Yeah , for some reason , ozone doesnt load that concept specifically , yet it exists in the csv files downloaded as part of the maven build
@kdaud can you confirm that with alpha.1?
@mozzy you say that concept d81d4698-e78c-420d-aac5-cb1f606fb32e (Visit Punctuality) isnât visible in Ozoneâs O3? What version of Ozone are you on?
This is very weird, since basically Ozone just repackages O3 as is, so we need to understand whatever may be causing a divergence like that.
It doesnât get loaded , yet all the other concepts in the csv files get loaded.
Am not sure about the Version but we are using the ozone-docker project to spin up things
probably its 1.0.0-SNAPSHOT
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@mozzy could you try again with the current alpha release?
You should just be able to reuse the quick start as of the latest commits, it will use the alpha release by default.
Yet @kdaud / @ruhanga letâs keep an eye here as to whether something goes fishy with this one concept.
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Finally we are taking a stab at this using the order basket as @OHRI. Our intention is to keep most of the functionality and flow of the order basket. We are approaching it as a simple lab order system without the lab sample processing part for the first iiteration. We will have a lab view in the patient chart to see pending or completed orders as well as facility level âLab viewâ where one can see all Labs ordered.
Hi @wamz . I have just done a major refactor of the order basket so that it can support lab orders (and other types of orders), and am now working on implementing the lab form, which is a relatively minor task. I suggest holding off for a couple days, so that you can see what we are building into the O3 refapp.
Thanks for the heads up @mksd
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This is awesome, could we schedule some time to talk so that we can identify areas we can collaborate?
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How are we handling lab orders eg Viral load, CD4 count etc which may have two kind of results outcome i.e qualitative or quantitative which are all represented by different concepts? Do we intend to create two orders in such cases to be able to record results?
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My inclination is to say that you should have a concept that is âCD4 Orderâ that is independent of the concepts for CD4 results.
@akanter Youâre opinion here would be very valuable.
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Hi all, @bistenes thanks for moving forward with the Lab Orders widgets. Continuing conversation from this Slack thread.
@bistenes while youâre putting together the Lab Order basket/widget, how do you intend to track Lab Order statuses so we have a way of viewing their fulfilment? If this will leverage the FHIR api (e.g ServiceRequest endpoint), then Iâm thinking already in leveraging the FHIR Task resource or status tracking. This is worth a discussion here to comprehensively layout a common approach because it will have an implication especially on EMR - LIMS integrations.
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FWIW, we do already have a fulfillerStatus and fulfillerComment fields on Order that we are using to track fulfillerStatus, both within the old Lab Workflow OWA and the new O3 Dipensing ESM, so we should try at least to be consistent with this. Weâve added this fullferStatus to the MedicationRequest endpoint as an FHIR extension.
Thereâs also active talk of the need to potentially track fulfillerLocation on an Order for Dispensing Orders, see:
(That being said, I wouldnât want to derail getting the basic Order Basket functionality working⊠not sure if this stuff in is @bistenes original remit).
Take care, Mark
Yeah, for right now, the target is being able to enter lab orders. What happens with those lab orders once they are entered is a separate discussion because we get into the realm of probably needing to support multiple things.
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I believe we have addressed this before. Roger from CDC recommended that we have separate concepts for orders which have multiple results. Labs can be orderable, resultable or both. A CBC is really a lab panel with multiple concepts which have results. A viral load or CD4 count is quantitative and should not have multiple results. Any test can have a separate interpretation, but the actual result probably is singular. Where there is one orderable test that has multiple component results, the individual results are separate concepts and are linked together by the lab. The way to make this easier is to have an orderable panel. the CD4 count is orderable and resultable (LOINC 24467-3 CD3+CD4+ (T4 helper) cells [#/volume] in Blood). It can be a member of a panel
There may be legacy concepts which have the ability to append a text result to an orderable only, but those should probably be replaced. Does @caseynth2 have input here?
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Do we have examples of actual tests you want to model in the demo?
Hi @akanter Thanks for looping me in!
I think that there are some cases for a multiple result, though perhaps youâd have a separate concept for every possible combination. Or at least a multi part result.
One example would be Malaria, it would have a three part result, the species, the stage it was in and the amount. In the LIS we have these as a sort of cascade multiselect, so it would be ideal to have a concept for each of them.
The next two use cases I think are modeled such that there is really just one result, with the interpretations added.
numeric tests that are expressed as both a numeric count (result), and a percentage (interpretation or separate test result depending on how you model it), or ones with a calculated log value attached.
Another use case would be a stool culture. You could have any number of organisms as a result, and then as a reflex, an antibiotic resistance test would be run on each, with a sensitive, resistant, or inconclusive result. In this case, there is a new test ordered, and the result is the result of the new test, with the software keeping the link, so I think this could work with just one result. Just have some reference to the result which triggered the antibiotic resistance result, since there may be more than 1. I think we need to see how to model that one in the FHIR resource as well.
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Yeah, this seems like a good use case for a lab orders status kind of dashboard, and an order status for each ordered test. We do use the task resource to track this on orders between OpenMRS and OpenELIS, weâd just need to query the task and add a status flag somewhere. maybe even in the patient history where you see the results, you could see tests which had been ordered, not yet resulted, and the status.
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