Lab Order
Lab Order
Source Object: Lab Order
The Lab Order source object is an integral part of healthcare data management, providing comprehensive information about laboratory orders, tests, and associated details. It plays a crucial role in facilitating diagnostic and monitoring processes for patients.
Overview
Laboratory orders are a common aspect of patient care, helping healthcare providers diagnose medical conditions and track patients' health. The Lab Order source object encompasses various data fields that capture essential information related to lab orders, tests, and their execution.
Usage
The Lab Order source object serves several key purposes in healthcare data management:
- Order Details: It captures information about the lab order, including the order's creation date, confidentiality status, and the physician who placed the order.
- Patient Information: It associates the lab order with the patient for whom the tests are intended, ensuring that test results are correctly matched with the patient's medical record.
- Practice and Facility: Specifies the practice responsible for the lab order and the facility where the tests will be conducted.
- Test Details: Provides comprehensive information about the tests, including test codes, names, compendium references, and associated procedures. This allows for clear test identification and proper execution.
- Submission Information: Tracks the state and metadata related to the submission of the lab order. This can include acknowledgment time and submission time.
- Answers: Captures answers to specific questions or queries related to the tests, providing additional context and information for healthcare professionals.
- Site Information: Specifies the location (address, city, state, etc.) where the tests are to be conducted.
- Specimens: Contains data related to the specimens collected for testing, including body site, container information, descriptions, and modifiers.
- Resolution Details: Documents information about the resolution of the lab order, such as notes and resolving documents.
By utilizing the Lab Order source object, healthcare professionals can effectively manage the entire process of ordering, conducting, and resolving laboratory tests for patients. It ensures that test results are correctly associated with the corresponding patient's medical records and that the diagnostic process is conducted efficiently and accurately.
Mapping Table
| Data Field | Source Field Data Type | Resource Mapping Context | Source Data Field Cardinality | Source Data Field Description | Example Value | Source Data Field Validation Rule | Mapped FHIR Resource | Mapped FHIR Data Field | Augmented Mapping | Associated Coding System | Associated FHIR Data Field Extension | Mapped FHIR Data Field Type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| bill_type | String | Top Level | 0..1 | Who is financially responsible for the order. | - | 'thirdparty', 'patient', 'client', 'workerscomp', 'specialbilling' | ServiceRequest | extension[*].valueCode | - | NA | bill-type | TBD |
| ccs | Integer | Top Level | 0..* | List of physician ids who should be cc'd on any reports. | - | - | ServiceRequest | extension[].extension[].valueInteger | - | NA | cc | integer |
| chart_date | DateTime | Top Level | 0..1 | Date at which this order was first seen in the patient's chart. | - | - | ServiceRequest | extension[*].valueString | - | NA | chart-date | string |
| confidential | Boolean | Top Level | 0..1 | Whether the provider has marked the order as confidential. Should not be shared with a patient. | - | true, false | ServiceRequest | extension[*].valueBoolean | - | NA | confidential | string |
| content | Object | Top Level | 0..1 | Represents the content of the lab order report. | - | - | ServiceRequest | - | - | NA | - | TBD |
| content.collection_datetime | DateTime | Top Level | 0..1 | If lab specimen collection is done onsite, this is the time at which the collection was taken. | - | - | ServiceRequest | extension[*].valueDateTime | - | NA | collection-date | TBD |
| content.fasting_method | String | Top Level | 0..1 | Instructions for patient and lab on how long they should fast before specimen collection. | - | 'fasting_12_hour', 'fasting_8_hours', 'fasting_2_hours', 'fasting_none', 'fasting_random' | ServiceRequest | extension[*].valueString | - | NA | fasting-status | string |
| content.icd10_codes | Object | Top Level | 0..* | ICD10 diagnosis codes provided along with the order. | - | - | ServiceRequest | - | - | ICD10 | - | TBD |
| content.icd10_codes.code | String | Top Level | 0..1 | - | - | - | ServiceRequest | reasonCode[].coding[].code | - | ICD10 | - | TBD |
| content.icd10_codes.description | String | Top Level | 0..1 | - | - | - | ServiceRequest | reasonCode[].coding[].display | - | NA | - | TBD |
| content.patient_instructions | String | Top Level | 0..1 | Notes for patient. | - | - | ServiceRequest | patientInstruction | - | NA | - | TBD |
| content.standing_order_end_date | Date | Top Level | 0..1 | Date at which standing order should be canceled. | - | - | ServiceRequest | extension[*].valueDateTime | - | NA | end-date | TBD |
| content.standing_order_frequency | String | Top Level | 0..1 | Number of times order should be performed on a standing basis. | - | string(50) | ServiceRequest | extension[*].valueString | - | NA | frequency | string |
| content.stat_method | String | Top Level | 0..1 | - | - | 'wet_reading_phone', 'wet_reading_fax', 'stat_phone','stat_fax', 'stat_phone_fax' | ServiceRequest | extension[*].valueString | - | NA | stat-method | string |
| content.test_center_notes | String | Top Level | 0..1 | Notes for Lab. | - | - | ServiceRequest | note[1].text | - | NA | - | markdown |
| content.tests | Object | Top Level | 0..* | The list of tests that should be performed by the lab. Must all be either from the same compendium or no compendium. | - | - | ServiceRequest | - | - | NA | - | TBD |
| content.tests.code | String | Top Level | 0..1 | Any code associated with the test, usually provided by the lab vendor's compendium. | - | string(50) | ServiceRequest | code.coding[1].code | - | NA | - | TBD |
| content.tests.compendium | Integer | Top Level | 0..1 | The id of the compendium provided the lab vendor that provides the lab order test. All tests in the same order MUST share the same compendium. | - | - | ServiceRequest | code.extension[*].valueInteger | - | NA | compendium | integer |
| content.tests.cpts | Integer | Top Level | 0..* | A list of CPT codes associated with the lab order test. | - | - | ServiceRequest | code.extension[*].valueInteger | - | CPT | cpts | integer |
| content.tests.created_date | DateTime | Top Level | 0..1 | Time at which Elation created this Lab Order Test. | - | - | ServiceRequest | code.extension[*].valueDateTime | - | NA | created-date | TBD |
| content.tests.deleted_date | DateTime | Top Level | 0..1 | Time at which this Lab Order Test was deleted. Can happen when a lab order compendium update deprecates a test. | - | - | ServiceRequest | code.extension[*].valueDateTime | - | NA | deleted-date | TBD |
| content.tests.id | Integer | Top Level | 0..1 | The id of the Lab Order Test. | - | - | ServiceRequest | code.id | - | NA | - | TBD |
| content.tests.lab_vendor | Integer | Top Level | 0..1 | The id of the lab vendor who provides the lab order test. | - | - | ServiceRequest | code.extension[*].valueInteger | - | NA | lab-vendor | integer |
| content.tests.name | String | Top Level | 0..1 | The name of the Lab Order Test. | - | string(255) | ServiceRequest | code.extension[*].valueString | - | NA | test-name | string |
| content.tests.practice_created | Integer | Top Level | 0..1 | The id of the practice that created the test if practice created. | - | - | ServiceRequest | code.extension[*].valueInteger | - | NA | practice-created | integer |
| content.tests.procedure_class | String | Top Level | 0..1 | Code provided by specific compendiums that indicate the "class" of test, e.g. histology vs cytology. Some lab vendors require that tests with specific procedure classes need to ordered separately. | - | string(50) | ServiceRequest | code.extension[*].valueString | - | NA | procedure-class | string |
| content.tests.questions | Object | Top Level | 0..* | A list of Ask on Entry (AOE) Questions that need to be answered by the orderer when creating the order. | - | - | ServiceRequest | code.extension[*].valueString | - | NA | questions | string |
| content.tests.synonyms | String | Top Level | 0..* | A list of synonyms that are useful when searching for a specific test. | - | - | ServiceRequest | code.extension[*].valueString | - | NA | synonyms | string |
| created_date | DateTime | Top Level | 0..1 | Time at which elation created this order. Can be different from chart_date when the order was imported into a chart from a different source and document_date when documenting an order that happened at some other time. | - | - | ServiceRequest | authoredOn | - | NA | - | TBD |
| document_date | DateTime | Top Level | 0..1 | Time at which this order was created in whichever system created it. Could be historical or same as the create_date. | - | - | ServiceRequest | occurrenceDateTime | - | NA | - | TBD |
| facility | Id | Top Level | 0..1 | An identifier that represents the facility placing the order. Usually assigned by the lab vendor. | - | - | ServiceRequest | extension[*].valueString | - | NA | facility | TBD |
| follow_up_method | String | Top Level | 0..1 | Freetext field communicating how the patient should receive their results. | - | - | ServiceRequest | extension[*].valueString | - | NA | follow-up | string |
| id | Integer | Top Level | 0..1 | The id of the lab order in Elation's systems. Will be unique. | - | - | ServiceRequest | id | - | NA | - | TBD |
| ordering_physician | Integer | Top Level | 0..1 | The id of the physician who created the order. | - | - | ServiceRequest | requester.reference | - | NA | - | TBD |
| patient | Integer | Top Level | 0..1 | The id of the patient. | - | - | ServiceRequest | subject.reference | - | NA | - | TBD |
| practice | Integer | Top Level | 0..1 | The id of the practice. | - | - | ServiceRequest | extension[*].valueReference.reference | - | NA | practice | TBD |
| requisition | Integer | Top Level | 0..1 | The requistion id of the order. Can be different from the order id if and when the order was created outside of elation. | - | - | ServiceRequest | extension[*].valueInteger | - | NA | requisition | integer |
| signed_by | Integer | Top Level | 0..1 | The id of the physician who signed off on the order | - | - | ServiceRequest | extension[*].valueInteger | - | NA | signed-by | integer |
| signed_date | DateTime | Top Level | 0..1 | The time when the order was signed. | - | - | ServiceRequest | extension[*].valueString | - | NA | signed-date | string |
| special_insurance | Object | Top Level | 0..1 | Used primarily to support specific electronic lab order integrations. | - | - | ServiceRequest | - | - | NA | - | TBD |
| special_insurance.code | String | Top Level | 0..1 | - | - | string(5) | ServiceRequest | insurance.reference | - | NA | - | TBD |
| special_insurance.name | String | Top Level | 0..1 | - | - | string(64) | ServiceRequest | insurance.display | - | NA | - | TBD |
| submissions | Object | Top Level | 0..* | Record of the attempts to submit | - | - | ServiceRequest | - | - | NA | - | TBD |
| tags | String | Top Level | 0..* | Any tags associated with the lab order. | - | - | ServiceRequest | extension[]extension[].valueString | - | NA | tag | string |
| test_date | Date | Top Level | 0..1 | The date on which the tests should be performed, or were performed. Can be different than document_date, create_date | - | - | ServiceRequest | extension[*].valueDateTime | - | NA | test-date | TBD |
| vendor | Integer | Top Level | 0..1 | - | - | - | ServiceRequest | performer.reference | - | NA | - | TBD |
| answers | Object | Contained | 0..* | List of the answers provided for the Ask on Entry (AOE) questions if required by any lab order tests. | - | - | QuestionnaireResponse | - | - | NA | - | TBD |
| answers.created_date | DateTime | Contained | 0..1 | When the answer was created. | - | - | QuestionnaireResponse | contained[].item[].extension[*].valueDateTime | resourceType == QuestionnaireResponse | NA | created-date | TBD |
| answers.deleted_date | DateTime | Contained | 0..1 | When the answer was deleted | - | - | QuestionnaireResponse | contained[].item[].extension[*].valueDateTime | resourceType == QuestionnaireResponse | NA | deleted-date | TBD |
| answers.question | Integer | Contained | 0..1 | The id of the AOE question for which this answer pertains. | - | - | QuestionnaireResponse | contained[].item[].linkId | resourceType == QuestionnaireResponse | NA | - | TBD |
| answers.test | Integer | Contained | 0..1 | The id of the test for which this answer pertains. | - | - | QuestionnaireResponse | contained[*].identifier.value | resourceType == QuestionnaireResponse | NA | - | TBD |
| answers.value | String | Contained | 0..1 | The value entered by freetext or chosen by the ordering physician. | - | - | QuestionnaireResponse | contained[].item[].answer[0].valueString | resourceType == QuestionnaireResponse | NA | - | string |
| site | String | Contained | 0..1 | The location where the patient will have the lab performed. Sites are specific to their lab vendor. | - | - | Location | - | - | NA | - | TBD |
| site.address | String | Contained | 0..1 | The streetname of the site. | - | string(200) | Location | contained[*].address.line[2] | - | NA | - | TBD |
| site.city | String | Contained | 0..1 | - | - | string(50) | Location | contained[*].address.city | - | NA | - | TBD |
| site.fax | String | Contained | 0..1 | - | - | string(20) | Location | contained[].telecom[].value | system == fax | NA | - | TBD |
| site.name | String | Contained | 0..1 | The name of the site. | - | string(200) | Location | contained[*].name | - | NA | - | TBD |
| site.phone | String | Contained | 0..1 | - | - | string(20) | Location | contained[].telecom[].value | system == phone | NA | - | TBD |
| site.state | String | Contained | 0..1 | - | - | string(2) | Location | contained[*].address.state | - | NA | - | TBD |
| site.suite | String | Contained | 0..1 | - | - | string(35) | Location | contained[*].address.line[1] | - | NA | - | TBD |
| site.zip | String | Contained | 0..1 | - | - | string(10) | Location | contained[*].address.postalCode | - | NA | - | TBD |
| specimens | Object | Contained | 0..* | Record of any specimens collected when creating the order. | - | - | Specimen | - | - | NA | - | TBD |
| specimens.body_site | Object | Contained | 0..1 | Information about the body site where the specimen was collected. | - | - | Specimen | - | - | NA | - | TBD |
| specimens.body_site.code | String | Contained | 0..1 | The HL7 code representing the body site from which a specimen was collected | - | string(16) | Specimen | contained.collection.bodySite.coding[1].code | - | NA | - | TBD |
| specimens.body_site.deleted_date | DateTime | Contained | 0..1 | Represents if the body site was removed from the specimen. | - | - | Specimen | contained.collection.bodySite.extension[1].valueDate | - | NA | deleted-date | string |
| specimens.body_site.text | String | Contained | 0..1 | A textual description of the body site from which the specimen was collected. | - | string(64) | Specimen | contained.collection.bodySite.coding[1].display | - | NA | - | TBD |
| specimens.container_id | Integer | Contained | 0..1 | An identifier representing the container used to store the specimen. | - | - | Specimen | contained.container[1].identifier[1].value | - | NA | - | TBD |
| specimens.description | String | Contained | 0..1 | A freetext description of the specimen. | - | string(40) | Specimen | contained.note[1].text | - | NA | - | markdown |
| specimens.modifiers | Object | Contained | 0..* | Coded Modifiers indicating more information about the body site from which the specimen was collected. | - | - | Specimen | contained.extension[1] | - | NA | modifier | TBD |
| specimens.modifiers.modifier.code | String | Contained | 0..1 | The HL7 code representing the modifier on the body site from which a specimen was collected | - | string(3) | Specimen | contained.extension[1].extension[*].valueString | - | NA | bodysite_modifier_code | string |
| specimens.modifiers.modifier.text | String | Contained | 0..1 | A textual description of the modifier of the body site from which the specimen was collected. | - | string(64) | Specimen | contained.extension[1].extension[*].valueString | - | NA | bodysite_modifier_text | string |
| specimens.modifiers.sequence | Integer | Contained | 0..1 | The cardinal position in which the modifiers should be listed. | - | - | Specimen | contained.extension[1].extension[*].valueString | - | NA | bodysite_modifier_sequence | string |
| specimens.test | Integer | Contained | 0..1 | The lab order test for which the specimen as collected. | - | - | Specimen | contained.extension[1].valueInteger | - | NA | test | integer |
| submissions.state | String | Contained | 0..1 | The state of the electronic order submission. | - | string(20) | Provenance | contained[].extension[].valueString | resourceType == Provenance | NA | state | string |
| submissions.state_metadata | String | Contained | 0..1 | Useful error information collected as part of the submission. Including ERRORs or ACKs. | - | string(1500) | Provenance | contained[].meta.extension[].valueString | resourceType == Provenance | NA | metadata | TBD |
| submissions.time_acknowledged | DateTime | Contained | 0..1 | The time at which a user acknowledged any error shown to them about the electronic submission. | - | - | Provenance | contained[*].recorded | resourceType == Provenance | NA | - | TBD |
| submissions.time_submitted | DateTime | Contained | 0..1 | The time the electronic order was submitted to the lab vendor. | - | - | Provenance | contained[*].occurredDateTime | resourceType == Provenance | NA | - | TBD |
| resolution.created_date | DateTime | Contained | 0..1 | The datetime when this resolution state was created. | - | - | Task | contained[].extension[].valueDateTime | - | NA | created-date | TBD |
| resolution.deleted_date | DateTime | Contained | 0..1 | The datetime when this resolution was deleted. Should never be null because we're providing the most updated resolution. | - | - | Task | contained[].extension[].valueDateTime | - | NA | deleted-date | TBD |
| resolution.document | Integer | Contained | 0..1 | Will be the same as the id of the lab order. | - | - | Task | contained[].extension[].valueInteger | - | NA | document | integer |
| resolution.id | Integer | Contained | 0..1 | Internal id to represent the resolution state. | - | - | Task | contained[*].id | resourceType == Task & code.coding[].code== fulfill | NA | - | TBD |
| resolution.note | String | Contained | 0..1 | Any note that was added to represent why an order was cancelled. | - | - | Task | contained[*}.note[1].text | - | NA | - | markdown |
| resolution.resolving_document | Integer | Contained | 0..1 | If the order is fulfilled will indicate the document referenced. For lab orders will usually be a report. | - | - | Task | contained[].extension[].valueInteger | - | NA | resolving-document | integer |
| resolution.state | String | Contained | 0..1 | The resolution state of the order. | - | outstanding, fulfilled, cancelled | Task | contained[].extension[].valueString | - | NA | state | TBD |