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[Gnumed-devel] test requests and importing, BC (CA) anticoag pilot (was:


From: J Busser
Subject: [Gnumed-devel] test requests and importing, BC (CA) anticoag pilot (was: test imports)
Date: Thu, 24 Feb 2005 14:58:35 -0800

At 9:10 PM +1100 2/24/05, catmat wrote:
are there examples of the messages used for requests ... for the anticoag trial?

For future and past reference, when I say "in Canada" or "in CA" (shorter than "British Columbia") what I say reliably applies to British Columbia and often will apply to the rest of Canada, it is just hard to know because we are rather "Balkanized" (is that term used/understood in DE?)

So in Canada we do not have electronic requests except:
a) inside *some* hospitals, for inpatient and hospital clinic tests and
b) one lab is wedded to the idea of coaxing people to enter requests into the *lab's* portal!

So how are labs requested? We print labels or handwrite patient information, and handwrite onto a paper form though COULD be printed on toilet paper provided the info legible and contains the date, patient identifying information and the doctor's id and signature. Computer printouts are discouraged to make harder the routine ordering of multiple tests and to encourage use of the approved lab forms which give policy guidance e.g. if a patient has no risk factors for cardiac disease, they must pay if they want a breakdown of lipid fractions whereas a total cholesterol is universally covered. Prostate Specific Antigen (PSA) is not covered except for clinical conditions (nodule, known or suspected Ca, follow-up).

It is also possible to make a request of a lab by telephone. We can also have a "standing order" for certain tests to be done on a patient (provided the patient actually attends the lab) either on a prescribed frequency (e.g. q2 months) or "on demand" (e.g. PT or INRs). Such "standing orders" must either specify an expiry date within one year or will auto-expire at one year. A few other matters of policy include indicating on an exception basis if a patient can be given a result by a lab (the doctor still receives their copy). Also, a doctor from the practice is always *supposed* to be available to be called out of hours in case it is during this time that a lab technician identifies a "critical result".

are there examples of ... test reports for the anticoag trial?

MediNet provided info about their uncoded ASCII reports (see below) and are mailing me their paper HL7 documentation. While I await what type of server-based connection they might enable, I am thinking to download their Windows-only visual basic client for the clinic. Our volume of tests that would come through MedNet is low but even the Windows client would give *some* clinical use and, of course, a real file whose patient id I can anonymize and share for reference & development.

PathNet provides the Clinic >90% of its results but have been hard to talk to about any technical matters. However I do have on my server a copy of java(?) code written for a local implementation of OSCAR so if you can identify from my grep output (at bottom) which files would be pertinent, I can forward to list or to individuals.

So first is the MediNet info:

Participating labs whom MediNet serves:

     - St Pauls Hospital           (HL7)
     - UBC Virology Laboratory
     - Vancouver Hospital
     - Ridge Meadows Hospital
     - Eagle Ridge Hospital
     - Royal Jubilee Hospital      (HL7)
     - Saanich Peninsula Hospital  (HL7)
     - Victoria General Hospital   (HL7)

Notice that HL7 is available for St Pauls Hospital as well as three of the
Vancouver Island Hospitals.

For text reports, each "page" of what would have been a printed paper
page is transmitted as a separate message (ASCII file). To assist EMRs,
Medinet parses each text file and inserts a header.
The format of the header is as follows:

JJJJJJ|Busser,J.R.^bus7081^07081|A5SS012345 LAST, FIRST^01|9029029022|LAST,
FIRST^19771209^F|20050215^20050218|CDC|3327221|V0N 1B4

- header always starts with six leading J's
- single (or compounded "^") field info delimited by vertical bars ("|")
remaining fields follow:
- physician^medinet address^MSP billing number
- lab requisition number^patient last name, first name^page #
- 10-digit Personal Health Number (unique public health [finance] identifier)
- patient last name, first name^birth date^gender
- collection date^report date
- laboratory
- chart number (if provided by hospital)
- postal code



And here is the OSCAR / PathNet output from grep:

Last login: Mon Feb  7 22:23:19 2005 from 192.168.1.202
                          ^^^^^^ hmm, no battery?
address@hidden:~# grep -iR "pathnet" /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/*
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Communication/CVS/Repository:web/WEB-INF/src/oscar/oscarLabs/PathNet/Communication
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Communication/HTTP.java:package oscar.oscarLabs.PathNet.Communication; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Communication/HTTPS.java:package oscar.oscarLabs.PathNet.Communication; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java:package oscar.oscarLabs.PathNet; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java:import oscar.oscarLabs.PathNet.Communication.HTTP; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java: this.url = Properties.getProperty(Properties.PathNetUrl); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java: "Error - oscar.PathNet.Connection.Open - Message: " /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java: "Error - oscar.PathNet.Connection.Close - Message: " /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java: "Error - oscar.PathNet.Connection.Retrieve - Message: " /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Connection.java: "Error - oscar.PathNet.Connection.Acknowledge - Message: " /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java:package oscar.oscarLabs.PathNet; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java:import oscar.oscarLabs.PathNet.HL7.Message; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: private oscar.oscarLabs.PathNet.Connection connection; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: run = Boolean.getBoolean(Properties.getProperty(Properties.PathNetRun, "false")); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: connection = new oscar.oscarLabs.PathNet.Connection(); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: System.err.println("Information - oscar.PathNet.Controller - Message: Thread Running " + run); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: Properties.getProperty(Properties.PathNetUsername); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: Properties.getProperty(Properties.PathNetPassword); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: "Error - oscar.PathNet.Contorller - Message: " /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: Long.parseLong(Properties.getProperty(Properties.PathNetSleep)) /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/Controller.java: "Thread has failed to sleep. Thread will end until error corrected and restarted - oscar.PathNet.Controller - Message: "
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/CVS/Repository:web/WEB-INF/src/oscar/oscarLabs/PathNet
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/CVS/Repository:web/WEB-INF/src/oscar/oscarLabs/PathNet/HL7
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/Message.java:package oscar.oscarLabs.PathNet.HL7; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/Message.java:import oscar.oscarLabs.PathNet.HL7.V2_3.MSH; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/Message.java:import oscar.oscarLabs.PathNet.HL7.V2_3.PID; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/Node.java:package oscar.oscarLabs.PathNet.HL7;
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/CVS/Repository:web/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3
/var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/MSH.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/MSH.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/MSH.java:public class MSH extends oscar.oscarLabs.PathNet.HL7.Node /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/NTE.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/NTE.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/NTE.java:public class NTE extends oscar.oscarLabs.PathNet.HL7.Node /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBR.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBR.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBR.java:public class OBR extends oscar.oscarLabs.PathNet.HL7.Node /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBR.java: System.err.println("Error During Parsing, Unknown Line - oscar.PathNet.HL7.V2_3.OBR - Message: " + line); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBX.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBX.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBX.java:public class OBX extends oscar.oscarLabs.PathNet.HL7.Node /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/OBX.java: System.err.println("Error During Parsing, Unknown Line - oscar.PathNet.HL7.V2_3.OBX - Message: " + line); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/ORC.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/ORC.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/ORC.java:public class ORC extends oscar.oscarLabs.PathNet.HL7.Node /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/ORC.java: System.err.println("Error During Parsing, Unknown Line - oscar.PathNet.HL7.V2_3.ORC - Message: " + line); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PID.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PID.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PID.java:public class PID extends oscar.oscarLabs.PathNet.HL7.Node /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PID.java: System.err.println("Error During Parsing, Unknown Line - oscar.PathNet.HL7.V2_3.PID - Message: " + line); /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PIDContainer.java:package oscar.oscarLabs.PathNet.HL7.V2_3; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PIDContainer.java:import oscar.oscarLabs.PathNet.HL7.Node; /var/lib/tomcat4/webapps/oscar/WEB-INF/src/oscar/oscarLabs/PathNet/HL7/V2_3/PIDContainer.java: System.err.println("Error During Parsing, Unknown Line - oscar.PathNet.HL7.V2_3.PIDContainer - Message: " + line);
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