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

[James Busser]

On 14-Feb-08, at 8:16 AM, Karsten Hilbert wrote:

> > We don't need them *in their own table structure* however the the
> > test org lab sections (HAEM, CHEM, MICRO, IMMUN) could be usefully
> > imported into a catch-all text field if we were to add one to
> > lab_requests, something like the test_result table note_provider (to
> > be renamed note_test_org)
>
> From reading a bunch of stuff (the HL7 standard itself is not freely
> available) on the web (such as http://aurora.regenstrief.org/ 
> ~gunther/)
> I figure that HL7 wants OBR to be what we consider lab_request to be.
>
> I think in the first iteration we will equate the two and add fields
> as necessary. IOW
>
> > If we had a field of same or equivalent name in lab_requests, the OBR
> > 024 "Diagnostic Service Section" names could update/append into here.
>
> we will add a field lab_request.service_section.

I agree that the service_section has (only) *limited* value. The  
section info is not *totally* valueless, it serves mainly if there is  
an issue with your test of interest, and you end up needing to know  
what section technician you will need to speak with, because the  
front desk never knows when the infrequently-performed test that you  
are waiting for will be done, nor do they tend to know --- when there  
is a suspicious or unclear result --- the section to which they  
should forward your call, and you can burn up a lot of the time on  
the phone waiting.

If we reconsider, and suppose that we ordered tests whose information  
returned by the lab included (any of which could be resulted or pending)

        OBR 004 Universal Service ID = YGT^Gamma GT
        OBR 024 Diagnostic Service Section = CHEM4

        OBR 004 Universal Service ID = ALT^ALT
        OBR 024 Diagnostic Service Section = CHEM4

        OBR 004 Universal Service ID = AST^AST
        OBR 024 Diagnostic Service Section = CHEM4

        OBR 004 Universal Service ID = HP^Hematology Panel
        OBR 024 Diagnostic Service Section = HAEM1

        OBR 004 Universal Service ID = PT^INR
        OBR 024 Diagnostic Service Section = HAEM3

        OBR 004 Universal Service ID = URC^URINE CULTURE
        OBR 024 Diagnostic Service Section = MICRO3
        OBR 025 Result Status  = P (pending)

        OBR 004 Universal Service ID = ENDO^Endometrium Culture
        OBR 024 Diagnostic Service Section = MICRO3
        OBR 025 Result Status  = P (pending)

If we ask ourselves

	"What would be most useful to capture from the above, and keep with  
the lab request as note_org_info *instead* of as service_section ... "

I would venture it could be:

	Gamma GT, ALT, AST, Hematology Panel, URINE CULTURE (P), Endometrium  
Culture (P)

IOW subsegments that combine the test names with their status (when  
not FInal).