Clinical Order Workflows
1.0.0-ballot - STU 1 Ballot International flag

This page is part of the Clinical Order Workflows (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Lab Order Workflow where a Reflex is imitated by the Laboratory

Page standards status: Informative

Simple Lab Order Workflow with a single TSH (LOINC 3016-3) Test triggering an FT4 (LOINC 3024-7) Test

Important Information

  • This is a minimal viable definition of a possible laboratory workflow
  • This is not implementable for now but tries to show the flow of the order and the minimal needed information

  • Assumptions

  • Physician knows which Specimen to draw (i.e. via an Order Catalog)
  • Specimen is drawn by the Physician
  • It is clear which Order Filler will execute the Order
  • ServiceRequest is owned by the Order Placer; changes are allowed only to be done by Placer
  • Task is a shared resource of Placer and Filler and updated by both
  • Order Result is reported via DiagnosticReport
  • DiagnosticReport is owned by the Order Filler
  • Order is accepted and is fulfilled
  • Lab internal flow is out of scope
  • Lab will trigger a FT4 Reflex test caused by a Laboratory internal protocol.
  • All needed data is accessible
  • All needed data around the Sample is in the Specimen like collection information (Procedure, collection date/time, body Site, …)

    Not defined

  • Ownership of Specimen Resource (Ownership should/could/might change with the physical location - this should be defined in a more detailed Lab IG build on the COW principles)
  • Transport of the Sample

Example

Simple Lab Order Workflow with a single TSH (LOINC 3016-3) Test triggering an FT4 (LOINC 3024-7) Test- generic Overview -PhysicianOrder Placer SystemOrder Filler SystemPhysician WorkflowEnter OrderDraw Sampleenter Specimen InformationIn Scope of this IG's GuidancecreateServiceRequestServiceRequest .code=3016-3 .intent="Order" ...createSpecimenSpecimen .request->ServiceRequest .type="SER" ...createTaskServiceRequest  .status="active"Task  .basedOn->ServiceRequest  .focus->ServiceRequest  .input->Specimen ...sendTasktoFillerall needed data is accessed by Order Fillerownership ofSpecimenmight be transfered to FillerAcceptServiceRequestTask .status=="accepted" .owner-> Order Filler businessStatusis set appropriatewait for SpecimenSetTaskto in-progressTask .status=="in-progress" businessStatusis set appropriateLaboratory Workflowexectute Ordercreate a FT4 Reflex OrderThe Laboratory creates FT4 (LOINC 3024-7) a Reflex Ordertriggered by a laboratory internal protocolexecute FT4 reflex TestThe Laboratory exectues the FT4 Reflex OrderCreateDiagnosticReportwith all resultsResult of Order execution is filled intoDiagnosticReportDiagnosticReport .basedOn=ServiceRequest ...UpdateTaskTask .output->DiagnosticReport  .status="completed"The Order Placer System gets information that the Task is finished via- Subscription- polling- messaging- ...UpdateServiceRequestServiceRequest .status="completed"Result Reporting to PhysicianReportDiagnosticReport