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Re: [Gnumed-devel] address@hidden: HL7 Question]


From: James Busser
Subject: Re: [Gnumed-devel] address@hidden: HL7 Question]
Date: Fri, 21 Nov 2008 09:25:51 -0800

On 21-Nov-08, at 7:41 AM, Karsten Hilbert wrote:

----- Forwarded message from richard terry <address@hidden> -----
...

OBR|1|1-00508|99059448-E-E498^NATA^2178^N|E-E498^E498^2178|| etc

When each request record is saved to the database it should generate a unique database primary key in a table linked to that patient episode and request
form.
<snip>
Not sure how a user sends a request electronically using hl7 to a lab

I am unaware of any systems in which users send electronic requests to a lab for a test to be done.

It appears that in Germany, it is often at the point of care that the doctor or doctor's aide would collect the blood / urine specimens which I believe they label "probes" and to which they affix bar codes and that allows both a reference number from the point of origin and de-identification while the specimen travels outside the praxis. It could allow for bar code scanning at the point of care, into GNUmed.

Australia may be more similar to Canada (or at least British Columbia), where the patient is provided with a "requisition" -- a doctor's specification of what is to be tested -- which in most cases also authorizes the cost to be paid from the public system. It is also possible, but not common, for the doctor to request the addition of tests by phone. Patients are entitled to take the requisition to either a private laboratory (which charges the public system) or to a public sector hospital laboratory.

As far as I know, only one of the two private BC laboratories have the capacity for a user-generated number to be written onto the request and (I think) the capacity to return this value electronically with the results. There is presently, however, no capacity for the request to be submitted electronically. Some architects have a concept in which doctors would log into a health system portal, into which the doctor would identify the patient and the tests to be done but of course this is problematic and typifies that such architects are thinking only of the public system administrative needs and not the need for the doctor to be able to manage their copy of the patient;s health information (and therefore care).




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