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

[Karsten Hilbert]

> just hard to know because we are rather "Balkanized" (is that term 
> used/understood in DE?)
yes

> 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!
This idea was briefly entertained here, too.

> 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. 
Same here ! We stick pre-printed barcode labels to the tubes
and/or stick written/printed patient information onto them. We
then usually tick off some items on a lab request scanner
sheet provided by the lab. For some tests we write down the
requested tests on a standard referral form.

> Computer printouts are discouraged to make harder the routine 
> ordering of multiple tests and to encourage use of the approved lab 
> forms
None of that here.

> It is also possible to make a request of a lab by telephone.
We can phone in and order some more tests on the sample sent
in earlier.

> 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).
Nothing like that.

> >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.
If that client can save to files on the hard drive that
alleviates the immediate need to write our own client. Just
dump the files to disk and run the GnuMed importer on them.

> 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.
Someone with Java skills should take a direct look at the code
and identify whether we can just run the OSCAR *downloader*
and then run "our" importer on the resulting files.

> >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
- importer could use that to warn on results not directed at us

> >- lab requisition number^patient last name, first name^page #
- lab requisition number - can be used as the lab_request.req_id
- identifying

> >- 10-digit Personal Health Number (unique public health [finance] 
> >identifier)
good for identifying patients via lnk_identity2ext_id

> >- patient last name, first name^birth date^gender
- identifying

> >- collection date^report date
lab_request
    clin_when
    results_reported_when respectively
or else stick the latter into test_result.clin_when

> >- laboratory
test_org

> >- chart number (if provided by hospital)
lnk_identity2ext_id

> >- postal code
identifying

Sounds all pretty doable to me.

Karsten
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