mcaloon wrote on Wednesday, August 01, 2012:
voipbound,
let them know we don’t byte. worst case we can proxy their feedback, but it would good to have firsthand vendor participation in the forum. let’s discuss sometime soon.
Mac
drbowen wrote on Thursday, August 02, 2012:
Dear Mac, voipbound,
Would you send please me your contact info?
drbowen @ bowenmd.com
Sam Bowen
voipbound wrote on Thursday, August 02, 2012:
You need my info or my contact man at CPL? I will direct him to the here but I really think one point of contact is best. CPL is doing this for free! I need to provide a contact person by this Friday!
mcaloon wrote on Thursday, August 02, 2012:
voipbound,
You can give them my contact number and we’ll go from there.
Mac
drbowen wrote on Thursday, August 02, 2012:
voipbound,
I was looking for your personal contact info?
Sam Bowen
voipbound wrote on Thursday, August 02, 2012:
my contact is caltyty at yahoo. My number is 703-930-9160. Mac and Sam, what are your contact number so I can give to him by the end of the day
drbowen wrote on Thursday, August 02, 2012:
Is there an API or oher description of the CDL interface?
I can contact LabCorp and seek out a descriptionof there interface requirements.
Jeremy Wallace at <jeremy at MI-Squared.com> knows the inner workings of the MI2 LEN and would be a useful resource. He has also been working on interfaces with Soltace and Quest.
It will be nice to have one interface that covers local laboratory and these 4 laboratory heavy hitters. I know the LabCorp is always evolving and they require pulling their compendium of laboratory tests. LabCorp is problably the “best” at complexity and adding tests. At least they easily bewilder me. I’ve been doing this since 1984 and I still get stumped by what LabCorp calls a basic test for whatever.
The majority of primary care doctors order the same tests over and over. They mostly want “I need the sceening test for disease X”. After staring at the LabCorp compendium for a while my response please call LabCorp and ask them what they consider to be "the basic screening test for X. I reviewed this with Thomas Wong and some of his contacts in 2009. I can easily come up with the most common stuff but we do need some imput from other primary doctors because there is some variation.
Each specialist (GI, Cardiology, Endocrine) has a different set of most commonly ordered tests than primary care.
In my mind there should be a data dictionary that translates
“I need a cbc” -> To a LabCorp CBC, or a CPL CBC, etc
The problem for the laboratory side is that a Labcorp Coulter A1c may have a different CPT code than a CPL Dade-Bering A1c becuase they use different methodologies. Even inside LabCorp an A1c is run on 3 different machines with different methodologies, three different reference ranges so they report three different A1c tests. Drives me crazy but they won’t report them as an “A1c” which is what I want as a practitioner.
I am hoping we can re-use the interface written by Z&H but re-map them to the existing tables created by Rod. I don’t get the point of changing the table structure if what is already there will work.
If any of you guys have primary care doctors who will share their frequency data on the tests they order it woud be very helpful during this planning process.
Sam Bowen, MD
OEMR
drbowen wrote on Tuesday, August 07, 2012:
I have assembled the APIs for the Coulter hematology analyzer, the Chemistry analyzer, and our A1c machine. I will post these on the old wiki.
Sam Bowen
voipbound wrote on Tuesday, August 07, 2012:
So what ever happen during the conference call last wk. CPL said that openemr is not ready to interface with their system. What is it that CPL requires that Openemr does not have?
drbowen wrote on Tuesday, August 07, 2012:
In terms of prioritizing the work, what we need the most is a way of more appropriately viewing and notifying our patients of the LabCorp results that are being imported from the MI-Squared LEN. We are receiving the discreet labs into the correct patient charts, and the practitioner can see the results but we can’t really do very much with them.
1) Currently, I never sign the results because they disappear and I can’t seem to ever get them back. Maybe this is a training issue but I just leave everything in “pending results” so that I can see everything a particular patient has available. What I would like to be able to do for the lab test results is:
Click on the name of the received labs in the Message Center.
Go to the labs to be reviewed.
Need to be able to view the labs and enter comments per discrete lab prior to signing off on them
Create a letter that includes the lab results and the new comments.
Send the letter out as a PDF by email, fax or print and send out regular mail.
Include the facility logo in the letter.
2) After signing results on the labs be able to more efficiently view old results and plot individual test types (like plot all sodium levels). We want to be able to easily plot these results.
3) Record our waivered labs including the INR tests for viewing from the existing lab results.
We are required to produce the Main Lab log, the waivered labs log, INR log before putting this into service.
4) Report Module. These are individual lab reports. The “lab letter” report, and all the logs.
blood_glucose_control_log
INR_result_log (CoaguChek_XS_Plus_result_log)
waivered_laboratory_result_sheet
main_lab_order_log
panic_value_log
temperature_log
test_kit_QC_log
urinalysis_control_log
waivered_labs_log
anticoagulation_flow_sheet
5) build the machine interfaces:
EON-100 Chemistry analyzer
Qualigen Imunoassay analyzer
Afinion A1C analyzer
Coulter AcT Diff II hematology Analyzer
6) Statistical analysis and the Job Cost Analysis
7) Reference laboratory Interface (LabCorp) and others
Sam Bowen, MD
OEMR
yehster wrote on Tuesday, August 07, 2012:
For your in-house lab I suspect you will also need an interface from whatever method you use for order entry in OpenEMR to a label/barcode printer to insure proper workflow for sample identification.
bradymiller wrote on Wednesday, August 08, 2012:
Hi,
Since there’s a lot of potential things going on in labs (Sam’s LIS and other lab improvements, Rod working with a lab and Shameem’s group working with a lab and making a lab viewing interface) figured it made sense to track what’s going on on the Active Projects wiki page. Feel free to use this (can also create new wiki pages if needed) if it helps Placed the initial stuff here:
http://www.open-emr.org/wiki/index.php/Active_Projects#Labs
-brady
OpenEMR
yehster wrote on Wednesday, August 08, 2012:
Sam.
It sound’s like your biggest priorities are getting Labcorp/MI2 LEN into your workflow more effectively. However, when you start using your in-house equipment I suspect that another critical piece will be billing for lab procedures.
sunsetsystems wrote on Friday, September 28, 2012:
Just wanted up post an update about where I am with support for direct electronic lab/client orders and results. I have contracts with two pathology labs to do this. I’m building on the existing manual system that uses the procedure_* tables. The first step is adding support for some additional data that the labs want in orders:
1. Custom questions that must be answered at order entry time, and which vary according to the test ordered. These may be multiple-choice or free text.
2. Diagnosis codes.
3. Notes, which are basically additional instructions for filling out the order.
Also I’ve added an “activity” flag to compendium items, allowing them to be flagged as inactive.
I’ve created a new table procedure_questions to contain the questions and their possible answers. There will also be a new table to store the answers entered into orders. The order form will be enhanced to present the appropriate questions and to save the corresponding answers.
I’ve created a loader script to load the lab’s compendium and corresponding questions. This will contain custom code for each lab, since each provides the data in their own format (usually a spreadsheet). I think I’ll eventually break this out into a separate “plug-in” module for each lab to make things more manageable.
This creates a need for a globally unique identifier for each lab. Rather than inventing one I’ve chosen to use the lab’s NPI number for that purpose, and so you must have an address book entry for each lab that you use, with the NPI number in it.
Testing all this exposed some bugs in handling of single quotes in the current lab configuration display code, and those have been fixed.
Some work in progress may be seen here:
bradymiller wrote on Friday, September 28, 2012:
Hi Rod,
Placed a quick review (things like page header comments, translations, escaping) on your commit.
-brady
OpenEMR
sunsetsystems wrote on Friday, September 28, 2012:
I saw that, thanks Brady!
voipbound wrote on Saturday, October 27, 2012:
It’s been awhile since I last visit this post. I have an update. Out of the blue today, CPL called me asking for a contact person. Apparently, they are now ready to invest in creating a bridge to our system. They said they want to pass he demographics between the 2 system. Do you guys have any suggestions who would be able to use this money to create this bridge? Hopefully, openemr can later receive labs too.
sunsetsystems wrote on Tuesday, December 18, 2012:
Making good progress. I’ve updated the github branch here:
https://github.com/sunsetsystems/openemr/commits/elabs
Commits of interest are the ones dated Dec. 15 and beyond. I’ve added PHPSECLIB to support SFTP file transfers. Generation and transmission of orders are working.
Visolve is also doing work that overlaps this, so some serious code merging seems on the horizon. For this reason I’d suggest not getting too picky with reviews at this stage!
sunsetsystems wrote on Saturday, December 22, 2012:
Yesterday I added a 5th commit to my “elabs” branch. This is for initial support of results retrieval, and includes some corrections to previous commits. Some successful testing has been done with a real lab.
Currently reworking orders_results.php which supports review and manual entry of results. One major change has been that “result types” in the procedure_type table are no longer needed (though are helpful for manual entry of results), so some significant logic changes were required.
We’re pretty close now to a usable system for labs that support SFTP exchange of HL7 orders and results.
voipbound wrote on Sunday, December 23, 2012:
hmmm, sounds good. I’ll contact CPL on the new development and see if there’s anyway they can contribute. They have been coming by pushing me for updates for the interface. Rod, can I have them contact you since you know way more than I do?