UCSDI V7 Element Support

CDC Looking for uses cases to support inclusion of these elements in USCDI V7:

Specimen received date/time (when the testing lab received the specimen)

• this correlates to notification that specimen is in lab (for example a repeating test on a patient, an urgent test can now be worked on, sample already drawn and in lab, so could avoid re-order, or get add-on test)

• affects the evaluation of specimen acceptabilty - but this would then be reflected in specimen condition (see chat) - also important for medicolegal chronology

• is a CLIA required element (most important for the lab)

• any element that must be included in the report, the EHR-s has to support this element

• avoid re-order, or get add-on test

• understand TAT - see articles referenced below

Laboratory Test Performed Date/time (the date/time the test is conducted by the testing laboratory)

• is this affected by prior auth evaluation (or is this the collection date)?

• re-analyzing of samples (genetics)

• supporting internal QA

• understanding relations between tests performed at different institutions

• Type of cross-match timing (within 72 hours)

• Needed for scheduling of certain imaging procedures (CT with contrast needs kidney function test results first)

• Understanding of protocol adherence: Stroke or Heart attack

• Pharmacy needs to know if current test results (kidney function) are available before administration of certain drugs

• ​https://pmc.ncbi.nlm.nih.gov/articles/PMC2282400/#:~:text=Abstract,initial%20goal%20for%20acceptable%20TAT.Open - see Table 1 for QL project of TAT tracking

• Ref#24 in Laboratory Turnaround Time shows 1996 CAP Q Probe for ED/ICU

• ​https://www.captodayonline.com/lis-ehr-results-transmission/Open

• ​https://www.captodayonline.com/tag/q-probes/Open

Result Report – Status changing date/time (Most commonly used as the date/time a result is reported as final or in certain situations when the status of a result changed, i.e., from Preliminary to Final, from final to correction)

• this can affect patient treatment (micro or pathology), as changes in results should be re-evaluated

• this is for the date, not the status change, so helps to pull together the treatment/diagnostics timeline, identifying what result is the newest

• this also has medicolegal implications (result chronology)

• it could be covered by: Diagnostic Report Date ?

  • if we think yes, then we need to submit a comment about updating the definition for this

  this is important for the doc to know, that a new report is available (and of course medicolegal reasons)

• there are papers about this one

  • ​https://pmc.ncbi.nlm.nih.gov/articles/PMC3038104/Open

  • ​https://pmc.ncbi.nlm.nih.gov/articles/PMC3038104/Open

  • Understanding the management of electronic test result notifications in the outpatient setting

  • Timely follow-up of abnormal diagnostic imaging test results in an outpatient setting: are electronic medical records achieving their potential?

  • ​https://pmc.ncbi.nlm.nih.gov/articles/PMC3243200/#:~:text=Wahls6%20defined%20missed%20results,(15%E2%80%9354%25)10.Open

  • 7/19 studies in this article show impact of missed lab tests:

    • Ref #32 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

    • missed cancer diagnosis:

      • Ref#45 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

      • Ref#40 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

      • Ref#31 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

      • ref#29 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

    • adverse drug events due to abnormal TSH: Ref #42 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review

    • related to abnormal serum potassium level: Ref#38 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review