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HL7 V2 messages for phlebotomists?

• ORM (or OML in later versions) might be used - the regular order, but could be in done with proprietary format
• print out the labels as a "worklist"
• also depends on internal workflow / assignment by ward, or to lab etc.
• Depends on patient status potentially

• Could chose to make an order just for the phlebotomist, but have not seen it in Epic, though heard there is increase to separate phlebotomy service from analytical services (e.g. for at home care) – maybe as a panel order – signs a single order – explodes to both services (phlebotomy gets type of tube and labels, the order gets to the lab) – ORM would not have a result back from phlebotomy – treat as nursing orders, so no result, but gets a complete status – hidden from patient chart review and only displayed in the work list (ORU^R24 message is not used) – Status update in ORM message (ORC-5)

• Labcorp subcontracts to phlebotomy service (Getlabs) – order comes to Labcorp from the physician – depends how the patient choses – not sure how that is indicated on the order (go to draw station, go to pharmacy, get at home service)

• Options for an order message are ORM_O01 or OMG_O19

Expanded DME project work

• Review planned scope against other FHIR IGs - limited number:
  • BSer – using messaging and task
  • Dental data exchange – unclear how
  • DME – task and messaging
  • SDOH / Gravity – is task-based exchange of what they call referrals
  • Specialty medication prescribing – supports both
  • V2-FHIR only translates the data elements – it does not include the workflow
  • 360X – dependent on Direct and FHIR
  • COW – universal work; not advanced enough yet
  • Genomics is making some revisions
  • Ophthalmology exchange – not sure here – need to review more
  • There are several others that don’t have actual IGs to be able to tell

• Also this review page: https://confluence.hl7.org/display/OO/Review+of+Existing+Workflow+Approaches

  • Here is spreadsheet review for lab workflows: https://confluence.hl7.org/download/attachments/4489770/FHIR%20Lab%20Orders%20IG%20Analysis%20%281%29.xlsx?api=v2

• Gravity and DME use task the same way – Bob wrote them both – would need to harmonize with BSer

• At-Home test – is just result reporting, not physician orders – so not applicable

• Need to make sure DME scope supports lab order workflow – in close coordination with the COW IG

• Bob will bring to FMG and update OO and also coordinate when calls are starting back up – for the FHIR in the lab call Friday 10-11 AM ET

Other Topics

• Andrea looked at USCore lab examples
  • several of them have been missing specimen in the past – that is now also being fixed, but they are going off the LOINC shortname (Ser/Plas) to update the sample to the single specimen, as LOINC lists the allowed
  • mis-matched specimen types in a panel, they are getting corrected
• Time swab
  • For OO on FHIR time will need more coordination
• Would be good to work through the lab order catalog examples and show each one in the workflow of orders – specimen - results
  • Still missing a pathology example – JD is working on that
  • Need to see how that works with the surgical procedures

• Connectathon in May?

  • for LIVD – Roche not, not yet Epic – probably more likely for September connectathon

  • for eDOS also in September, since dependent on R5 publication

• V2 OO/Specimen
  • none reviewed
• FHIR Specimen JIRAs
  • FHIR-40538
    • Missing search parameters in the examples –
      • Uri – has to have version and flag – JD can fix this this week – are we ok to fix this in QA also
      • Content deadline got pushed to COB today
    • Motion to fix Rob, Riki, no further discussion, against: 0, abstain: 0, in favor: 7
      • Riki to update the jira
• All the ballot related, non-HCP jiras have been applied otherwise
• Diagram work – Rob is working on this now

From Chat

MISSED Copying

Call Adjourned at 2:42 PM ET

Next Meeting March 6th, 2023

Next Time: 

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