Test Result Displaying in PKB

Owned by Tim Whitlock (Deactivated)
Feb 08, 2021
4 min read

We are actively reviewing lab result processing rules so we will keep you apprised of any developments that come up on our roadmap. We’d appreciate any feedback or suggestions you have to feed into this process.

I have summarised the as-is processing below....

Here is some more information regarding the panels your test results display within:

  1. Within an ORU^R01 message the OBR-4.2 service name field will help determine the panel grouping. Any OBX’s following that OBR that are for a test type we haven’t received previously by the organisation / partner will be placed within a panel named as per the message OBR-4.2.  This assumes the OBR group conforms to one of PKB’s supported content patterns.

E.g.

OBR|1||TFTF|^Thyroid function test|||202001230800|||^|||||||||||||||F

OBX|1|NM|B3588^TSH||4.20|mU/L|0.27-4.20|N|||F|||202001230800

OBX|2|NM|B3546^Free T4||25.0|pmol/L|11.0-25.0|N|||F|||202001230800

When the OBR-4.2 field is populated there are two permutations to the above which may result in the OBX level test(s) being assigned to a different panel.

  1. If a OBX test result is included on the ORU^R01 but has previously been received (based on test code, units) by the organisation / partner with a different OBR-4.2 service name then all those test results assigned to the previous and new OBR-4.2 will be displayed within the ‘Other’ panel as PKB is unsure which panel the tests should belong to.

E.g. resending the original example message with new values and a different OBR-4.2 moves all TSH and Free T4 test results to the ‘Other’ panel.

OBR|1||TFTF1|^Thyroid function different test|||202001240800|||^|||||||||||||||F
OBX|1|NM|B3588^TSH||5.20|mU/L|0.27-4.20|N|||F|||202001240800
OBX|2|NM|B3546^Free T4||10.0|pmol/L|11.0-25.0|N|||F|||202001240800


  1. If a OBX test is included on the ORU^R01 but has previously been received by the organisation / partner with a different set of units then this would display as a separate test type.

E.g

Message 1:

OBR|1||COL|CHOLO^Cholesterol|||202002020800|||||||202002020800||||||||202002020800|||F

OBX|1|NM|B35321^Cholesterol||10.0|mmol/L||N|||F|||202002020800

Message 2:

OBR|1||COL1|CHOLO^Cholesterol|||202002030800|||||||202002030800||||||||202002030800|||F

OBX|1|NM|B35321^Cholesterol||18.0|mmol/l||N|||F|||202002030800


Within an ORU^R01 message if the OBR-4.2 field is omitted, then there are some permutations:


  1. If OBR-4.2 is omitted on an HL7 message...but has been previously supplied by the organisation / partner for the same OBX test identifiers (test code, units) then we will add this to the existing panel. 


E.g. In the below example OBR-4.2 is omitted but because it has previously been supplied in earlier messaging from the organisation / partner and because the OBX test level identifiers are consistent with those received previously then we add the tests to the existing panel ‘Thyroid function test’ even though this message did not include that specific detail.


OBR|1|||1b63320e-662a-11eb-ae93-0242ac130002^|||202001230900||||||||||||||||||F

OBX|1|NM|B3588^TSH||4.20|mU/L|0.27-4.20|N|||F|||202001230900

OBX|2|NM|B3546^Free T4||25.0|pmol/L|11.0-25.0|N|||F|||202001230900


  1. If OBR-4.2 is omitted on an HL7 message...and we can’t identify any previously supplied value from the sending organisation / partner for the OBX test identifiers (test code, units) then we don’t know what to name the panel and it defaults to the ‘Other’ panel.


Note: I would imagine this will be the most common scenario for yourselves as you generally don’t send OBR-4.2 as a result of automatically collating many tests into one ORU^R01 message.

E.g. In the below example OBR-4.2 is omitted and we can’t reconcile the OBX test level identifiers with any previously sent OBR-4.2 service name from the organisation / partner.

OBR|1|||171e7b7a-662c-11eb-ae93-0242ac130002^|||20201021140526||||||||||||||||||F

OBX|1|NM|1e9689f6-662c-11eb-ae93-0242ac130002^% BCR/ABL in blood^||0.34832638|%|||||F|||20201021140526|^Centr. Hematologisch Lab.^^^^||||20201021140526

With all of the examples above I reference the caveat of identifiers being supplied by the organisation / partner. This is because the partner (yourselves) share the data point ID namespace with the organisation (site/customer). Reference: http://dev.patientsknowbest.com/home/hl7-api/connecting-hl7-to-pkb/partner-connections#TOC-Considerations. So for example, if yourselves and Newcastle both send lab feeds and you utilise the same test identifiers but different OBR-4.2 service names then it is likely some results will plot on the same graph but within the ‘Other’ panel.