Clinical Order Workflows, published by HL7 International / Orders and Observations. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cow-ig/ and changes regularly. See the Directory of published versions

Lab Order Workflow where a Reflex is imitated by the Laboratory

Simple Lab Order Workflow with a single TSH (LOINC 3016-3) Test triggering an FT4 (LOINC 3024-7) Test

Important Information

• This is a minimal viable definition of a possible laboratory workflow
• This is not implementable for now but tries to show the flow of the order and the minimal needed information

• Assumptions

• Physician knows which Specimen to draw (i.e. via an Order Catalog)
• Specimen is drawn by the Physician
• It is clear which Order Filler will execute the Order
• ServiceRequest is owned by the Order Placer; changes are allowed only to be done by Placer
• Task is a shared resource of Placer and Filler and updated by both
• Order Result is reported via DiagnosticReport
• DiagnosticReport is owned by the Order Filler
• Order is accepted and is fulfilled
• Lab internal flow is out of scope
• Lab will trigger a FT4 Reflex test caused by a Laboratory internal protocol.
• All needed data is accessible
• All needed data around the Sample is in the Specimen like collection information (Procedure, collection date/time, body Site, …)

  Not defined

• Ownership of Specimen Resource (Ownership should/could/might change with the physical location - this should be defined in a more detailed Lab IG build on the COW principles)
• Transport of the Sample

Example