APHL Detor PHL and HCO Post-Production Update Process

Owned by Emma Sudduth
Last updated: Dec 19, 2024 by riki.merrick
5 min read

With the use of Detor, post-production changes to tests will require a coordinated effort between the PHL, APHL, and all impacted HCOs. While APHL will provide the support necessary for panel adjustments to be added to Detor, it is the responsibility of the PHL to notify and coordinate these updates with APHL and its partner HCO(s).

The intended audience for this process document includes APHL’s Detor Team and both PHLs and HCOs that are in production with Detor.

Update Scope

The following process is relevant to a PHL that needs to do one of the following:

  1. Add a new test to an in-production panel for a new disease

    1. This would be the addition of a new test for an analyte that indicates the presence of or lack of disease that IS NOT currently addressed in the panel. An example includes MPS II addition to the Newborn Screening (NBS) panel.

  2. Add a new analyte to an in-production panel for an existing disease

    1. This would be the addition of a new test for an analyte that indicates the presence of or lack of disease that IS currently addressed in the panel. Examples include a new amino acid pathway addition to Amino Acid Disorders or a second-tier test for existing disease (e.g., mutation detection for GAMT).

  3. Add a new order to an in-production domain

    1. This would be the addition of a new order to be received by the public health lab for a domain already in production. Examples include expanding NBS to sibling or parent testing when newborn screening indicated an existing disease that other family members should be checked for and adding diagnostic testing per direction by the newborn screening follow-up team.

Note that this process is not relevant for establishing Detor with a new HCO partner, adding a new testing domain with an established Detor-partnered HCO (e.g., adding microbiology when NBS is live), nor adding a new laboratory section / group of panels within an in-production testing domain (e.g., adding TB testing when Microbiology is live).

APHL will review all post-production update requests and reserves the right to notify the submitting PHL if their request exceeds the level-of-effort expected for a simple post-production update. Should this happen, the PHL, partner HCO, and APHL will collaborate to determine next steps for TA engagement.

Post-Production Update Process

Task

Responsible

Schedule

Task

Responsible

Schedule

1

Notify Impacted HCO(s) of Update

Include:

  • Details on and requirements of update

  • Timeline for update go-live at PHL

  • Notification that APHL Support will be requested, and additional information will be shared

  • Impact if HCO(s) is not prepared by production date

PHL

As soon as PHL is aware of update

HCO updates may need to follow a rigorous approval and scheduling process so notification and planning should begin ASAP.

2

Request APHL Support via Help Desk

Submit a ticket and include the following information:

  1. The relevant service: ETOR

  2. The relevant panel (if your PHL has multiple panels in-production)

  3. Details of the panel adjustment(s), including:

    1. Type of adjustment

      1. New analyte for a new disease,

      2. New analyte for an existing disease, or

      3. New AOE/ASC questions (if appropriate)

    2. Name of test

    3. Possible values for test results

    4. The status of the adjustment in your LIMS

      1. Whether it's coded into the system

      2. Whether it’s programmed to output

    5. The date the test will be implemented at the PHL

  4. Any relevant documentation, such as a compendium

PHL

As soon as PHL is aware of update and can provide ticket details, ideally no less than 90 days before production update

3

Review and Respond to Support Ticket

  • Assign ticket and add appropriate participants

  • Review ticket details and request any additional details needed to scope and schedule work

  • Notify PHL if the update cannot be handled via this simple process and requires more significant TA engagement

APHL

Within 1 week of ticket receipt

4

Provide Schedule and Communication Details to PHL

Provide PHL:

  • A target date for updated mapping to be complete in Detor (i.e., when mapping will have been configured in Detor’s ONBOARD environment and is ready for testing with partners)

  • The value(s) the partner HCO(s) should expect for the panel adjustment

  • A reminder to let the partner HCO(s) know what will happen if they don’t update their EHR by the implementation date

APHL

Within 1 week of receiving all required details from PHL

5

Communicate APHL Support Information to Impacted HCO(s) and Coordinate Testing

Include:

  • APHL’s target date for updated mapping to be complete in Detor (i.e., when mapping will have been configured in Detor’s ONBOARD environment and is ready for testing with partners)

  • Potential testing windows (after APHL’s target date for updated mapping to be complete in Detor) for PHL/HCO(s) update validation

  • The value(s) the partner HCO(s) should expect for the panel adjustment

  • A reminder to let the partner HCO(s) know what will happen if they don’t update their EHR by the implementation date

PHL

As soon as details are received from APHL

6

Update Detor ONBOARD Environment to Support Update

Update Detor and provide update within ticket to reflect completion and readiness for PHL and HCO testing.

Note that addition of new tests will require sign off in Symedical Waypoint, so the approprate folks on the PHL and HCO side need to be included in the notifications

APHL

Depends on update complexity; expected timeline will have been communicated by APHL via ticket

7

Update LIMS TEST Environment to Support Update

 

PHL

Depends on update complexity; expected timeline will have been communicated by PHL via ticket

8

Update EHR TEST Environment to Support Update

HCO(s)

Depends on update complexity; expected timeline will have been communicated by HCO to PHL

9

PHL and HCO Testing via Detor ONBOARD

PHL should coordinate and monitor all testing with HCOs. If issues arise that are related to Detor processing, a service ticket should be submitted.

PHL

 

10

Notify APHL of Confirmed Production Date

This update should be provided within the original ticket.

PHL

No less than 2 weeks before the planned production use date

11

Update Detor PRODUCTION Environment to Support Update

Update Detor and provide update within ticket to reflect completion and readiness for PHL and HCO go-live.

APHL

Before the confirmed production use date

Risks of Not Updating EHR for Panel Adjustments

Should a panel adjustment be implemented at the PHL/LIMS without updating Detor and/or the HCO EHR, there are multiple types of errors that could occur. The HCO may receive an error result message, certain result data elements could be rejected, or all result data could be rejected. This could cause major delays in data transfer and/or missed diagnoses, and ultimately affect patient care.