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Re: [Gnumed-devel] More lab test result considerations: groupings

From: James Busser
Subject: Re: [Gnumed-devel] More lab test result considerations: groupings
Date: Sat, 16 Feb 2008 23:50:08 -0800

On 15-Feb-08, at 3:14 AM, Karsten Hilbert wrote:

None of this touches on lab_request which, again, isn't really needed
so far -- we apparently don't *have* to equate lab_request with test_panel.
Which eventually seems better to me because lab_request really should
be a GNUmed-side thing.

It may mean we need to move the test status into test_result...

Moving test status into test_result won't be any benefit with HL7 lab result messages.

When a test_panel has one or more components pending, the message sends no OBX (result) segments for these components, only for those components for which a result is *available*. OBX results will be only be able to be imported (created) after they are received as "final". Any that would later be updated to status "Corrected" would be reflected in the audit.

Populating test_results in advance of them being retrieved (say, by inferring from previously-received test_panels) can make the unsafe assumption that the lab will not redefine its panel components.

I am a bit worried...

lab_request really should be a GNUmed-side thing.

Did we take a step back here? I think the above is too narrow, otherwise
- for those workflows where no request_id is available (like, outside Germany), the possibility for retrieved lab data to auto-populate our own request is lost - knowledge of pending test results would then be split partly in lab_requests and partly elsewhere... I am not sure we want to have to look in too many places for both the pending and resulted values
- we will still have the problem of pendings without any OBX

I agree that we don't have to *relate* (key) lab_requests to test_panel. But I am strongly convinced that remains value to auto- create a lab_request row when the importer could find no original request already created inside GNUmed (thus benefiting from the lab essentially entering for us, when we *were* the doctors who ordered the tests, what we cannot in Canada easily input), and to be able to keep, in this request, one text field into which to simply store the test codes and test status until the results go into test_result.

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