HIS Hospital Information System ADT Order Placer LIS

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用語 システム構成(モデル) HIS : Hospital Information System (主にADT, Order Placer)      LIS : Laboratory Information

用語 システム構成(モデル) HIS : Hospital Information System (主にADT, Order Placer)      LIS : Laboratory Information System     (主にOrder Filler, Order/Result Tracker) LAS : Laboratory Automation System     (主にAutomation Manager, Analytical Instruments) 標準  ASTM : American Society for Testing and Materials  HL 7 : Health Level Seven Standard  IHE : Integrating the Healthcare Enterprise 2 IHE in Japan

適用分野(Non exhaustive list of specialties) Value • BG • BLB • CUS • CTH

適用分野(Non exhaustive list of specialties) Value • BG • BLB • CUS • CTH • CP • CT • CH • HM • ICU • IMM • LAB • MCB • MYC • NMS • NRS • OSL • PF • SR • TX • VUS • VR Description Blood Gases Blood Bank Cardiac Ultrasound Cardiac Catheterization Cytopathology CAT Scan Chemistry Hematology Bedside ICU Monitoring Immunology Laboratory Microbiology Mycobacteriology Mycology Nuclear Medicine Scan Nursing Service Measures Outside Lab Pulmonary Function Serology Toxicology Vascular Ultrasound Virology Addressed by Laboratory TF 2003 - 2004 Yes No Yes Yes  (stands for a multi-specialties laboratory. ) Yes Yes Yes 8 IHE in Japan

Integration profile Pt registration: 1 Pt Update: 12 1: Pt Registration 12: Pt Update

Integration profile Pt registration: 1 Pt Update: 12 1: Pt Registration 12: Pt Update ADT Laboratory T 1. Placer Order Mgmt Order Filler (LIS) T 2. Filler Order Mgmt Order Placer T 3. Order Results Mgmt T 5. Test Results Mgmt T 4. Work Order Mgmt Order Result Tracker Automation Manager (LAS, ME) 10 IHE in Japan

 Actors in Laboratory Technical Framework • ADT : Admission Discharge and Transfer. A

Actors in Laboratory Technical Framework • ADT : Admission Discharge and Transfer. A system responsible for adding and/or updating patient demographic and encounter information, and delivering this information to Order Placer, Order Filler, Order Result Tracker. This Actor is also present in the Radiology Technical Framework and IT Infrastructure Technical Framework. • Automation Manager : A system or component that manages the automation in the laboratory or a part of it. Automation involves the integration or interfacing of automated or robotic transport systems, analytical instruments, and pre- or postanalytical process equipment such as automated centrifuges and aliquoters, decappers, recappers, sorters, and specimen storage and retrieval systems. This actor receives work orders from the Order Filler. It manages the processing of the ordered tests on the appropriate devices, and sends technically validated results back to the Order Filler. This actor must be considered even if it manages a small part of the analytical process; e. g. if it manages one single analytical instrument. Multiple Automation Managers can be related to one Order Filler : A system used by a laboratory, that receives test orders from the Order Placer, collects or controls the related specimens, accepts or rejects the order, schedules work orders, and sends them to Automation Manager, receives the results from the Automation Manager, performs the clinical validation, appropriately manages all state changes of the order and sends the results to the Order Result Tracker. In some cases, Order Filler will create test orders itself (e. g. a paper order received by lab from a department not connected to the Order Placer, or a paper order was received from a physician external to the organization) Order Placer : A hospital or enterprise-wide system that generates test orders for various clinical laboratories, distributes those orders to the correct laboratory, and appropriately manages all state changes of those orders. In some cases the Order Placer is responsible for collecting and identifying the specimens. Therefore, the transaction between Order Placer and Order Filler may carry specimen related information. Order Result Tracker : A hospital or enterprise-wide system that stores observations of various types (test results, images, clinical examinations reports, radiology reports, surgical act reports…) obtained for the patients, registers all state changes in the results notified by Order Fillers. This actor doesn’t store standalone observations, but ordered observations. The observations are always stored within the context of the order that generated them, with all the information related to that order. The Order Result Tracker may also alert the Order Filler when a new or updated observation is consulted. 11 IHE in Japan

Actors in Laboratory Technical Framework • T 1 : Placer Order Management : This

Actors in Laboratory Technical Framework • T 1 : Placer Order Management : This transaction contains all the messages required between Order Placer and Order Filler for the management of the life cycle of the order. Its main goal is to keep a consistent vision of the order, (content and status), between the two actors. • T 3 : Order Results Management : This transaction carries the observation results from Order Filler to Result Tracker, informs the latter of all state changes of the order and its results : state of validation, corrections, cancellations, …It also allows Order Result Tracker to inform Order Filler when the results are viewed by an end-user. • T 4 : Work Order Management : This transactions contains all the messages required between Order Filler and Automation Manager for the execution of a work order representing a subset of tests of the filler order. The main goal of this transaction is to distribute the work to Automation Manager, and to keep this actor informed with all patient updates and order updates. This transaction will be based on a push mechanism, the query mechanism will never be used in this transaction. • T 5 : Test Result Management : This transaction carries the technically validated test results from Automation Manager to Order Filler. 12 IHE in Japan

Laboratory Scheduled Workflow : placer ordering 13 IHE in Japan

Laboratory Scheduled Workflow : placer ordering 13 IHE in Japan

OML^O 21 static definition for transaction T 1 14 IHE in Japan

OML^O 21 static definition for transaction T 1 14 IHE in Japan

ORC segment definition for transaction T 1 15 IHE in Japan

ORC segment definition for transaction T 1 15 IHE in Japan