Laboratory Orders Interface
Subject
LOI Initiative
Facilitator
Location
Attendees
Dave Shevlin
Conf. Call/WebEx
See “Meeting Attendees” on Wiki
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4.
Date /
Time
Scribe
Materials
5/24/2012
2:00 – 3:00 PM ET
Saunya Williams
See Presentation on Wiki
Agenda
Announcements
Use Case Review – Risks, Issues, and Obstacles
Use Case Review – Dataset Requirements
Next Steps
Key Discussion Points
1. Announcements
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LRI IG WG resumed meetings for ballot reconciliation
o LRI IG: Tuesday’s 3pm – 5pm and Thursday’s 3pm – 5pm
LOI Use Case meeting has been reduced until the LRI IG ballot is complete
o LOI UC: Thursday’s 2pm -3pm
2. Use Case Review - Risks, Issues, and Obstacles
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Since several LOI members attended the HL7 WGM, we wanted to revisit this section and review
some new comments
Luke H. suggested the removal of the bullet “Often laboratory orders are delivered through paperbased means (letter, fax)…” because it’s not a risk or an obstacle
o Final Decision: Agreement to delete
Pam B. commented on “each laboratory may have different LOINC terms associated with their
laboratory order as they each may use different methods…”
o Per Scott R., maybe the laboratories need to determine the appropriate LOINC code
o Per Gai E., the vast majority of laboratories do not currently have LOINC
o Local coding systems exist today. If different LOINC codes are used, then the laboratories
will have to determine what is appropriate
o Per Merideth V., we will have a separate work effort for eDOS, which may address some of
these issues
o This comment may not be considering all of the business cases of all laboratories.
o Per Freida H., Meaningful Use began with a threshold and increased the threshold with
time. The DOS allows LOINC as well as a map to LOINC codes
o Per Gai E. and Eddy R., we could consider the outcome of the Vocab WG
o Per Hai N., suggested change “LOINC terms” to “order codes interfaces”
o Final Decision: This comment is contingent on the work of the Vocab WG and will be
finalized following the recommendation of the Vocab WG
2/9/2016
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Action Item: Dave S. will follow-up with the Vocab WG to finalize all of the comments regarding
vocabulary
Action Item: Megan S. to update “When an interface is initiated between a laboratory
environment and any external (to the laboratory) entity…” and will work with Dave S. to update
offline in support of CLIA requirements and present to WG next week
Luke H. updated “An EHR may feature orderable tests from several laboratories in its menu. The
EHR will be…”
Revisit the bullet “limited process/workflow/technology hinders the ability to echo the original
requisition (order) identifier…”
o Per Freida H., added “patient identifiers” because there can be multiple identifiers
o Per Scott R., revised to “limits in the process/workflow/technology within the laboratory
system…” to clarify the focus of the statement
3. Use Case Review - Dataset Requirements
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We encourage you to read the Use Case document in its entirety. We will conduct a formal End-toEnd review prior to consensus
Dataset Requirements can be accessed via the “LOI Use Case button” on the wiki
Thank you Eddy R. for all of your help!
Action Item: Dave S. will send the updated spreadsheet in an upcoming email
The spreadsheet aims to identify the elements that are needed for the LOI Use Case
A “” denotes that the element was included in the corresponding implementation guide
Yellow-highlighted “” were added by Eddy R.
CLIA number should be included in the identifier to ensure a match
o The real information about the laboratory is located elsewhere in the spreadsheet
Per Scott R., “Sequence Number” and “Continuation Pointer” are probably not an issue for LOI
Per Scott R., “Security”: we should compare to see what was used by LRI
o Per Freida H., verified that “Security” is optional
o Final Decision: “Security” cell was grayed out as a reminder to revisit for further discussion
Per Dave S., the actual usage of each data element (R, RE, O, etc.) will be solidified by the Tiger
Team
Per Merideth V., our goal is to make sure that all of the data elements are captured in order to
meet the requirements of the LOI Use Case. Once we are finished with selecting these required
data elements we will hand it off to the harmonization team to begin defining the Usage,
Cardinality, etc.
“Alternate Patient ID” was included to account for multiple identifiers (i.e., ID of the patient at the
practice may not be the same at the laboratory)
o Per Freida H., the HL7 standard recommends the use of “PID 3”
o Final Decision: removed the “Alternate Patient ID” element
The elements “Phone Number-Home” through “Patient Account Number” were added to include
more identifiable information about the patient
o Should the data elements in the LOI IG parallel the LRI IG to ensure interoperability?
 Not necessarily because some elements are optional
o Per Gai H., the element ”Religion” should be a comment that is not required
2/9/2016
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 Per Freida H., “Religion” is optional in LRI
 Per Eddy R., added “Religion” to account for certain patient preferences
 Final Decision: added a comment to mark this field as optional
o Per Ken W., some of these data elements are important for the laboratory workflow
o “Patient Account Number” - is it the EHR number or the laboratory number?
 The element is a “CS” and will dictate the originator to avoid any confusion
o Additional data in the message may be useful to different systems, like a hospital
 We should only consider the ambulatory setting, not the hospital
Per Ken W., we will probably need to revisit the discussion about how orders are delivered to an
LIS vs. a hospital system
4. Next Steps
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Please review the Dataset Comparison Spreadsheet and use the feedback form for your comments
Action Items
Subject
Item
Owner
Vocab WG
Follow-up with the Vocab WG
to finalize all of the comments
regarding vocabulary
Risks, Issues, and
Obstacles
Dataset Comparison
/Defining the
Dataset
Requirements
2/9/2016
Status
David Shevlin
Due Date/
Timeline
5/29/12
Work with Dave S. to update
offline in support of CLIA
requirements. “When an
interface is initiated between
a laboratory environment…”
Megan Sawchuk
5/30/12
In
Progress
Send the updated data
comparison spreadsheet
David Shevlin
5/25/12
In
Progress
In
Progress
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