Order Laboratory Test
Electronic Medical Records (EMRs) systems can send an electronic lab order to a laboratory information system (LIS).
Interaction Description
Last updated
Electronic Medical Records (EMRs) systems can send an electronic lab order to a laboratory information system (LIS).
Last updated
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Interaction
Data
Transaction Options
1
Create Lab Order
The order save generates a FHIR R4 Task Resource (see example here)
Alternatively, the order save could generate a FHIR R4 ServiceRequest Resource for direct transmission.
2
Send New Lab Order
FHIR R4 bundle (example)
Alternatively a FHIR R4 ServiceRequest and Patient Resource bundle could be sent
3,4
Send New Lab Order
Bundled order is routed through the IOL to both the SHR and the LIS
FHIR R4 bundle (example)
5
Save Order and Update Order Status
FHIR R4 Task Resource Status is updated locally to either rejected or accepted. A FHIR R4 ServiceRequest Resource (example) is created for order processing with a reference to the associated task. EMR test requests and LIS orders are matched based on LOINC codes.
Alternatively, a ServiceRequest with a link to the referenced ServiceRequest could be populated.
6
Send Order Update
Update Task Resource Status from [5] is sent to the IOL
Alternatively, this could be an update to a FHIR R4 ServiceRequest resource
7,8
Send Order Update
IOL routes the updated FHIR R4 Tasks to the SHR and the EMR
See transaction options [6]
9
Update FHIR Task Status
FHIR task status updated locally
See transaction options [6]
Workflow Maturity
Newly Defined
Workflow is defined and ARB approved
Initial implementations are being implemented
Standards
FHIR R4 search on Task, DiagnosticReport, ServiceRequest or Patient resources
FHIR R4 bundle search response
FHIR R4 Workflow
Assumptions and Prerequisites
The EMR and LIS are trusted applications known by the IOL
The IOL supports node authentication, audit tracking, and rerunning of failed transactions
The SHR adheres to OHIE specification
Actors
EMR - The electronic medical record system that captures the patient and order information and sends the electronic order to the LIS
LIS - The laboratory information system that pulls order information, processes orders, updating statuses and generating results sets
IOL - The interoperability layer that secures and orchestrates the exchange of information (see OHIE Interoperability layer)
SHR - The shared health record that serves as a centralized data store for patients’ longitudinal health record