Sept 13-15, 2004IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Status of IHE Laboratory Francois Macary, GWI Medica France Charles Parisot, GE Healthcare IHE Laboratory Planning and Technical Committee

Sept 13-15, 2004IHE Interoperability Workshop 2 Laboratory IHE Integration Profiles In Process –TI Nov 2004 Laboratory Device Automation (LDA) In Process –TI Nov 2004 Pre-analytic process, analysis and post-analytical treatment Laboratory Scheduled Workflow (LSWF) Completed in 2003 Tests performed by a laboratory for an identified inpatient or outpatient In Process Laboratory Patient Information Reconciliation (LPIR) In Process Tests performed on an unidentified or misidentified patient In Process Laboratory Code Set Distribution (LCSD) In Process Sharing the batteries and tests code sets throughout the enterprise In Process –TI Nov 2004 Laboratory Point Of Care Testing (LPOCT) In Process –TI Nov 2004 Tests performed on point of care or patient’s bedside

Sept 13-15, 2004IHE Interoperability Workshop 3 The Laboratory IHE Technical Framework Laboratory Scheduled Workflow

Sept 13-15, 2004IHE Interoperability Workshop 4Scope Integrate the clinical laboratory in the enterprise Ordering, scheduling and performing clinical laboratory tests Delivering the observation results to the medical staff, at various steps of validation. All specialties working on specimen, not on the patient itself. Anatomo-pathology and blood banks excluded

Sept 13-15, 2004IHE Interoperability Workshop 5 LSWF: Three major use cases Externally placed order with identified specimens  The ordering provider collects the specimens and uniquely identifies them (in the order sent in the message as well as on the container with a barcode label) Externally placed order with specimens unidentified or to be collected by the laboratory Filler order with specimens identified by the laboratory

Sept 13-15, 2004IHE Interoperability Workshop 6 LSWF: Workflow Technical validation Clinical validation Selected standard: HL7 version 2.5

Sept 13-15, 2004IHE Interoperability Workshop 7 The Laboratory Technical Framework Laboratory Point Of Care Testing

Sept 13-15, 2004IHE Interoperability Workshop 8 LPOCT Scope Specialties addressed:  Tests that can be performed on analyzers used on the point of care or on patient’s bedside, under the supervision of a clinical laboratory In vitro specimen testing  Tests on a specimen taken from the patient, not on the patient itself.  Tests that do not need pre-analytic processing of the specimen Two general use cases:  Testing on a point of care device permanently connected to the network  Testing on a point of care device periodically connected to the network

Sept 13-15, 2004IHE Interoperability Workshop 9 LPOCT Workflow ADT Point Of Care Data Manager Point Of Care Result Generator Order Filler ITI: Patient Demographic Query LAB-11: Initiate patient specimen testing LAB-13: Raw observation set LAB-15: POCRG Handling LAB-14: Complete Observation Set Laboratory LAB-16: Order Query Tecnical validation Clinical validation

Sept 13-15, 2004IHE Interoperability Workshop 10 The Laboratory Technical Framework Laboratory Device Automation

Sept 13-15, 2004IHE Interoperability Workshop 11 LDA Workflow Automation Manager Pre-analyzerAnalyzerPost-analyzer Aliquoter, decapper,, robotic conveyer, … recapper, refrigerated storage, Performs the tests and delivers the results LAB-25 Query for WOS LAB-26 WOS performed LAB-24 WOS download LAB-22 Query for WOSA LAB-23 WOSA performed LAB-21 WOSA download LAB-25 Query for WOS LAB-26 WOS performed LAB-24 WOS download WOS: Work Order Step WOSA: Work Order Step with analysis (tests and results) Download bebore specimen arrival, or query triggered by specimen arrival on the device Chosen standard: HL7 v2.5 Chapter 13 (Lab Automation) WOS: Work Order Step WOSA: Work Order Step with analysis (tests and results) Download bebore specimen arrival, or query triggered by specimen arrival on the device Chosen standard: HL7 v2.5 Chapter 13 (Lab Automation)

Sept 13-15, 2004IHE Interoperability Workshop 12 The Laboratory Technical Framework Laboratory Code Set Distribution

Sept 13-15, 2004IHE Interoperability Workshop 13 LCSD Workflow Laboratory Code Set Master LAB-xx: Laboratory Code Set Management Laboratory Code Set Consumer Order Filler Enterprise Common Repository … Order Placer Order Result Tracker Automation Manager Order Filler … Chosen standard: HL7 V2.5, Master Files (chapter 8)

Sept 13-15, 2004IHE Interoperability Workshop 14 The Laboratory Technical Framework Laboratory Patient Information Reconciliation

Sept 13-15, 2004IHE Interoperability Workshop 15 Laboratory Patient Information Reconciliation Match clinical lab observations produced on specimens collected from misidentified or unidentified patient with the patient’s record. Match clinical lab observations produced on specimens with orders created afterwards, either in the Order Placer or in the Order Filler application.

Sept 13-15, 2004IHE Interoperability Workshop 16 More information…. IHE Web sites with Lab Information:

Sept 13-15, 2004IHE Interoperability Workshop 17 Thank you for your attention…