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Aggregate all Results for One Patient

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  • December 3, 2018 at 4:50 pm #55839
    mike brown
    Participant

      Has anyone ever done the process of Aggregating of multiple Result messages for one patient into one Result message outbound to Vendor.

      Here is what the doctor is requesting…

      Due to receiving each individual test in a separate message/file for a patient, one message/file may display the CBC result, that file has to be closed before 2nd file opened with the CMP results etc..

      Requesting single message that would contain all tests ordered for that visit (DOS).

      any ideas welcome..

      mike

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      • December 4, 2018 at 1:46 pm #86653
        David Gordon
        Participant

          It’s not really feasible because when will you know that all the results have been received? How long do you wait before sending them?

          We’ve had similar requests in the past but this is really something that needs to be solved in the application/presentation layer, not the interface.  The closest we managed to come up with was one thread that would write results to a database and another that would poll on a set schedule, but then you end up with results being delayed which no one wants.

        • December 4, 2018 at 2:19 pm #86654
          mike brown
          Participant

            Thank You

            I agree, but this is from a user

            I had to ask because,, i did my due diligence in hoping it was feasible and pool for ideas.

          • December 4, 2018 at 2:34 pm #86655
            mike brown
            Participant

              Cerner is our source of truth for results, so i am thinking Cerner can do this and send out the data as requested.

              Anyone worked on this with them yet? or any other way, these are clinics and they dont care about the delay if there is one on the sending of the data.

              mike

            • December 4, 2018 at 8:40 pm #86656
              Jeff Dinsmore
              Participant

                We’ve done this for a large practice that we work closely with.

                We aggregate all lab results for a given encounter.

                When we receive a discharge message for the encounter, that’s the trigger to aggregate.  All of our outpatient encounters are auto-discharged at the end of the day.  Inpatients are, of course, discharged at the end of their stay.

                We bundle up all lab results received for an encounter, up to its discharge time, into a single result message and send to the practice.  We keep a database of all messages that were part of that bundle.  This bundle covers most normal results.

                Any results received after that first bundle is sent are delivered one at a time as they’re received. That takes care of longer-term tests like cultures.

                The combination of these two ensures that we deliver as much as we can at discharge, and that all results are eventually delivered.

                Jeff Dinsmore
                Chesapeake Regional Healthcare

              • December 4, 2018 at 8:53 pm #86657
                mike brown
                Participant

                  Great Jeff, not knowing how to even start this process, can we talk about how or can you post here how you are doing it…

                  that will help a lot..

                  mike

                • December 4, 2018 at 11:56 pm #86658
                  Jeff Dinsmore
                  Participant

                    You could store results in a DB as they’re received from Lab.  Then, at discharge for example, retrieve them from the DB, mash them into a single message and send it to the receiving system.

                    The way we do it is similar, but we read messages directly from SMAT files for the aggregation step.  We have a separate DB that indexes SMAT files for quick retrieval.  When we hit the discharge trigger, we look up results from our SMAT index DB, retrieve the files directly from SMAT and mash them together into a single message – same as with the first option.

                    Neither of these approaches is trivial.  Both require some solid programming expertise with Tcl or Java, databases, etc.

                    If you’d like, we can chat offline.

                    Jeff Dinsmore
                    Chesapeake Regional Healthcare

                  • December 5, 2018 at 1:55 pm #86659
                    mike brown
                    Participant

                      thank you for the information..

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