CHOS-WG Scenario: laboratory

• Introduction:
• Laboratory profile:
• A domain requiring intensive information handling inside the lab. 
  
• Labs are dealing with a large range of available tests, as well with a relatively large number of test per patient.  For example larger numbers than in the domain of radiology.
  
• The diagnostic process supported by labs should be considered from begin to end, i.e. the lab as as partner in the regional network, from the creation of the request to the transmission of the final report.
  
• Most of the time labs are simply dealing with the current "cases", i.e. the current received requests for tests, one at a time. 
  However most labs want to have a good patient identification, because one patient can have multiple requests and because the follow-up of biological parameters is very meaningful in order to provide useful medical advices.
• The purpose of this scenario is to identify:
• How far the generic requirements are valuable and sufficient in the context of oncologic situations, ../ActivityManagement.html .
  
• Which additional requirements are necessary for labs.
  
• Usual scenario:
• Request registration:
• Standard patient identification, as common in most medical applications.
  
• Not essentially different from other type of requests registration.
  
• The presentation should show tables of available lab test, making easy to select which test are required.
• Planning:
• Most routine test does not require appointments.  Just send the patient, or sample from the patient.
• Work lists:
• Labs need elaborated work lists.  Indeed one global request may imply several test, to be done by different persons in different rooms.  Every technician need to know exactly what he has to do.
  
• Data acquisition:
• The basic data registration is to be done on a work station, type the new results in forms showing what is expected.
• Labs may have automated equipment requiring specific software interfaces.
  
• ...
• Validation:
• As for any other kind of reports, lab report must be validated.
  The principle is that an expert in the domain must:
• Review of the draft report on screen,
• Validate, which means that the draft report becomes now definitive, and may be reported outside the lab.
• With the possibility to add some comments.
• With the possibility to refuse the draft and to ask new tests.
  
• Evaluations and automatic warnings:
• Specific lab validation procedure are necessary.  Procedures like warning about values out of expected range, normal range or even completely out of possible range.
• Reporting:
• Similar to reporting procedures common with other kinds of reports:
• Reports printed on paper and transported manually to the requester,
• Reports made available in a network.
• ...
  
• Administration:
• As any other departments providing services, labs provide "declarations" to be processed in the pool of the central administration of hospital centers.
  The problem is here that labs create a great number of items, with relatively small refunding.  This makes that computerized billing is here earlier useful that for other kinds of services.
• As any other department providing services, labs must provide tables defining the properties of all the tests.
• Data collection for statistics:
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