The specimen loading section of an automated analyzer with unlabeled tubes.

Laboratory integration

Laboratory device and LIS connection (HL7, FHIR)

Order, specimen, device and result are tracked in one chain. Preliminary results, final results, corrections and withdrawals are stored as separate states, and earlier versions are never lost. A result is not attached to a patient until the order and specimen have been verified.

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The connection rests on three things

A microbiology result or report from a connected enterprise system is also taken in with its source and version.

Message families: HL7 v2 order and result messages are used, and where a device needs it, an ASTM or manufacturer-specific adapter steps in. With partners that support it, orders, specimens, observations and reports are mapped over FHIR R4. The profile is derived from the actual partner specification.
Code mapping version: The source test code, the HekimBis test code and the mapping version are stored together, so an old result is still read with its old meaning even after the mapping changes.
Units and reference ranges: Units and reference ranges are carried over from the source. If a conversion is applied, its source and formula are written to the audit log. Ranges that depend on age, sex, pregnancy, device or method are supported.

From order to result, from device to physician

From the moment a test order is opened until the result reaches the physician and is published on the portal with the physician's approval, every step is recorded with its time.

Portal06End

Portal release

Released only with physician approval.

The process is complete here.

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Gloved hands labeling a blood tube beside a rack of tubes

Which states does a specimen go through?

When a specimen is collected, its barcode, the collector and the time are recorded. The laboratory accepts the specimen or rejects it if it is unsuitable, and a recollection task is opened for a rejected one. The order goes to the analyzer's worklist, and a specimen that does not match is quarantined.

A result from the device starts as a preliminary result. It becomes final once it passes technical and clinical verification, and for a critical value an acknowledgment is awaited. When a result is corrected or withdrawn, a new version is published and the earlier one is kept.

Every state is recorded with time, source and version; no version is ever deleted.

Checks before a result reaches the physician

Identity verification: Order, specimen and identity details are verified together. A specimen that does not match is quarantined.
Flags: Abnormal and critical flags pass laboratory verification.
Critical values: For a critical value, the target person, channel, retries, acknowledgment and escalation rule are defined.
Comparison warning: When a unit or method changes, a warning is shown so results are not compared incorrectly.
Portal publication: A result is published on the patient portal with the physician's approval or under the organization's rule.
Version history: When a result is corrected or withdrawn, the earlier version is kept.

Frequently asked questions about the laboratory connection

FAQ

What is HL7, and which messages does HekimBis support?

HL7 is the messaging standard between health systems. HekimBis supports the order and result message families with profiles derived from the actual partner specification.

My analyzer does not speak HL7.

Where a device needs it, an ASTM or manufacturer-specific adapter is used. Whether a device counts as integrated depends on evidence by manufacturer, model, protocol and version; until that is complete, results can be imported as files.

Can a result go to the wrong patient?

Order, specimen and identifiers are checked together. A specimen or result that does not match is quarantined and needs human review.

Who receives a critical value?

The target person, channel, retries and escalation rule are defined in your organization, and the alert stays open until it is acknowledged.

When do patients see their results on the portal?

When they are published with the physician's approval or under the organization's rule.

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