| DESCRIPTION OF ENHANCEMENTS |
LR*5.2*143 Patch Description:
File Installed:
guidelines:
Each sendout test should be coded with an appropriate specific WKLD Code
prefix. If there is not an appropriate specific WKLD Code available,
submit a request for WKLD Code addition(s) to the P&LMS Informatics Manage
at the Dallas CIOFO. Forms are available in Patch LR*5.2*138 for making
these requests.
Each sendout test should have a .8XXX suffix. All nationally recognized
sendout laboratories have a suffix code numbers in the range of
LAB DSS LAR EXTRACT ^LAR(64.036)
.8000-.8999. Each sendout test should be assigned an .8XXX suffix
indicating the laboratory that the specimen was sent for analysis. If the
same sendout test is sent to two or more laboratories, one method, is to
have a separate test for each sendout laboratory. Separate test for each
sendout laboratory will allow different normal ranges and specimen
requirements and test cost. At the very least the sendout tests should be
coded to include the ordered test and the sendout laboratory whenever
possible. In certain situations, sendout testing represents a significant
percentage of total patient care cost. This cost requires better tracking
to determine patient's overall treatment cost.
The Lab DSS API (routine LRCAPDSS) will be enhanced by patch LR*5.2*143 to
extract all sendout tests based on the .8XXX suffix. It is not necessary
to set the DSS Feeder Key to 'YES'.
Example
CEA done at VA Milwaukee
86617.8694 CEA~VA MILWAUKEE
CEA done at Smith Kline Beecham
86617.8001 CEA~SMITH KLINE BEECHAM
==================
With the new Lab DSS API enhancement, WKLD Codes conforming to any of the
following patterns will be extracted and passed to the DSS Workload API.
WKLD CODE marked as Billable Procedure [LMIP Unit] (Austin Database)
WKLD CODE with the suffix of .9999 (DSS ACC)
WKLD CODE with the suffix of .8XXX (Sendout laboratory destination )
WKLD CODE with the DSS Feeder Key (#14) field in the WKLD CODE file (#64)
marked YES
Note:
National Laboratory Tests (NLT)and WKLD Codes can be considered to be the
same codes. NLT is the name of the VistA Package responsible for
distributing and updating WKLD Code files.
Installation Instructions:
NOTE: This patch is invoked by patch ECX*2*18 and does not function
independently. There are no laboratory options associated with the patch.
1. All users may remain on the system.
DSS Clinical Data Extract API
2. No options need be placed out of order.
3. Install patch during non-peak hours.
4. This patch has no effect on routine laboratory operations.
5. The Auto-Instruments 'LAB' job(s) does not have to be stopped.
6. Installation time of this patch is less than ten minutes.
7. Journalling requires no special attention.
===========================
NOIS List
None
==================
DSS Program Office Request
===========================
Test Sites:
Alpha Test Site: Long Beach
Beta Test Sites : Portland, Murfreesboro
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Functionality:
The Laboratory Clinical Extraction API replaces the earlier clinical data
ROUTINE SUMMARY:
extraction software that utilized the LABORATORY SITE file (#69) and the
ACCESSION file (#68). In an earlier guideline, DSS requested that the LIM
adjust the purge date for these two files to retain 300 days of data. This
request could not be done by numerous sites because of the lack of disk
storage capacity. Patch LR*5.2*143 will relieve the sites from retaining
300 days of ORDERS and ACCESSION, and the normal PURGE OLD ORDERS AND
ACCESSION option date range can be restored.
Implementation:
The DSS LAR Data (Patch LR*5.2*143 and the companion DSS patch ECX*2*18)
extract utilizes the LAB DATA file (#63) and does not require the LAB
ORDERS file (#69) or the ACCESSION file (#68). Implementation of the DSS
LAR API DOES require that the LIM link the 12 DSS LAR tests in the DSS LAB
TEST file (#727.2) to all local corresponding tests in the LABORATORY
TESTS file (#60). For DSS purposes, these corresponding laboratory tests
must be linked to the WKLD CODE file and must be individually orderable
(atomic) tests. The link between LABORATORY TESTS file and the WKLD CODE
file is accomplished by assigning a WKLD CODE. The NATIONAL LABORATORY
TEST field (#64) of the LABORATORY TESTS file (#60) provides this linkage.
Routine Name Before Patch After Patch Patch List
The NATIONAL LABORATORY TEST field is not used by LMIP data capture
software and will not effect LMIP counts. Patch LR*5.2*127 provided a
menu, "National Laboratory Test" [LR70 60-64], to link the LABORATORY
TESTS file to the WKLD CODE file.
NOTE: When linking the DSS LAR tests to local laboratory tests, only
atomic Laboratory Tests are selectable. Panel tests are NOT permitted to
be linked to any DSS survey test.
The DSS LAR extract also requires the LIM to identify all specimens that
LRCAPDAR NA 5854094 143
are derived from blood or urine, i.e., plasma, serum, clean catch. The LAB
DSS LAR API will use these specimens to screen patient's results in the
LAB DATA file and extract information for the 12 DSS tests.
The local DSS Coordinator will seek the LIM's assistance to identify tests
and specimens. This should require less than 30 minutes to complete. The
LIM is not required to actually initiate the data extraction. This will be
done by the local DSS Coordinator.
The LIM SHOULD coordinate the purging/archiving of the LAB DATA and the
LRCAPDSS 5467821 5610986 127,143
WKLD DATA files with the DSS Coordinator.
The data for the DSS LAR extract will be stored during processing in a new
file LAB DSS LAR (#64.036) and the data is stored in the global
^LAR(64.036). This global will be purged by the calling DSS option when
the data has been transferred to the DSS laboratory clinical database.
Normally this file will be empty. The design and functionality are the
same used by the WKLD LOG file (#64.03) for the DSS LAB extract. Neither
the LIM nor the Laboratory Package is responsible for purging data from
the WKLD LOG file (#64.03) or the LAB DSS LAR file (#64.036).
==================
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Laboratory Management Index Program (LMIP) and DSS sendout tests setup and
referral lab identification guidelines:
LMIP and DSS are reviewing data collected for laboratory sendout testing.
The collected data indicates that a consistent nation wide coding method
for capturing sendout tests is not being used. Each site should review
the WKLD Codes for sendout tests to assure that it follows these
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