eDOS Workgroup UpdateJune 4, 2013

Laboratory Orders Interface Initiative

Meeting Etiquette

• Remember: If you are not speaking keep your phone on mute• Do not put your phone on hold – if you need to take a call, hang up

and dial in again when finished with your other call • This meeting, like all of our meetings, is being recorded

– Another reason to keep your phone on mute when not speaking!

• Feel free to use the “Chat” or “Q&A” feature for questions or comments

• Please announce your name each time prior to making comments or suggestions during the Q&A portion of the meeting

NOTE: This meeting may be recorded and, if recorded, will be posted on the eDOS wiki

page after the meeting

NOTE: This meeting may be recorded and, if recorded, will be posted on the eDOS wiki

page after the meeting

From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute

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Agenda

• Announcements• eDOS Pilot Updates• eDOS Test Cases (if open questions)• eDOS IG Project Updates • Q&A

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eDOS Summary – Background • eDOS: Provides an electronic interchange of a laboratory’s

Directory of Services (DOS) in a structured format based on HL7’s master file update found in Chapter 8 of version 2.5.1. This implementation guide, initially developed by the members of the American Clinical Laboratory Association’s (ACLA) in conjunction with their Health Information Technology (HIT) Committee, is intended to provide all necessary information to help an Ordering Provider properly request laboratory tests consistent to aide patient diagnosis.

• The eDOS work effort will:– Validate that the current Informative Implementation Guide meets the

objective through a pilot of eDOS– Align the IG with the in-scope tests in the Lab Result Interface (LRI) IG– Incorporate pilot findings to update the Implementation Guide to develop a

normative document to be balloted based on HL7’s ANSI process.– The Normative IG is intended to support the efforts of the Lab Order Interface

(LOI) IG and the Lab Result Interface (LRI) IG by providing the services necessary to meet the needs of the users of those guides.

Directory of Service (Test Compendium)

Lab Order Lab ResultOrder item from

compendiumResult on item ordered

Background

• eDOS, or the Laboratory Test Compendium Framework, provides an electronic interchange of a laboratory’s directory of services in a structured format based on HL7’s master file update. – An Implementation Guide was developed by the members of the

American Clinical Laboratory Association (ACLA) in conjunction with their Health Information Technology (HIT) Committee to provide all necessary information to help an Ordering Provider properly request laboratory tests consistent to aide patient diagnosis.

– The eDOS IG is available as an informative document from HL7

• The LOI Tiger Team identified the importance of coordinating the LOI and eDOS efforts so that LOI can validate the eDOS IG as part of the LOI alignment activities

• To ensure that the eDOS efforts don’t delay the LOI Initiative, the Tiger Team decided to spin off a separate eDOS Work Group to focus on eDOS

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Background

• The initial work group efforts outlined focus on kicking off pilots to validate the Implementation Guide with the goal of creating a normative document to be balloted based on HL7’s ANSI process

• To ensure successful validation and pilots, a Use Case and Functional Requirements will be developed to validate existing industry requirements and the current informative IG– Real-world scenarios will help create specific pilot test conditions

and metrics for use in Pilot validation of the IG– Clearly defined functional and data set requirements facilitate

eDOS & LOI coordination and alignment– A well-articulated Use Case supports awareness of the clinical

and implementer communities’ real-world needs

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Pilot Updates• Quest Diagnostics

– Working to find a Partner and Site

• LabCorp– Contact made at May 2013

HL7 Working Group Meeting – following up

• Bioreference Labs– Not able to Participate

• Mayo– Request for Pilot

Submitted; approved 4/9• Genoptix

– Request for Pilot Submitted; approved 4/23

• Kaiser Permanente– Initial Contact

• ARUP– Not able to Participate

eDOS Test Cases

• NIST draft test messages posted to eDOS wiki– Works in Progress

• Reviewed May 14 Lab Pilots call

eDOS IG Project Update

Reminder re: target dates (discussed 5/21 call)eDOS ballot announced 5/20•Ballot Open Date: Wednesday, June 19, 2013 • Ballot Close Date: Friday, July 19, 2013

Join Ballot Pool•Ballot Pool Sign-Up Open Date: Wednesday, June 5, 2013 •Ballot Pool Sign-Up Close Date: Friday, July 12, 2013

Other ballots:•HL7 Version 2.8.1 Messaging Standard (1st Normative Ballot) •HL7 Version 2.5.1 Implementation Guide: S&I Framework Laboratory Orders from EHR, Release 1- US Realm (2nd DSTU Ballot)

eDOS IG Project Update

• Release 2 IG (v10) draft posted on wiki; may have to complete IP form to download

• Review Change Requests Release 2 IG– Link deactivated test to replacement test(s)– Clarify request for prior results from EHR to

accompany order for specific test(s)• Example: for Thyroid FNA* Evaluation need

prior results of Ultrasound Findings

*Fine Needle Aspiration

eDOS IG Project Update

Errata•Correct cardinality M04 – Charge Description Master File Message to synch with HL7 V2.5.1 base standard•[0..*] to [0..1] – no repeat•CDM-7 Procedure Code does repeat•OO CR 133-753

eDOS IG Project Update

OM1-2 Producer's Service/Test/Observation ID •Definition: This field contains the producer’s usual or preferred identification of the test or observation. Only three components should be included: <ID code>^<service text name/description>^<source list of code>. All components should be non-null. The source list may be any of those included in ASTM Tables 3 and 5, or a local code.

• Recommend pre-adopt V2.8 definition which removes ASTM reference (last sentence)

• Create CWE flavor that requires first three components (only) for use OM1-2 per base standard

• Do we want to provide guidance on length OM12-2.2 (input Genoptix pilot, using length of 50)

eDOS IG Project Update

Ask at Order Entry (AOE) Appendix A– V16 posted, incorporates edits from Peer

Reviews– LOI Vocabulary meeting weekly to resolve

Peer Review comments, Tuesday 9:30 am (Eastern)

Next Steps - Reminders

• Alternating calls Tuesday, 2 pm Eastern• June 11 Laboratory Pilots

• June 18 eDOS WG call

• Sign up as a Committed Member for the Workgroup (link)

• Review the Workgroup Charter Workgroup meeting (link)• Fill out the Pilot Spreadsheet (link)

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Q&A