Clinical Order Workflows
1.0.0-ballot - STU 1 Ballot International flag

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 Flow with Specimen Rejected

Page standards status: Informative

Lab Order Workflow with an unsufficient Sample

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
  • Order is accepted and is started to be fulfilled
  • Lab internal flow is out of scope
  • Lab detects an insufficient samples
  • 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

Lab Order Workflow with an unsufficient SampleLab Order Workflow with an unsufficient SamplePhysicianPhysicianOrder Placer SystemOrder Placer SystemOrder Filler SystemOrder Filler SystemPhysicianOrder Placer SystemOrder Filler SystemPhysician WorkflowEnter OrderDraw Sampleenter Specimen InformationCOW workflowcreateServiceRequestServiceRequest .code=2345-7 .intent="Order" ...createSpecimenSpecimen .request->ServiceRequest .type="SER" ...createTaskServiceRequest  .status="active"Task  .basedOn->ServiceRequest  .focus->ServiceRequest  .input->Specimen ...sendTasktoFillerall needed data is accessed by Order Fillerownership ofSpecimenmight be transfered to FillerAcceptServiceRequestTask .status=="accepted" .owner-> Order Filler businessStatusis set appropriatewait for Specimenandexecution of ServiceRequestSetTaskto in-progressTask .status=="in-progress" businessStatusis set appropriateLaboratory WorkflowCheck Specimen AppopriatenessSpecimen is HemolyzedUpdate SpecimenUpdateSpecimenwith Reject ReasonSpecimen .status="unsatisfactory" .condition="HEM" - hemolyzed ...UpdateTaskTask .output->Specimen  .status="failed"The Order Placer System gets information that the Task is failed via- Subscription- polling- messaging- ...UpdateServiceRequestServiceRequest .status="ended"Result Reporting to PhysicianReportDiagnosticReport