and OBX segments – this implies usage of C(R/X) with CP: If OBR-25 is not valued ‘X’, ‘O’, ‘I’ or ‘S’.
4 NTE/OBR listed a C – no Condition Predicate listed – change to usage O orto RE with cardinalty 0..*
5 Change usage of OBR-11 to RE [0..1]
3.3.5.3 OBR Segment
Lines: 1113:
1 OBR-24 Typo in IHE profile cardinality [0..0] field is described as required in text (line 1164)
Lines 1142 - 1148: OBR-11 Specimen Action Code (ID), conditional , required if available
Condition Predicate:Note: This field is only required in the following events:
• The order is entered at the Order Filler (LIS) level as described in LAB TF-1:4.2.3. The value of the Action Code is A.
• The battery or test has been added by the Order Filler (LIS) for confirmation of a diagnostic (reflex testing); value G.
In all other triggering events of this transaction, this Action Code field is meaningless.
- Neither of these conditions are computable from the message – suggest changing usage to RE
Lines 1166 - 1170: OBR-25 Result Status (ID)
This field is required and should be filled according to HL7 Table 0123 described in Chapter 4. Depending on the triggering event of the OUL or ORU message the possible values for this field are:
Lines 1198 – 1200: OBR-26 Parent Result (PRL), conditional
Condition Predicate: If OBR-11 (Specimen Action code) is valued "G".
This field is used to report spawned orders in microbiology. See section 3.11 for detailed specification of usage.
Lines 1204 - 1205: OBR-29 Parent (EIP), conditional
Condition Predicate: If OBR-11 (Specimen Action code) is valued "G".
This field is used to report spawned orders in microbiology. See section 3.11 for detailed specification of usage.
OBR-35 is NOT listed in the table view, but has the following text in lines 1218 – 1220: OBR-35 Transcriptionist (NDL) This field is only applicable when the final report has been dictated and transcribed, which is frequent for Histology and Cytology reports.
- suggest to add as Optional in table, since text is provided?
OBR-36 is NOT listed in the table view, but has the following text in lines 1221 – 1223: OBR-36 Scheduled - Date/Time (TS) This field is optional and only applies when the value of the Result Status field (OBR-25) is S.
- suggest to add as Optional in table, since text is provided?
OBR-44 is listed as X in table, but has note in text lines 1224-1226: OBR-44 Procedure Code (CE) This field is in principle meaningless in an OUL message sent by a Laboratory but may be 1225 needed in some organizations.
- What is the intent – if allowed to be used, should be O
OBR-45: mismatch between table (usage X) and text lines: OBR-45 Procedure Code Modifier (CE) This field can be used only when OBR-44 (Procedure Code) is filled.
- (if OBR-44 indeed, X, then delete this statement from the text, otherwise mark OBR-45 as O)
1 For ACK - ERR group is cardinality 0..1 – how to send more than one error?
Vol 2 x
Update the section with the following corrections to bring back in compliance with the base standard.
C.1 MSH – Message Header Segment
2 MSH-17 – mismatch usage and cardinalty – so change cardinality to [0..1]
3 MSH-19 - mismatch usage and cardinalty – so change cardinality to [0..1]
C.3 PID – Patient Identification Segment
Line 435: PID-35 Species Code (CE), PID-36 Breed Code (CE), conditional. Condition predicate: shall be used if the test subject is a non-human living subject, i.e. when SPM-11 is valued "ANM" or "PLNT" or "MIC". PID-36 is subsumed when using SNOMED CT as coding system in PID-35, so will not be populated.
C.5 ORC – Common Order Segment
Line 524: ORC-10: mismatch between text and table in usage: Is marked RE in table, but labeled O in text – which is it?
Line533: ORC-11: mismatch between text and table in usage: Is marked RE in table, but labeled O in text – which is it?
For consideration:
Line 574: ORC-17: CP: This field represents the medical organization or team (e.g., the cardiology department) who places a new order. It should be provided by the Order Placer in OML messages carrying new orders (ORC-1=”NW”) sent to the Order Filler, over transaction LAB-1. It should be propagated by the Order Filler in all messages related to this order, sent to the Automation Manager over transaction LAB-4 as well as to the Order Result Tracker over transaction LAB-3.
· not a clear CP - what is meant by should be provided = RE? it should always be available for the placer, s then make C(R/?)? With CP: When MSH-21 is valued ‘LAB-1’ or ‘LAB-3’ or ‘LAB-4’ and ORC-1 is valued ‘NW’
· Also why not use ORC-21 for this instead? HL7 Definition: This field contains the name of the facility placing the order.
C.9 OBX - Observation/Result Segment
Lines 925:
Lines 966 – 970: OBX-6 Units (CE), conditional.
This field should be populated when there is an effective observation value (OBX-5 not empty) and when the type of this observation value is numeric (OBX-2 = "NM" or "SN"), and when this value is associated with a unit of measure. The content of this field shall be taken from the Unified Code for Units of Measure (UCUM). OBX-6: CP: This field should be populated when there is an effective observation value (OBX-5 not empty) and when the type of this observation value is numeric (OBX-2 = "NM" or "SN"), and when this value is associated with a unit of measure.
- not computable from the message for second part
OBX-16: Is listed as RE, but has this comment lines 1018 – 1023: OBX-16 Responsible Observer (XCN), required if available.
This field is required when the observation result status (OBX-11) is valued with "D" or "R" or "P" or "F" or "C" or "X" and the Producer's ID field is not valued.
- this should be a C(R/O) with CP: If OBX-11 (observation result status) is valued with "D" or "R" or "P" or "F" or "C" or "X" and the OBX-15 (Producer's ID field) is not valued
Lines 1024 – 1028: OBX-17 Observation Method (CE), conditional.
Condition Predicate: This field is required when the value of the result may be dependent of the Observation Method and the Observation Identifier does not permit to identify the Method.
- hard to implement without a LOINC part look up based on the code in OBX-3.
- suggest changing to RE
Lines 1042 – 1048: OBX-23 Performing Organization Name (XON), conditional.
This field has been added by release 2.5.1 of HL7. It specifies the laboratory that produced the test result described in this OBX segment. When this field is null, the receiving system assumes that the observations were produced by the sending organization. 1045 Condition predicate: This field shall be valued in transaction LAB-3 when the test result carried by this OBX is produced by an outside laboratory, subcontracting a part of the order. In that case, this field shall be populated with the name of the subcontractor laboratory.
- is not computable from message, so change usage to RE
- reconcile with OBX-15 use; since we now have (Performing Organization OBX-23), should OBX-15 be marked O or X?
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