¶ Introduction
The Clinical Laboratory module, or Lab module for short, is designed specifically to accommodate requirements for setting up and maintaining results about clinical disciplines, including:
- Haematology
- Biochemistry
- Immunology/Serology etc.
To enable the ordering, resulting management and reporting of tests associated with these clinical disciplines, specific laboratory setups should be completed, including setting up Tests and, if required Calculations. To set up laboratory tests and calculations, some General LIMS and standard D365 setups should be completed before this. These setup dependencies include:
- Lab departments
- Canned comments
- Methods
- Markers
- Questionnaires and group responses
- Specimen containers
- Medical aids (Customers)
- Service products defined for use in Laboratory Billing
- Providers (Global address book)
- Laboratories (Warehouses)
- Units of measure (Organization administration)
¶ Navigation
¶ Step 1: Setup Laboratory tests
- Go to: Clinical lab information management > Setup > Laboratory > Laboratory tests
- The Laboratory tests list is primarily sorted by Department print sequence as per Laboratory department setup explained in the General setup steps.
- The secondary sort of the laboratory list is the test Print number. The Print number determines the sequencing of tests when viewed in D365 and on laboratory reports. Each laboratory department has its own and separate print range, not affected by other laboratory departments. This means the same print number may be allocated to different tests for different laboratory departments.
Laboratory tests by default appear in department sequence first, then in print number sequence for that department in ascending order.
- The laboratory test list is generally filtered to hide inactive tests and show active tests. Click on the Show inactive slider button to view both active and inactive tests.
- Enter data in the various Filter fields to find a specific test
- Click on the record in the list to maintain or view the record details.
- Expand the Related information pane, to the right of the list, to view dependencies to other records as well as a simple event log, which lists modification events.
¶ Step 1.1 Create a laboratory test
Tests may be created by either copying another existing test with similar parameters or from scratch.
- Click on New in the action pane to create a test without reference data from another OR
- To copy an existing test:
- Select an existing test to copy
- Click on Copy in the action pane
- In the Copy laboratory test dialogue
- Enter a short Name for the new test
- Enter a unique Print number for the department
- Select the appropriate Department from the dropdown list
- Click on OK
- If the Name is not unique or the Print number selected has already been allocated for the selected department, an error message will appear:
- Correct the Name and/or Print number and click on OK again to create the record
- The Laboratory test detail form will be displayed, containing all values from the copied test if successful, with only the name, print number, and department as per the copy dialogue.
Although the copied data in many of the fields may also apply to the new test, it is important to check and update all fields where required.
¶ Step 1.2: Complete the General index tab
The General index tab is always completed for all types of tests. Some of the fast tabs in the General index tab may, however, be mandatory or optional based on the test type. Warning messages appear to guide users during setup if mandatory fields are not completed.
¶ Step 1.2.1: Complete the General fast tab details
- Expand the General fast tab
- Enter the Identification details for the test:
| Field name | Purpose | What to enter | Additional information |
| Name | Primary key for the test. Used to order or locate the test. | A short name, abbreviation or known acronym for the test e.g., Na for Sodium |
The name should be short, meaningful if possible, and easy for staff to use, as the test is likely already known to staff by that name The name must be unique. If a unique name is not selected, an error message will appear. |
| Description | To assist with the selection of the correct test |
Enter a longer description for the test. If a test may be analyzed using different specimen types, it is suggested to reference the test first then the specimen type. This may however be reversed in the report name. By entering the test name first, staff will be able to find the test easily and see the different variations as well whilst, if the specimen type is entered first, the variations of the test will not appear together in the search e.g. Name: NaU Description: Sodium Urine Report name: Urine Sodium |
A warning may appear if the test name is already in use and serves as a guide to prevent unnecessary duplication of tests but may be ignored if the duplication is correct. Typically, if the specimen type is not indicated in the name and/or descriptions for a test, it is accepted the test is performed using the standard specimen type e.g. Serum for Sodium testing. |
| Abbreviated description | Used to identify the test in forms/reports where space is limited e.g. Enter results | The Abbreviated test description will default from the Description field entry but may be changed if required. | |
| Active | Indicate if the test is active or not. |
The Active slider button may be set to Yes when all mandatory data has been entered/selected and the test should now be made available for use in the laboratory. Set to No when the test is made obsolete by the laboratory. |
If not all mandatory fields have been completed, error messages will appear to indicate the missing data when trying to activate the test. |
| Start date | Indicates date from which the test was introduced to the laboratory | Select or enter a date | Optional entry which does not affect ordering and selection |
| End date | Indicates date from which test was marked obsolete | Select or enter a date | Optional entry which does not affect ordering and selection |
- Select the Test type from the dropdown list in the Specification field group:
| Test Type | Purpose |
| Target tests | Single result target test used to capture analysis results. The target test contains parameters for reference ranges, units; decimals; result actions etc that should be applied during entry of results. This is the building blocks of the Laboratory test setup and a minimum required setup for ordering and resulting of clinical discipline tests. |
| Group tests | Allows tests to be grouped together, so that multiple tests can be ordered together and easily using the group test name. Grouping tests reduce the risk of manual entry of individual tests as well as the risk of leaving out a test that should be included in a standard test profile. The Group tests also have capability to define selection groups to accommodate ordering preferences for Providers; Laboratories or Priority e.g. If a provider has a preference to always include an ESR test with a Full blood count profile, a selection group may be defined in the Full blood count group that automatically always adds the ESR test, when a Full blood count group is added for the referring provider. |
| Charge tests | A non-reportable and non-resultable test. The purpose of a charge test is to add a service charge to the visit e.g. Collection fees and consumables. |
- The Muli-department group slider button will only be enabled if the test type is Group.
A multi-department group is a group that contains tests from various departments e.g. Arthritis profile. If set to No, only tests with the same department as the group test, may be included in the group.
- Enter a Print number in the format specified in the LIMS parameters. If the print number is not entered in the correct format, an error message will appear to indicate the correct format
Best practice suggestions for print number selection:
- Plan print number allocation of the lab test compliment prior to creating the tests in D365, to ensure tests appear in the expected order.
- Leave adequate space between print numbers to ensure new tests may be added if required in future
- Allocate print numbers for the Group and contents tests so that the Group is listed first followed by the target tests included in the group.
- Set the Confidential slider button to Yes if the test and result should be treated as confidential e.g. HIV and other sensitive tests.
- Set the Reportable slider button to Yes, if the test should be included in laboratory reports to providers and patients. If the test is however only relevant internally e.g. Machine values used to determine the result to be reported, then select No.
- Billing details
- If the test has a payable charge, add the CPT/Tariff code from the dropdown list. This is the code expected by the medical aid/insurance to identify the charge in claims.
- If a CPT/Tariff code is added for a test, the Lab product must also be completed. The lab product is used to define the charge price of the test, as set by the laboratory, independent of the amount the medical aid is willing to pay.
- Select if the test should be Billed on order or on Completion of the sample, by selecting the appropriate option from the dropdown list.
- Order instructions
- Set the Orderable slider button to Yes if the test should be available for ordering during the creation of a laboratory visit. If a test should not be ordered on its own, but instead always be ordered as part of a group of tests OR if the test should just not be available for ordering, set the slider button to No.
- Complete the other Order instructions fields as follow:
| Field name | Purpose | What to enter | Additional information |
| Available |
Indicates if test is currently available and restricts ordering if set to No. Typically set to No when the procedure is temporarily unavailable |
Yes to allow the test to be ordered for a laboratory visit. No to prevent the ordering of the test for a laboratory visit.
|
If an active and usually orderable test, is not available for a period due to e.g. reagent not being available, then the slider may be set to No and a reason added why the test is not available. Whilst the test is not available, the staff will not be able to order the test but will be able to still see it in their selection list with the reason why it is not currently available. This enhancement allows staff to advise providers when usually available tests are suddenly not available by providing them with the necessary information. This is a cleaner and friendlier solution than completely removing the test from selection lists by making it non-orderable or inactive. |
| Test unavailable comments | Provides a reason when the test is not available | Enter the reason why the test us currently unavailable e.g. Reagent shortage. (See previous point) | Only enabled when an active and orderable test is made unavailable. The reason entered will be visible in visit requests so those ordering tests can see the reason why the test is not available. |
| Allow patient order | Restricts patient ordering of tests | Set to Yes, if the patient should be allowed to order the test without a doctor's referral e.g. Blood group test | |
| Duplicate hours | Check to dissuade reordering of a test for the same patient within set period of hours | Enter a value if a check should be performed during visit creation | Used when e.g. clinically it would not be prudent to reorder a test within a period e.g. an HIV test within 24 hours for the same patient. By entering 24 in this field, D365 will perform a check during the ordering process and if found the test was ordered before for the patient within the set time, a warning message would appear to dissuade the staff member from ordering the test again. If the user decides to still continue with the ordering, a reason will have to be entered for the duplication and this will be recorded in the Order audit log. |
| Ask order count | Allow increase charge count for billing | Set to Yes if count may be increased. | The default count and if the slider is set to No, will always be 1. |
| Restrict to priority | Restrict ordering of the test to a certain priority | Select an option from the dropdown list if required | If the ordering of a test may only be done when the visit is either Urgent or Routine e.g. Troponin T should only be ordered as Urgent |
| Restrict to gender | Restrict ordering of the test to a certain gender | Select an option from the dropdown list if required | If the ordering of a test may only be done when the patient is either Male; Female or Non-specific e.g. PSA should only be ordered for male patients |
| Order screen | Add additional required data during ordering of tests for the visit | Select a Questionnaire from the dropdown list if required | Used to capture relevant and required data e.g. Patient weight required for the calculation of eGFR result. |
¶ Step 1.2.2: Add Alternate test descriptions
Using multiple names for the same test (e.g., Syphilis vs. RPR) can make it hard for staff to find and order the correct test when providers use a less common but still valid name. Adding variations and alternate names for a test in this fast tab, allows users to find a test during ordering using either standard or alternate descriptions.
To add other names and descriptions for a test:
- Expand the Alternate test descriptions fast tab to record alternate names for the test if applicable. Multiple alternate names may be added.
- Click on Add
- Enter the Alternate description in the line added
¶ Step 1.2.3: Add specimen containers
Specimen containers are configured so that, during visit creation, the system can automatically calculate and display the required types and quantities of containers needed to collect specimens for the ordered tests.
Orderable target tests must have at least one specimen container defined because a Sample record can only be received after the associated containers have been marked as collected and received. In turn, test results can only be entered when the Sample record status is set to Received.
When a Group test is ordered, the system will utilize the containers, defined for each of the tests included in the group, to calculate the number and type of containers required. This may however lead to the system calculating a disproportionate number of containers to collect. Good practice would suggest only adding the specimen container required to one/few relevant tests inside the group. Alternatively, adding the required containers to the Group test itself, will mitigate the risk of over calculating required containers, as the system will in this case ignore containers of the contents tests and only request the container(s) defined for the group test.
- Expand the Specimen containers fast tab to record the specimen containers required for collection in order to perform the test.
- Click on Add
- Select the required Specimen container from the dropdown list. The Description will automatically be populated based on Specimen container selected.
- Enter either the Count or Volume ml required to perform the test
Either the Count or Volume ml field will be available for data entry, depending on the option selected during the specimen container setup.
- If an Alternate container may be used to perform the test, select the container from the dropdown list and then add the count or volume.
Alternate containers may be selected during specimen collection for laboratory visits if they have been configured for the test. When an alternate container is defined, either the primary container or the alternate container may be collected and selected for the visit, but not both.
- If different container types are required to perform a test—for example, an Arthritis profile that requires both an EDTA whole blood container and an SST (Serum) container—each required container must be added on a separate line as an always-required primary container.
- Click Add to create a new container line in the grid, select the additional required containers from the dropdown list and add required volume or count.
- To Remove alternate containers only, select the relevant line then click on the fast tab button of the same name
- To remove an entire container line, select the line and click on the Remove fast tab button
¶ Step 1.2.4: Add laboratories
Laboratories must be defined for all Target and Charge tests to indicate which laboratories are able to perform or charge for the test.
Adding laboratories to Group tests is optional. When a Group test is ordered, the system uses the laboratories defined for the individual tests within the group to determine the performing laboratory.
When a test is ordered by a laboratory, the system checks whether the ordering laboratory is configured as a performing laboratory for that test:
- If the ordering laboratory is defined as a performing laboratory, the system will assign the same laboratory as the performing laboratory.
- If the ordering laboratory is not defined as a performing laboratory for the ordered test, the system will route the test to the default laboratory specified in line 1 of the Laboratories grid.
To add a laboratory:
- Expand the Laboratories fast tab
- Click Add. A new line will be added with the next line number automatically
- Select a Laboratory from the dropdown list. The Description will automatically be displayed
Except for the default laboratory in line 1, good practice suggests adding the other performing laboratories in alphabetic order in the grid to allow for easy maintenance in future. Use the Move up and Move down buttons to move laboratories in the desired sequence.
¶ Step 1.2.5: Add comments
- Expand the Comments fast tab
- Add any required Collection instructions in the memo box.
- Enter any relevant laboratory information or instructions for users capturing results in the User Notes memo box.
Collection instructions are visible in the Specimen collection section of Visit requests to assist users collecting samples.
User notes are visible in the Enter results forms to assist laboratory users.
¶ Step 1.3: Complete the Target test index tab
The General index tab contains and requires largely the same information for all test types. However, before a test can be activated, additional test type–specific information must be completed for Target and Group tests, in addition to the data entered on the General index tab.
To complete the required information for a Target test, select the Target Test index tab.
¶ Step 1.3.1: Add general Target test data
- Expand the Target test fast tab
- The Numeric slider button defaults to Yes. If set to Yes, the test will require a numeric value to be entered as the result. If however, the test should be resulted from a dropdown list of preset results e.g. Negative and Positive or 1:32 and 1:64; then set the Numeric slider button to No.
- If a Result comment only is expected during the resulting of the test, set the slider button to Yes. Typically set for interpretation comment tests.
- Enter the Turnaround time in hours. This is a mandatory field and will determine when tests are flagged as overdue.
- Select if a Historical check is required by selecting the relevant option from the dropdown list. For Numeric tests, the available option is Delta whilst for Non-numeric tests the available option is a Match check.
Whilst entering results, the previous result for the same test for the same patient is visible irrespective if the historical check was defined. If however a historical check is selected for the test, the system will additionally compare the current result to the previous result and display a warning flag to indicate a difference if relevant.
If Delta is selected for Numeric tests, a percentage value has to be added in the Result actions fast tab so that parameters are defined for the historical check comparison. An error message will be displayed if Delta is selected without entering a percentage value in the Result actions fast tab.
- Select if Authorization is required in addition to verification of the test results. The authorization options available include:
| Authorization option | Purpose |
| (none) | Authorization is not required. However, authorization may still be set in the Result actions fast tab for specific result groups and age and gender groups. |
| All | All results require authorization always irrespective of result group; result and age/gender groups. |
| Abnormal | Only abnormal results should be authorized. Abnormal results are defined as those outside the normal reference ranges or non-numeric values defined as abnormal. Authorization will be required irrespective of result group and age/gender groups. |
| Critical | Only critical results should be authorized. Critical results are defined as those outside the critical ranges or non-numeric values defined as abnormal. Authorization will be required irrespective of result group and age/gender groups. |
| Range | If a result range or non-numeric result should be authorized as specified for age/gender groups within a selected result group. The authorization specifications will have to be defined in the Result actions fast tab if Range is selected. |
- If a result should automatically be added for the test upon ordering, enter that results in the Auto results field e.g. NP (no print) may be defined for abnormal cells that are not always present and therefore not often resulted. The auto result may however be removed by the lab should a result be available for entry
- If a canned comment should default for the test irrespective of result and age/gender or result group, select the required Auto comment in the dropdown list
- If normal results should automatically be verified upon, set the Auto verify normal results slider button to Yes.
If results are automatically verified, the system will record the verification date and time as usual but the Verified by user will be recorded as Auto
¶ Step 1.3.2: Add Non-numeric result codes
Expand the Non-numeric result codes fast tab to add the list of result answers for non-numeric tests.
The Non-numeric results codes tab is only enabled when the Numeric slider button is set to No in the Target test fast tab.
- Click Add
- Enter a short Identifier to identify the result
- Enter the full Result definition to be displayed in D365 and on the report
- Select if the result should be regarded as Abnormal and flagged as such
- Select if the result should Auto verify
- Add as many codes as required by repeating these steps
- If resulting should be Restricted to result codes, set the slider button below the grid to Yes. If set to No, then any result could be entered for the test.
If Result comment only is set to Yes and/or Restrict to result codes is set to No, then no result codes need to be captured for a non-numeric test, as the test may be resulted using a comment and/or any result.
¶ Step 1.3.3: Create a result group
Result groups contain result specifications, reference ranges, and result actions linked to a specific laboratory or laboratory method. If all laboratories use the same method or similar instruments and therefore share the same reference ranges, specifications, and result actions, a single result group can be created and used across all laboratories.
Result groups are linked to the relevant methods and laboratories in the Methods FastTab, ensuring the correct ranges, actions, and specifications are applied per method and laboratory.
If an existing result group needs to be updated (for example, changes to specifications, actions, or reference ranges), best practice is to create a new result group rather than modifying the existing one. This ensures traceability for future reference.
- Expand the Result groups fast tab
- Click Add
The In use column is non-editable and the check boxes will automatically be ticked if the result group is currently selected for a method.
- Enter a descriptive Name
- The description of the test will default to the Test report name field. This is the name that will print on laboratory reports.
- Select the appropriate Units from the dropdown list if applicable
- For numeric tests, enter a numeric value to indicate with how many Decimals the result should be entered.
The value entered in the Decimals field automatically determines the number of decimal places used for reference ranges. When results are entered, the system will also automatically round the result up or down according to the defined decimal precision.
- If a Canned comment should automatically default to the result comment for the result group, select the comment from the dropdown list
- Enter an Acceptable low value if applicable
- Enter an Acceptable high value if applicable
If a result is entered equal to or lower/higher than the acceptable low/high value, a warning message will be displayed indicating the test has exceeded set limits. The user must then confirm that the results are correct.
These limits are typically used to alert laboratory users to extraordinary or critical results and to help prevent common data entry errors, such as entering a Sodium result of 12.5 instead of 125.
¶ Step 1.3.4: Add reference ranges and result actions
Reference ranges are typically added for numeric tests, but age and gender groupings can also be created in the Reference Ranges group so that result actions can be applied to both numeric and non-numeric tests.
- Select the parent result group in the Result groups grid if there is more than one created
- In the Reference ranges grid, click Add
- Select the appropriate Gender in the dropdown list i.e .Female, Male or Non-Specific
- Enter the start Age for the reference range or the age/gender group.
Use the following formats when entering age:
| Age Format | Example age | Enter as |
| #D | 15 Days | 15D |
| #M | 6 Months | 6M |
| #M #D | 1 Month and 15 Days | 1M 15D |
| # | 18 Years | 18 or 18Y *The system automatically selects Y if no age identifier is entered |
| #Y #M | 1 Year and 6 Months | 1Y 6M |
The age entered represents the starting age for a reference range and associated list of actions. The selected reference ranges and actions will be applied to patients from this age up to one day before the next starting age defined for the same gender.
- Enter a Critical low value if required
- Enter a Low value if required
- Enter a High value if required
- Enter a Critical high value is required
- The Reference range will automatically default based on the Low and High values entered but may be changed e.g. a range of 0 - 10 might be replaced with a range of < 10.
- Add Result actions for the Age/Gender group:
- Select the relevant Age/Gender group line in the Reference ranges grid if not selected yet
- Click Add in the Result actions grid
- For numeric tests, add a From and To values in order to define the range of results for which the actions should be applied. For Non-numeric tests, select the applicable Result code in the dropdown list
Actions for various ranges and result codes may be defined by adding lines for each range or each result code in the Result actions grid.
Note however that From and To values may not match or override From and To values in other lines.
- Acceptable Low and High values may be selected for Numeric tests. Values entered here will supersede limit values added for the result group.
- For non-numeric tests, the selected result code may be indicated as an Abnormal result code
- If a Marker should default for the specific result for the age/gender group, select it in the dropdown list
- If a Comment should default for the specific result for the age/gender group, select it in the dropdown list
- If an ICD10 code should default for the specific result for the age/gender group, select the Diagnosis code in the dropdown list
- If a delta check should be performed for numeric tests, enter the value in Delta% field. If the current result differs more than the percentage value entered to the previous result, a delta flag will be added for the test.
- Select if the result should Auto verify. Note this field is only enabled if Auto verify normal results was set to No in the Target tests fast tab.
- Select if the results should require Authorization
Continue to add Age/Gender groups followed by the reference ranges and/or result actions for every possible Age/gender group. If an Age/Gender group's definitions may be applied to another, use the Copy function to copy the ranges and result actions:
- Select the Age/Gender group to be copied
- Click on the Copy button
- Select a Gender and enter an Age in the dialogue box.
- Click OK. If the combination already exists in the grid, an error message will be displayed indicating this. Make the necessary changes and try again.
- The copied group with selected details will now be added to the group and will also include result actions if any were defined.
Below is an example of a Result group with it's Reference ranges and the Result actions for the selected Age/Gender group.
¶ Step 1.3.5: Add methods
- Expand the Methods fast tab
- Click Add
- Select a Method from the dropdown list
- Select the appropriate Result group from the dropdown list. The reference ranges and result actions defined for the selected result group, will then be applied to the method selected.
- If some laboratories use a different method that must be specified, or require a different result group with alternative result definitions and actions, then add the additional methods to the grid and select the appropriate result group to use for each method.
- A method and result group combination may be defined for specific laboratories by selecting the appropriate method line and then adding the applicable laboratory in the child Laboratories grid.
- If more than one method is added to the grid, the Default method should be identified by selecting the method and then clicking on the Set default button
Any laboratories defined in the General index tab, but not selected in the Methods fast tab, will automatically utilize the Default method and associated result group when ordered. It is therefore suggested to set the method and result group, that applies to most laboratories, as the default.
¶ Step 1.4: Complete the Group test index tab
The Group test index tab is only enabled and completed if the test type selected in the General index tab is Group. The contents tests to be included in the Group during ordering and entering of results, is specified in the Group test index tab and therefore mandatory once the General index tab is completed and before the Group test may be activated.
¶ Step 1.4.1: Define Group test contents
Once the General index tab of the Group test has been completed:
- Select the Group test index tab
- Expand the Group test fast tab
- Create a Group to house the contents tests:
- In the Groups grid buttons, click Add
- Enter a descriptive name for the Group
- Add Group contents:
- Click Add in the Group contents grid buttons
- Select a Test from the dropdown list. The test details columns will automatically be populated with data of the selected test
- Add as many tests as is required to be included in the group following the steps above
Only active tests will be visible and selectable in the Tests dropdown list.
If the Multi Department Group slider button in the General index tab has been set to No, then the Tests dropdown will be limited to tests with the same Laboratory department as the Group test.
¶ Step 1.4.2: Add Selection groups
If a different complement of tests than the default is required for specific providers, laboratories, or visit priorities, special Selection Groups can be created to accommodate this requirement. For example, if a specific doctor (provider) requests that an ESR test must always be included when a Full Blood Count profile is ordered, a selection group can be configured to ensure this requirement is met.
The Selections feature allows a single test to be used for ordering test profiles, while automatically ordering the correct constituent tests based on defined selection criteria. This enables laboratories to:
- Use a single test for a profile, regardless of varying content requirements
- Reduce confusion during test ordering
- Ensure the correct tests are ordered according to special requirements
- Automate test ordering instead of relying on users to remember special arrangements
- Prevent incorrect ordering, analysis, and reporting
To create a selection group:
- Create another Group with the desired Group contents in the Group test fast tab
- The original / default group may be copied by:
- Selecting the Group to copy in the grid
- Click on Copy in the Groups grid buttons
- Enter a descriptive Group name for the new group in the Copy group test dialogue
- Click OK
- The new Group will now be added to the grid and the Group contents may be updated to match the requirements for the specific group by adding or removing some of the contents
The first group created will automatically be set as the default group, and its contents tests will be ordered for visits where the selection criteria does not match. A different group can be set as the default by selecting the group and clicking the Set Default button in the groups grid.
- Expand the Selections fast tab in the Group test index tab
- Click Add in the Selections fast tab buttons
- Select the appropriate Selection type in the dropdown list i.e. Provider; Priority or Laboratory
- In the Selection value column, select a record/value from the dropdown list
- In the Group column, select the Contents Group to be ordered for the Provider; Laboratory or Priority specified
¶ Step 1.5: Activate the test
Once all mandatory fields of the test have been completed, access the General fast tab in the General index tab and set the Active slider button to Yes.
If any mandatory fields have not yet been completed, an error message will be displayed indicating which fields to complete and the test will not be allowed to be activated.
Once a test has dependent orders and results, it cannot and should not be completely deleted. Therefore, if a test is no longer in use, set the Active slider button to No so that it is no longer available for ordering but can still be traced when needed.
¶ Step 1.6: Troubleshoot and view dependencies
The Laboratory tests form provides access to a full Audit log as well as Related information pane fact boxes to access dependent records and last edited information.
- Expand the related information pane on the right of the form by clicking on the Related Information icon
- Expand the various fact boxes to view related data including:
| Fact box | Contains |
| Included in groups | Lists Group tests in which the selected test is included as part of the contents tests |
| Included in calculations | Lists Calculation records where the test has been specified |
| Laboratory quality controls | Lists Quality control records in which the test has been utilized |
| Last edit | Displays date and time of last modification event as well as the name of the worker as a quick way to gauge if a modification was recently done that could have caused a problem or difference in output |
- Click on record names listed in the fact boxes to access the records directly
To view a full history of changes for a selected test, go to the Audit Log Index tab. This tab displays all modification events in chronological order, with the most recent changes shown first.
You can also sort and filter the grid to quickly locate specific updates or changes based on your needs.
¶ Step 2: Setup Laboratory result calculations
Laboratory result calculations can be configured to automatically generate test results and/or result comments based on the outcomes of one or more tests whilst taking into consideration defined conditions.
- Go to Clinical lab information management > Setup > Laboratory > Laboratory result calculations
- Click New in the action pane
- Enter a short Name for the calculation
- Enter a longer Description for the calculation
- Select the appropriate Type from the dropdown list i.e.
- Post The calculation is evaluated after results of the trigger tests have been entered
- Pre: The calculation is evaluated on ordering of the tests and does not have to wait for the results of the trigger tests
- Select the Target test from the dropdown list.
The Target Test dropdown only shows active laboratory target tests. This is the test for which the system will calculate and populate the result and/or result comment.
- The Active slider is set to No by default when a new item is created. It can only be switched to Yes after all mandatory fields have been completed. If you try to activate the test before completing these required fields, the system will display error messages indicating which fields still need to be filled in.
- Expand the Trigger tests fast tab
The entry of the result for a Trigger test is what prompts the calculation to be evaluated. If more than one trigger test is added, the results of all the trigger tests must be entered before the calculation is evaluated.
- Click Add in the Trigger tests fast tab buttons
- Select the appropriate Test from the dropdown list
- Enter a short identifier as a Variable label for the trigger test.
The Variable label is a unique identifier used to refer to the test in the Calculation formulas and conditions.
- Select Allow NP Result if the calculation should be evaluated even when the result for the trigger test is NP.
NP is entered as a result for a test when the laboratory did not analyze the test or could not derive a result. NP or ‘No Print’, prevents the test from appearing on laboratory reports to providers.
- Add all the required Trigger tests by following the steps above.
- Expand the Variables fast tab
Conditions to be considered during the evaluation of the calculation, other than test results of trigger tests, may be added in the Variables fast tab. The variables are optional when Trigger tests have been defined for the calculation.
- Click Add in the Variables fast tab buttons
- Select a Data source from the dropdown list
- Enter or select a Selection value for the data source if required e.g.
- If Test method is selected as a data source, then in the Selection column indicate the Test for which the method should be inspected
- If Provider is selected as a data source, then in the Selection column select the Provider from the dropdown list
- If Questionnaire response is selected as a data source, then in the Selection column, locate and select the relevant Question of a specific Questionnaire. The Question ID will automatically be populated by the selected record.
The Selection value field will only be enabled for certain selected Data sources where the additional information is required.
- The Description field is non-editable and automatically displays the description of the selected data source record
- Add a unique identifier as a Variable label to be used in the calculation to refer to the condition
- Add as many variables as needed by following the steps above
- Expand the Calculation formulas and actions fast tab
- Click Add in the fast tab buttons
- The Calculation line number is automatically assigned in numeric order. To change the line number of the calculation line, use the Move up and Move down buttons to update all lines affected.
The calculation lines are evaluated one by one in numeric sequence based on the Calculation line number. Lines are evaluated until a line is found that meets the conditions of the calculation, whereupon the true calculation line only is executed. Once a true statement line is evaluated the system exits the calculation evaluation and does not evaluate other calculation lines. Good practice therefore suggests adding calculation lines is a logical order, typically entering lines with most stringent conditions first.
- If relevant, enter a Condition to be met for this line to be evaluated. Enter the condition in similar syntax as would be used in Excel spreadsheets
- If relevant, enter a Formula to be used to calculate the result in the same syntax as would be used in Excel spreadsheets
- If a specific result should be entered e.g. A result code for a Non-numeric test, then enter the appropriate value in the Enter results column
- If a result comment should be added, select the appropriate canned comment in the Add result comment dropdown list
If a result comment is added via the calculation, ensure to select the correct Comment option above the calculations grid i.e. Append or Replace.
If Append is selected (default), then the result comment will be appended and added below any existing result comments.
If Replace is selected, then existing comments for the test will be cleared and replaced with the result comment in the calculation.
- Add as many calculation lines as needed by following the steps above
- Once all calculations have been added, set the Active slider button in the General fast tab to Yes
Calculation example 1:
In calculation example 1, the calculation would be evaluated as follow:
- If the Method (T) is Architect and the Result (M) is less than 10.00, then enter the result a N (which translates to Negative as set up for the test) ELSE IF THIS CONDITION IS NOT MET
- Then if The Method (T) is Architect and the Result (M) is more than 9.99, then enter the result a P (which translates to Positive as set up for the test) and append the canned comment HEPAMP in the test result comment field ELSE IF THIS CONDITION IS NOT MET
- Then if the Result (M) is less than 25.0, then enter the result a N (which translates to Negative as set up for the test) ELSE IF THIS CONDITION IS NOT MET
- Then if the Result (M) is more than 24.9, then enter the result a P (which translates to Positive as set up for the test) and append the canned comment HEPAMP in the test result comment field ELSE IF THIS CONDITION IS NOT MET
- Then exit the calculation and do nothing
Calculation example 2:
In calculation example 2, there are not conditions, hence the formula would be evaluated as soon as the last of the trigger tests is resulted. The formula is a simple calculation adding the results of all the trigger tests together. The result of the formula would then be entered as the result for the target test.
Calculation example 3:
In calculation example 3, the calculation would be evaluated as follow:
- If the patients age in days is less than 700 days, then using the patient height, as recorded in a questionnaire response during ordering of the test, as well as the Creatinine result, calculate the eGFR result with the defined formula ELSE IF THIS CONDITION IS NOT MET
- Then if the patient if Female, using the patient weight as recorded in a questionnaire response during ordering of the test, as well as the Creatinine result, calculate the eGFR result with the defined formula ELSE IF THIS CONDITION IS NOT MET
- Then if the patient if Male using the patient weight as recorded in a questionnaire response during ordering of the test, as well as the Creatinine result, calculate the eGFR result with the defined formula ELSE IF THIS CONDITION IS NOT MET
- Then exit the calculation and do nothing
In the evaluation above it is important to note, that by eliminating patients younger than 700 days in the first line, this automatically means that the patients considered in lines 2 and 3 are older than 700 days.
Good practice suggests that calculations should always be set up in a non-production test environment and thoroughly tested before it is implemented in a production environment.