Page Comparison

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1.  Use a Generic OBSERVATION ‘laboratory test’ archetype as the basis for most, if not all laboratory tests, including microbiology and histopathology tests. This handles the ordered test name and other overall test-related data and is heavily aligned with the HL7v2 OBER segment and FHIR Diagnostic report resource.
2.  Analyte (individual results) are handled by slotting in a variety of CLUSTER archetypes, the most common pattern being the simple tabular panel represented by CLUSTER.laboratory_test_panel. This pattern will handle the majority of tabular lab tests e.g. haematology and biochemistry. Other tests such as immunology may require different patterns and some specialities such as microbiology and histopathology will require more specific patterns. even where only a single analyte is reported, we recommend that it be carried within a laboratory panel structure to allow for consistent querying.
3.  For tabular results in CLUSTER Laboratory Test Panel the result is carried as ‘Result Value’ with the name of the analyte as the Result Value /name attribute. This will normally be coded with a reference terminology.
4.  It is not planned to try to create specific panel archetype specialisations or templates at international level, as, in practice the exact content of each panel varies enormously depending on the analyser and local lab terminology use. We make create a couple of exemplars for demo purposes, or where very specific additional metadata is required e.g. Glucose tolerance testing.
5.  If, at a national or local level, it appears possible to construct more definitive ‘hard-wired’ representations of lab panels, this should be done by analytes and possible units via templating. Some examples will be provided in the international CKM but this will largely have to be a local exercise since it is highly dependent on local terminology use and messaging.
6.  Microbiology is particularly difficult as their is a lack of consistent reporting of micro results. Experience shows that it is generally better to work with a more generic archetype which can respond to incoming data at run-time but we will attempt to define aspects of micro reporting, such as antibiotic sensitivities, for which clear standard patterns are emerging.

This approach produces the 2 variant hierarchy of lab result data for biochemistry and haematology:

• OBSERVATION – Lab test result
  • data/events/data:
    •  ITEM_TREE
      • items:
        • ELEMENT – Test Name
        • CLUSTER – Specimen detail ← Archetype
        • etc
        • CLUSTER – Test Findings ← Archetype lab analyte - triglycerides
          • items
            •  ELEMENT
              • value
                • QUANTITY 

Template examples

Template for use in message-driven contexts.

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