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General Laboratory Overview

General Laboratory Overview. General Laboratory Overview. Objectives: Overview of the general laboratory package inc depts Phlebotomy Accessioning Processing Results/reports. General Laboratory Overview. The Laboratory package is one of many packages available with OpenVista

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General Laboratory Overview

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  1. General Laboratory Overview

  2. General Laboratory Overview • Objectives: • Overview of the general laboratory package inc depts • Phlebotomy • Accessioning • Processing • Results/reports

  3. General Laboratory Overview • The Laboratory package is one of many packages available with OpenVista • CIS is like an umbrella

  4. File Structure Laboratory Test (#60) NAME: GLUCOSE// TEST COST: // Select SYNONY// TYPE: BOTH// SUBSCRIPT: CHEM, HEM, TOX, SER, RIA, ETC.// LOCATION (DATA NAME) :Glucose Select INSTITUTION: DIRDEV HOSPITAL/CLINIC// INSTITUTION: DIRDEV HOSPITAL/CLINIC// ACCESSION AREA: CHEMISTRY// UNIQUE ACCESSION #: NO// UNIQUE COLLECTION SAMPLE: NO// LAB COLLECTION SAMPLE: BLOOD// REQUIRED TEST: YES// EXTRA LABELS: HIGHEST URGENCY ALLOWED: STAT// FORCED URGENCY: ROUTINE// PRINT NAME: GLUCOSE// Reserved: PRINT CODE: PRETTY PRINT ENTRY: PRETTY PRINT ROUTINE: PRINT ORDER: 14// . . Select SITE/SPECIMEN: BLOOD// REFERENCE LOW: 70// REFERENCE HIGH: 110// CRITICAL LOW: 40// CRITICAL HIGH: 350// INTERPRETATION:1> UNITS: mg/dL// TYPE OF DELTA CHECK: DELTA VALUE: . Select COLLECTION SAMPLE: BLOOD// Topography File (#61) NAME: BLOOD// ICDO CODE: HL7 CODE: BLD// LEDI HL7: Whole blood // SNOMED CODE: 0X000// SEX SPECIFIC: Select SYNONYM: BL// WEIGH: COLLECTION SAMPLE: Select TITLE OF ARTICLE: ABBREVIATION: B// *NEGATIVE BACTERIOLOGY COMMENT: Accession (#68)AREA: CHEMISTRY// LR SUBSCRIPT: CHEM, HEM, TOX, RIA, SER, etc.// COMMON ACCESSION #'S WITH AREA: ACCESSION TRANSFORM: DAILY// ACC CODE: S LRAD=DT// VERIFICATION CODE: VER CODE: *IDENTITY CONTROL: PRINT ORDER: 1// BYPASS ROLLOVER: ABBREVIATION: CH// Collection Sample (#62) NAME: BLOOD// DEFAULT SPECIMEN: BLOOD// TUBE TOP COLOR: MARBLE// VOLUME LARGE: 10// VOLUME SMALL: 1// LAB SECTION: CHEMISTRY// CAN LAB COLLECT: YES// Select SYNONYM: TIGER// Select ACCESSION AREA

  5. General Laboratory Overview • The Laboratory Package is made of up three different/ distinct modules • General Lab • Microbiology • Anatomic Pathology

  6. General Laboratory Overview Section 1 - Phlebotomy Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.

  7. General Laboratory Overview Section 1 - Phlebotomy This menu allows the laboratory to: • Work with scheduled collections • List • labels • Add to an existing order • Add to an existing accession • Print reports • Future order • Not collected

  8. General Laboratory Overview Section 1 - Phlebotomy ? for more options, ??? for brief descriptions, ?OPTION for help text.

  9. General Laboratory Overview Section 1 - Accessioning Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.

  10. General Laboratory Overview Section 1 - Accessioning • Accessioning allows the lab personnel to: • Create an new order/accession • Accept an order created by CIS • Allows the separation of accessions • Chemistry • Hematology • Urinalysis • Microbiology • Etc.

  11. General Laboratory Overview Section 1 - Accessioning • Order Test/Status • Ordered – through CIS • Collected • Pending • complete • Allows the printing of labels • Current • Future

  12. General Laboratory Overview Section 1 - Accessioning Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.

  13. General Laboratory Overview Section 1 - Resulting Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.

  14. General Laboratory Overview Section 1 - Resulting • Order Test/Status • Verification of results • Manual • Automated Instrument Interface • Worklists • Batch data input • Workload Statistics • Pending workload

  15. General Laboratory Overview Section 1 - Resulting Resulting Menu Options

  16. General Laboratory Overview Section 1 – Misc. Processing menu Miscellaneous Processing Menu • Allows the lab to perform miscellaneous reports • Incomplete work • Statistics • By provider • Turnaround time • Manipulate loadlist/worklist entries

  17. General Laboratory Overview Section 1 – Processing (Misc. menu) Select Misc. Processing Menu Option:

  18. General Laboratory Overview Reports Menu Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.

  19. General Laboratory Overview Section 1 – Reports • This menu contains several report options • Allows the review of laboratory results • Interim reports • All results by time frame • By provider • By location • By selected test • Graphing of result • By grouping of selected tests

  20. General Laboratory Overview Section 1 – Reports Reports Menu Options

  21. INTRODUCTION TO VA FILEMAN Super User Training

  22. Training Goals and Objectives • Define VA Fileman • Identify VA Fileman Options • Enter/Edit • Print • Search • Inquire • Utilities • Establish Access Assignment Rules

  23. Definitionof VA Fileman • VA Fileman is a database management system written in MUMPS. • A database management system manipulates data and interacts with the user. • VA Fileman runs on computers in an interactive dialogue with a variety of users working on their terminals. • It is used to define, enter, and retrieve information from a set of computer stored files, each of which is described by a data dictionary (DD).

  24. VA Fileman Options • Enter/Edit File Entries use to enter or edit entries in existing files • Print file entries: use this option to create reports • Search File Entries: use to select and display entries that conform to predetermined criteria • Inquire to File Entries: use to display file entries and values • Data Dictionary Utilities: use this file to print a file’s data dictionary

  25. Enter or Edit File Entries INPUT TO WHAT FILE: LABORATORY SITE// Collection CHOOSE 1-2: 2 COLLECTION SAMPLE (83 entries) EDIT WHICH FIELD: ALL// Select COLLECTION SAMPLE NAME: blood CHOOSE 1-5: 1 BLOOD BLOOD LAVENDER NAME: BLOOD// DEFAULT SPECIMEN: BLOOD// TUBE TOP COLOR: LAVENDER// VOLUME LARGE: 7// VOLUME SMALL: 1// LAB SECTION: HEMATOLOGY// CAN LAB COLLECT: YES// Select SYNONYM: PURPLE TOP// Select ACCESSION AREA:

  26. Print File Entries OUTPUT FROM WHAT FILE: COLLECTION SAMPLE// SORT BY: NAME// START WITH NAME: FIRST// FIRST PRINT FIELD: NAME;L25 THEN PRINT FIELD: DEFAULT SPECIMEN;L20 THEN PRINT FIELD: ************************* Heading (S/C): COLLECTION SAMPLE LIST Replace STORE PRINT LOGIC IN TEMPLATE: DEVICE: COLLECTION SAMPLE LIST AUG 3,1999 09:23 PAGE 1 NAME DEFAULT SPECIMEN -------------------------------------------------------------------------------- ASPIRATE WOUND-DEEP/SURGICAL ASPIRATE WOUND-SUPERFICIAL BIOPSY LUNG BIOPSY LIVER

  27. Search File Entries OUTPUT FROM WHAT FILE: LABORATORY TEST// -A- SEARCH FOR LABORATORY TEST FIELD: DATA NAME -A- CONDITION: CONTAINS -A- CONTAINS: ANTI -B- SEARCH FOR LABORATORY TEST FIELD: IF: A// DATA NAME CONTAINS "ANTI" STORE RESULTS OF SEARCH IN TEMPLATE: SORT BY: NAME// START WITH NAME: FIRST// FIRST PRINT FIELD: NAME;L25 THEN PRINT FIELD: DATA NAME;L25 Heading (S/C): LABORATORY TEST SEARCH Replace STORE PRINT LOGIC IN TEMPLATE: DEVICE: LABORATORY TEST SEARCH AUG 3,1999 09:34 PAGE 1 NAME DATA NAME -------------------------------------------------------------------------------- A2 HEMOGLOBIN BY COLUMN ANTI-DNA SINGLE-STRANDED ALPHA-1-ANTITRYPSIN ALPHA-1-ANTITRYPSIN AMOEBIC IHA ANTIBODY AMOEBIC IHA ANTIBODY

  28. Inquire to File Entries OUTPUT FROM WHAT FILE: LABORATORY TEST// Select LABORATORY TEST NAME: glucose ANOTHER ONE: STANDARD CAPTIONED OUTPUT? Yes// (Yes) Include COMPUTED fields: (N/Y/R/B): NO// - No record number (IEN), no Computed LABTEST IEN: 175 NAME: GLUCOSE TYPE: BOTH SUBSCRIPT: CHEM, HEM, TOX, SER, RIA, ETC. LOCATION (DATA NAME): CH;2;1 UNIQUE ACCESSION #: NO UNIQUE COLLECTION SAMPLE: NO LAB COLLECTION SAMPLE: BLOOD TEST COST: 47 FIELD: DD(63.04,2, HIGHEST URGENCY ALLOWED: STAT REQUIRED TEST: YES FORCED URGENCY: ROUTINE COMBINE TEST DURING ORDER: YES PRINT NAME: GLUCOSE PRINT ORDER: 14 DATA NAME: GLUCOSE SITE/SPECIMEN: BLOOD REFERENCE LOW: 70 REFERENCE HIGH: 110 UNITS: mg/dl SITE/SPECIMEN: SERUM REFERENCE LOW: 70 REFERENCE HIGH: 110 UNITS: mg/dL

  29. Data Dictionary Utilities START WITH WHAT FILE: LABORATORY TEST// GO TO WHAT FILE: LABORATORY TEST// Select SUB-FILE: ? Select SUB-FILE: 6 ACCESSION AREA Select LISTING FORMAT: STANDARD// DEVICE: STANDARD DATA DICTIONARY #60.11 -- ACCESSION AREA SUB-FILE 08/3/99 PAGE 1 STORED IN ^LAB(60, (1088 ENTRIES) SITE: TUCAPD UCI: DEV,DEV DATA NAME GLOBAL DATA ELEMENT TITLE LOCATION TYPE ------------------------------------------------------------------------------- 60.11,.01 INSTITUTION 0;1 POINTER TO INSTITUTION FILE (#4) INPUT TRANSFORM: S DINUM=X LAST EDITED: JUL 31, 1985 DESCRIPTION: This is the appropriate institution/division this test is performed at. If this test is part of a panel that does not have an accession area defined for the panel, that panel will be expanded based on the institution/division the program is operating under.

  30. Access to VA Fileman • Access to Fileman must be assigned by the site manager to the individual(s) responsible for editing the laboratory files #60-#69.9 • Fileman access of “L” (General Fileman) and “l” (Supervisor) will be needed Certain files and fields may contain mumps code and require great caution when editing or entering data. • These files require a fileman access code of programmer and may not be accessible to the LIM. • The assignment of programmer access codes is a local issue.

  31. VA Fileman Access • Access to fileman can be viewed using “tbox”, “Display user characteristics” • Select User's Toolbox Option: display User Characteristics MOORE,CATHERINE (#2041) DEVICE: CHC417 ($I: 417) JOB: 97 ENVIRONMENT ATTRIBUTES ----------- ----------- Site ........ NAVCHA Type-ahead ....... Y UCI ......... IHS,CHC Time-out ......... 600 Signed on ... 12:25 Fileman code(s) .. M#L Terminal type C-VT100

  32. VA Fileman Summary A database management system: • Written in mumps • Manipulates data • interacts with user • Runs on an interactive dialogue • Used to define, enter and retrieve information from a data dictionary

  33. Open Vista Lab Set up

  34. Lab Configurators Before the Clinical Team can start building orders in CPRS or CIS, there is setup the Lab Consultant will need to do. • The Laboratory Test File configurators need to be run. - File 60 Configurator • Data Name Configurator • Site/Specimen Configurator • Panel Configurator • Loadlist Configurator • Autoinstrument Configurator What is a configurator??

  35. Site file set up-File 69.9 • There are many Domain settings in the Laboratory site file required to be defined before lab order build can begin: Using the Enter/Edit option in File Man, define the following: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL SITE NAME: HOSPITAL// BLOOD DONOR UNIT ID PREFIX: 1// DEFAULT LAB OOS LOCATION: LAB DIV 050 OOS ID 108// DEFAULT INSTITUTION: GENERAL HOSPITAL    CA    058 Select IMMED COLLECTION DIV.: GENERAL HOSPITAL    CA    058   Are you adding 'GENERAL HOSPITAL' as     a new IMMED LAB COLLECT DIV. (the 1ST for this LABORATORY SITE)? No// Y   (Yes)   HOLIDAYS ?: Y  YES   IMMED LAB COLLECT PRINTER: After Lab printers have been defined, enter The STAT Order printer here   MINIMUM RESPONSE TIME: 15   MAXIUM HOURS AHEAD ALLOWED: 2    SUNDAY: 1  YES     SUN START TIME: 0001   SUN END TIME: 2359   MONDAY: 1  YES   MON START TIME: 0001   MON END TIME: 2359 Continue defining the rest of the days of the week to enable Immediate collect, or STAT orders

  36. Site file set up-File 69.9 • Anatomic Pathology subdivisions: Using the Enter Edit option in File Man define the following: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . . . . . . ASK FROZEN SECTION: YES// ASK SURG PATH DIAGNOSIS: YES// ASK CYTOPATH DIAGNOSIS: YES// ASK EM DIAGNOSIS: YES// @    SURE YOU WANT TO DELETE? Y  (Yes) For the AP Module, if all sections will be used, accept defaults. If, for example EM, is not used, delete as displayed below.

  37. Site file set up-File 69.9 • Default Workload Setting: Using the Enter/Edit option in File Man define the following: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . . CHOICE OF ACCESSION NUMBERS: NOT ALLOWED// GRACE PERIOD FOR ORDERS: 90// GRACE PERIOD FOR CUMULATIVE: 30// WKLD STATS ON: YES// NO??      Enter YES to have WKLD Workload statistics collected.      Choose from:        1        YES WKLD STATS ON: YES// @    SURE YOU WANT TO DELETE? Y  (Yes) *AMIS/CAP DEFAULT: YES// *GRACE PERIOD FOR STATISTICS: 10// The default setting for Workload is on, set to off if the client will not be implementing workload.

  38. Site file set up-File 69.9 • Default Nature of an Order: Using the Enter Edit option in File Man define the following: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . DEFAULT NATURE OF ORDER: ?      Enter the default nature of order for the package.      Data Standardization of NATURE OF ORDER file #100.02  Answer with NATURE OF ORDER NUMBER, or NAME, or CODE  Do you want the entire NATURE OF ORDER List? Y  (Yes)    Choose from:    1            WRITTEN     W    2            VERBAL     V    3            TELEPHONED     P    4            SERVICE CORRECTION     S    5            POLICY     I    6            DUPLICATE     D    7            REJECTED     X    8            ELECTRONICALLY ENTERED     E    9            AUTO     A    10           CHANGED     C    11           MAINTENANCE     M DEFAULT NATURE OF ORDER: 5  POLICY     I With Client input, select the default nature for an order

  39. Site file set up-File 69.9 • Default DC Reason: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . DEFAULT DC REASON: ?      Enter the Default DC Reason for the package.      Data Standardization of ORDER REASON #100.03  Answer with ORDER REASON NAME, or SYNONYM, or CODE  Do you want the entire ORDER REASON List? Y  (Yes)    Choose from:    Admit    CLOTTED SPECIMEN    DUPLICATE TESTS    Death    Discharge    Duplicate Order    Entered in error    HEMOLYZED SPECIMEN    INSUFFICIENT SPECIMEN    OTHER CANCEL REASON    Obsolete Order    PATIENT UNAVAILABLE    REQUESTING PHYSICIAN CANCELLED    Requesting Physician Cancelled    SERVICE CORRECTION    Surgery    Transfer    Treating Specialty Change    DEFAULT DC REASON: OTHER CANCEL REASON With Client input, select the default Discontinue reason for an order

  40. Site file set up-File 69.9 • Cancellation settings that should be left blank: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . . CANCEL ON ADMIT: CANCEL ON DISCHARGE: CANCEL ON SPECIALTY TRANSFER: These settings for cancelling lab orders that have not been collected, need to be left blank. CPRS/CIS control these actions now, not the Open Vista Lab application.

  41. Site file set up-File 69.9 • Collection List Setup (see separate presentation also): Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . . Select PHLEBOTOMY ORDER CUT-OFF TIME: 0545   Are you adding '0545' as     a new PHLEBOTOMY ORDER CUT-OFF TIME (the 1ST for this LABORATORY SITE)? No//  Y  (Yes)   PHLEBOTOMY COLLECTION TIME: 0600   DIVISION: ?      Enter the Division this collection time applies to.  Answer with INSTITUTION NAME, or STATE, or STATUS, or STATION NUMBER, or OFFICIAL VA NAME, or CURRENT LOCATION, or CODING SYSTEM/ID PAIR, or NAME (CHANGED FROM), or CODING SYSTEM   DIVISION: GENERAL HOSPITAL    CA           058 Collection List setup is done by Division. Enter the cut-off first , allowing enough time for the task to run in the background, at least 5 minutes. Enter as many schedules as the client would like.

  42. Site file set up-File 69.9 • Collection List Setup (see separate presentation also): Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . . . BUILDING COLLECTION LIST: NO// COLLECTION LIST BUILD $H: COLLECTION LIST BUILDER (DUZ): COLLECTION LIST TIME: COLLECTION LIST PRINT COUNT: Leave the following fields blank. The system will update once the collection list task has been built in Task Manager, and will run to completion

  43. Site file set up-File 69.9 • AP Esig and Lab Reflex Orders: Input to what File: LABORATORY TEST// 69.9  LABORATORY SITE                                           (1 entry) EDIT WHICH FIELD: ALL// Select LABORATORY SITE SITE NAME: HOSPITAL . . AP ESIG ON: Y  YES . . . REFLEX ALERT MAILGROUP: LAB REFLEX ORDERS All other fields in the Site File would have the defined settings accepted If the AP module will be used, enter Yes for the AP E-signature to be activated. If the auto reflex order feature will be used, enter the name of the Mail group that will be defined via FileMan for alerts, or notifications .

  44. Data Name Definitions

  45. Data Name Definitions • Used for tests with a CH subscript and a type of BOTH or OUTPUT (more information to follow) • Displays in the LOCATION (DATA NAME) field of the file • Defines what type of value you can enter as a result (free-text, numeric or a set of codes). • Note: Panels, profiles, and tests with subscripts other than CH do not have data name entries. • Note: Data Name must be built FIRST before building the actual lab test (if the test qualifies)

  46. Data Name Definitions Example of test inquiry in FM for single test: NAME: PLATELET COUNT TYPE: BOTH SUBSCRIPT: CHEM, HEM, TOX, SER, RIA, ETC. LOCATION (DATA NAME): CH;1108;1 UNIQUE ACCESSION #: NO UNIQUE COLLECTION SAMPLE: NO LAB COLLECTION SAMPLE: PURPLE-WB FIELD: DD(63.04,1108, HIGHEST URGENCY ALLOWED: STAT REQUIRED TEST: YES REQUIRED COMMENT: ORDER COMMENT PRINT NAME: PLT CNT PRINT ORDER: 169 DATA NAME: PLATELET COUNT SITE/SPECIMEN: BLOOD UNITS: K/mm3 COLLECTION SAMPLE: PURPLE-WB MIN VOL (in mls.): 1 CONTAINER (c): PURPLE SYNONYM: PLT CNT INSTITUTION: GENERAL HOSPITAL ACCESSION AREA: HEMATOLOGY INPUT TRANSFORM (c): S Q9="0,999,0" D ^LRNUM DATA TYPE (c): NUMERIC

  47. Data Name Definitions Example of a test inquiry in FM for a panel: NAME: FREE&TOTAL TESTOSTER TYPE: BOTH SUBSCRIPT: CHEM, HEM, TOX, SER, RIA, ETC. UNIQUE ACCESSION #: NO UNIQUE COLLECTION SAMPLE: NO LAB COLLECTION SAMPLE: RED-SP HIGHEST URGENCY ALLOWED:ROUTINE REQUIRED TEST: YES REQUIRED COMMENT: ORDER COMMENT PRINT NAME: TES T-F NUMBER: 1 LAB TEST: TESTOSTER FR M NUMBER: 2 LAB TEST: TESTOST ADULT MALE NUMBER: 3 LAB TEST: SEX HORMON BIND GLOB NUMBER: 4 LAB TEST: TESTOSTERONE % FREE COLLECTION SAMPLE: RED-SP MIN VOL (in mls.): 1 CONTAINER (c): RED SYNONYM: F&T INSTITUTION: GENERAL HOSPITAL ACCESSION AREA: SENDOUTS

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