1. Trace evidence used to create Rules
RBS Rules
Trace evidence used to create Rules

2. Objectives RBS interfaces RBS Rule Types
RBS rules can: cause messages to appear, call requests to be made, tests to be reflexed, reports to print, control instrument posting via RBS, etc.
How to convert normal RBS screen (Grid form) to textual format
Enter calculations in an RBS rule

3. RBS Interfaces
More than 1 RBS server can be added. They are virtual so your SCC Lab specialist can add as needed.

4. RBS Rule Types
Only ‘draw charge’ and ‘Positive for Epi Report’ are available in 4.5 and above. ‘Collection Type’ field is available in 4.5 and above.

5. RBS Rules – Types and Servers
Order Entry
Autoposting Server
RBS Server
Test Ordering Restriction
Stop Autoverification
Reflex
Test Ordering Warning
Stop Autoposting
Pathologist Review
OE Add On
Send Message
OE Update
Print Instant Report
Test Call Request
Posting
Draw Type – Lab 4.5
Positive for Epi Report - Lab 4.5
Evaluated every time order is saved.
Evaluated for every result from autoposting instruments.
Evaluated every time an order is saved or results is posted/verified.

6. RBS Rules – Types D- test ordering restriction A- OE add-on
 W- test ordering warning
 R- reflex test ordering
 G- draw charge
 C- test call request
 M- send message/warning
 I- print instant report
 A- OE add-on
 U- OE update
 V- Pathologist Review
 S- Stop auto-posting
 H- Stop auto-verification
 B- Positive for Epi Report
 P- post result

7. Events
‘Specimen attribute changed’ is only available in 4.5 and above.

8. Flags – Type of Search

9. With a time frame of 1, date of 03/18 at 1300, then:
Flags – Type of Search
With a time frame of 1, date of 03/18 at 1300, then:

10. Flags – Effective for not verified results

11. Flags – Do NOT show results with message

12. Flags – Do NOT show results with message

13. Flags – Do NOT create RMOD for Canned Messages

14. Flags – Do NOT create RMOD for Canned Messages

15. Flags – Cancel reflex when trigger is canceled
Only available for Reflex Rule Type - SoftLab 4.5

16. Flags – Verified flag

17. RBS Fields
and
Examples

18. Pre-Active status, the system does not actually trigger the rule on any orders/results, but a log is kept that allows the user to see all the times this rule was evaluated and the response of the system to each of the criteria listed in the rule x Only

19. Start Date RBS rule’s activation date/time.
It only tells RBS when rule becomes active, and has no relation to ordering time.
This DOES NOT limit the Rule from firing on historical results
before the rule became Active
***You can control when the rule is applied based on order level to be collected date, ordered date, or even stay admission date or specific test’s collection date.
GETDBF("ACCDATE")>
GETDBF("ASRCDATE")>

20. Inactivating RBS Rules Containing Canned Message Calculations
For the proper ‘shutdown’ of a RBS rule that contains a Canned Message calculation listed in Textual format:
If the Canned Massage is Expired, the RBS rule will not do anything but will keep producing syntax errors by RBS since RBS will still try to evaluate it as an Active rule..
It is recommended to:
Inactivate the RBS rule and leave the Canned Message as is (No Expiration Date needed in Canned Message setup). Or
Expire the RBS rule with End Date

21. Inactivating RBS Rules Containing Canned Message Calculations
Canned Message remains Active in system
Expire Option = Select Not Active
Expire Option = Select End Date

22. Tests – Test ID Fields [4]
Used differently depending on the Rule Type selection. These fields may indicate the tests that will be affected, canceled, ordered, called, etc.
test ordering restriction - Enter up to four test ID’s that will NOT be able to be ordered if the criteria of the rule are met. Enter to prevent any tests from being ordered if criteria are met.
test ordering warning - When the tests listed in these fields are ordered, a warning message will appear in OE if the criteria of the rule are met. Enter to display the warning if any test is ordered and the criteria are met.
reflex test ordering - Enter up to four test ID’s that will be added to current order when rule criteria is met.
test call request - There are three possible entries for the fields with Call rules. Enter to cause the entire order to be marked. If a test ID is entered in this field, only the entered test will be marked in the call list. Leaving the field empty will cause all tests included in the logic section (bottom of window) to be marked on the call list when the criteria are met.
send message/warning - Not used. Do not enter any test ID’s in these fields.
print instant report - Not used. Do not enter any test ID’s in these fields.
OE add-on - Enter up to 4 tests to be added to the current order upon saving.
OE update - The test in the first field will be canceled. The tests in fields 2-4 will be added to the order upon saving.
Pathologist Review - Enter up to four tests that will be marked for pathologist review based on the included criteria. Tests are sent for pathologist review when the criteria are met.
Post Result - Only the first test field is used. The rule will cause a result to be entered or appended for the test entered in the first field.
Stop autoposting - Enter up to four test ID’s that should NOT autopost based on criteria setup.
Stop autoverification - Enter up to four test ID’s that should NOT autoverify based on criteria setup.
Draw Charge - Enter the Test ID of the billing test that will be added to the order 4.5.x Only
Positive for epi report - Enter the test(s) to be qualified to the epi report if different than the tests listed in the logic area. 4.5.x Only

23. Printer Field

24. Printer Field >T – send to terminal causing the rule to take place
>D – send to the Autoprinter designated in the Doctor setup file
>C – send to the Autoprinter designated in the Ward/Clinic setup file

25. Send Message/Warning

26. Age Range

27. Age Range Enter an age range in the format X## - X## where X is:
D = Day (0-14)
W = Week (0-4)
M = Month (0-36)
No Prefix = Year (default) Can then format as ###-###

28. Only available for SoftLab 4.5
Collection Type
Only available for SoftLab 4.5

29. Additional Criteria

30. Additional Criteria Maximum of 60 characters
!D Requesting physician (if no requesting physician, attending physician is used.)
!C Clinic
!I Insurance carrier
!P Patient type
!G Clinic group
!GC Groups of Clinics (4.5 versions only)
!IG Insurance group
!F Report format
!L Report layout
!O Group of doctors
!LB PRN PRN is printer code for label printing (reflex test ordering)
!LBL XXXXXXX Label layout ID for label printing (reflex test ordering)
!R Region (Can use single Region character and/or Region-Depot combination)
Entering codes within parenthesis indicates negative logic. In other words, a rule can work for every entry “except” what is within the parentheses.
EXAMPLE: !D (1324,VAFA); !C PCCU; !I MCR; !P IO; !G ABC

31. Logic Section – Grid Form

32. Logic Section – Grid Form
Comp column has 4 additional choices COL, REC, TRU, and NOT
Only available SoftLab 4.5
COL = Collected
RCV = Received
TRU = RBS rule ID in ‘Test/Rule’ column is ‘True’
NOT = RBS rule ID in ‘Test/Rule’ column is Not ‘True’

33. Logic Section – Grid Form
Comp column TRU
Select TRU from the ‘Comp’ column
Select the Rule ID from the dropdown in the Test/Rule column

34. Logic Section – Switch to Textual Formula

35. Logic Section – Switch to Textual Formula

36. Logic Section – Textual Formula

37. RBS Only Operators/Calculations
- Returns the same but reads the test level data even if there is no result.
Invented because "AFLAGS1" can have collection flags set before test resulting and we wouldn't be able to inspect them until resulting.
- Returns the same but reads not just the result but the abnormal Flags of the test.
Invented because there was a need to have rules based on result flags (AFLAGS2) as well, not just the result, which is another test field besides ARESULT, to check and fire RBS based on abnormal flags.

38. RBS Only Operators/Calculations
RESETNTEST( )
Sets sequential access to a Test in the current order. Resets the pointer does not point to any test
GETNTEST()
Sets to the next test in the current order. First call after RESETNTEST() to the first test in the order.
• Example: Entering the following formula in a Reflex rule. This formula returns TRUE if any test in the current order is flagged as absurd or panic.
$A:=0.0;
RESETNTEST(); WHILE(!$A && GETNTEST()) DO( IF & FLG("XP")) THEN $A:=1.0 ELSE 0.0 ); $A

39. RBS Only Operators/Calculations
RESETNSPEC( )
Sequential access to Specimens in current order. Resets the pointer does not point to any test.
GETNSPEC( )
Sets to the first test on the next specimen in the current order. First call after RESETNTEST() to the first test on the first specimen in the order. Formula returns TRUE if "LAV" specimen was collected for current order.
• Example: $A:=0.0; RESETNTEST(); WHILE(!$A && GETNTEST()) DO( IF = "LAV" && $A:=1.0 ELSE 0.0 ); $A
• Example: Add some test (BUN) for any order that has a test ordered that has atwrkid that is defined in the calculation. In this case, "QUEST" workstation. This type of example could be used for something like an extra handling fee for sendouts.
$A:=0.0;
RESETNTEST(); WHILE(!$A && GETNTEST()) DO( IF == "QUEST" ) THEN $A:=1.0 ELSE 0.0 );$A

40. Time Frames
Calculations can only look back in time if written in a Post Result RBS rule.
@TEST[2] >3
Search back 2 days for numeric result of CREAT>3 (includes current order)
@TEST[-2] >3
Search back 2 hours for numeric result of CREAT>3 (includes current order)
@TEST{1}[2] >3
Search back 2 days for numeric result of CREAT>3 but skip current order
In an RBS posting rule, use this SYNTAX to use the results of tests not on the order (i.e. a PSA done within the last year or a Creatinine done in the last 3 days). The SYNTAX test ID, open bracket, number of days or negative number to indicate hours, close bracket. This SYNTAX would include the current order. To exclude the current order, add braces and a number to indicate which order within the timeframe included in the brackets.

41. !#@CREAT{1}[3]&&#@UCRCL[0]
Time Frames Examples
== "COUMADIN"? == "HEPARIN"?
== == "HEPARIN"?
The MATCH or the STRSTR function at the beginning of the calculation and will stop any looping by looking for a canned message character, specifically the in any position of the result field and returning a ‘true’ value.
This example is pronounced- If the alphanumeric value of the test ACOAG on any order in the last two days- including the current order- is HEPARIN- just like that, then report the numeric value of the test PTI plus the canned Otherwise, if the alphanumeric value of the test ACOAG on this order alone is COUMADIN- just like that- then report the numeric value of the test PTI plus the canned Otherwise, report the numeric value of the
If there is NOT a CREAT from the last 3 days…excluding this order AND a UCRCL is on the current order

42. Time Frames MATCH for Subsequent Order Updates
Needed to check all 12 (monthly) results for a POS* match result for test ID = TREP
would find the ‘most recent’ result as far back as 365 days. It does NOT account for any POS* result within the 365 days

43. Specimen age calculation : We have a request to add a canned message to a test PHFLD whenever the test result time and test collection time differ by greater than 4 hrs.

44. Delta Check on Any Test on the Order
This formula checks if any test in the order is flagged with %D. However, it is not possible to check if the current test result is greater than the previous one, i.e. the rule will be triggered for both flags +%D and -%D
Create a RBS rule (type = message/warning) to apply to all tests in the client system that flag as a %D (or any other AFLAGS) .
     .  

45. Reflex Test Based on Container/Tube Type
Want test ABC reflexed whenever an order contains specimen GGT.
Can use ASPECIM but it requires entering test ID. If there‘ are too many tests that can use specimen LAV, then use formula below (only if the version supports looping).
This formula is a loop that goes over all tests on the order and checks a condition on each test until it $A is set to true (1.0) or all tests are checked
$A:=0.0;
RESETNTEST();
WHILE(!$A && GETNTEST())
DO( IF = " LAV ")
      THEN $A:=1.0 ELSE 0.0 );$A
Formula returns TRUE if there is any test on the order with specimen LAV.

46. Draw Charge Rule for ER Collected Phlebotomy Containers:
RBS reflex to trigger charges for VENIP when specimens come from a specific Ward/Clinic (in this case the RBS rule is built for ER Ward/Clinic.)
$A:=0.0;                                                               
RESETNTEST();                                                       
WHILE (!$A && GETNTEST()) DO (IF "ASPECIM" == "BLU" || 
@NTHTEST-> "ASPECIM" == "BRL" "ASPECIM" == "CLO"  ||  
@NTHTEST-> "ASPECIM" == "ESR" "ASPECIM" == "GGG"  ||  
@NTHTEST-> "ASPECIM" == "GRN" "ASPECIM" == "LAV"  ||  
@NTHTEST-> "ASPECIM" == "PST" "ASPECIM" == "XBC"  ||  
@NTHTEST-> "ASPECIM" == "XBC" )                                     
THEN $A:=1.0 ELSE 0.0); $A &&

47. NO Draw Charge Rule for Nurse Collected Phlebotomy Containers:
VENP rule active (as is with no changes) except added additional criteria line :
!C (ICN,NSY,PNY)
2.  Created new RBS rule ID = VENIP with the same added additional criteria line :
!C ICN,NSY,PNY
3.  Added calculation to rule = VENIP to have the system check each specimen on the order for the presence of specific containers (container code) for GRN,LAV,BLU, etc. if the order was a NURSE Draw type.
$A:=0.0; $B:=0.0; RESETNTEST(); WHILE(!$A && GETNTEST()) DO ( IF (STRSTR("BLU,BLUE,BT0,G5R,GC3,GEN,GIC,GRN,GRN1,GWB,L1C,LAV,LBB,LCT,LDT,LFL",   > 0 || > 0 || STRSTR("R2C,R3C,RBB,RCF,RED,RGR,RHV,RLB,RMD,RNA,RPR,RRL,RTD,T0C,T1C,T2C,T3C", > 0 || STRSTR("T4C,T5C,T6C,T7C,T8C,TTT,VE9,WNL,X1C,XBC,XFU,XIA,XMY,XNB,XPD,YEL,Z1R", > 0 || STRSTR("Z2R,Z3L,Z5E,Z6F,Z7A,Z8A,Z9L,ZB9,ZD9,ZE9,ZG9,ZL9,ZR9,ZS9,ZV9,ZY9,AL9", > 0 || > 0 || > 0) THEN $A:=1.0 ELSE 0.0 ); RESETNTEST(); WHILE(!$B && GETNTEST()) DO ( IF == "NUR") THEN $B:=1.0 ELSE 0.0 ); $A && !$B

50. Questions ????