Laboratory Order Service

Manages laboratory test ordering, specimen tracking, and integration with lab information systems (LIS)

Service HL7 v2 Safety Critical

Overview

The Lab Order Service manages the complete laboratory testing lifecycle from order entry through result reporting, with integration to laboratory information systems.

🔄 Integration Standard

This service uses HL7 v2.5 for bidirectional communication with Laboratory Information Systems (LIS). See ⚠️ LabOrderWorkflow (broken link) for the complete process.

Key Capabilities

HL7 v2 Integration

Outbound (ORM - Order Message)

MSH|^~\&|EHR|HOSPITAL|LIS|LAB|20231211120000||ORM^O01|MSG001|P|2.5
PID|1||MRN12345||DOE^JOHN^||19800101|M
ORC|NW|ORD001||||||20231211120000
OBR|1|ORD001||CBC^COMPLETE BLOOD COUNT^L|||20231211120000

Inbound (ORU - Result Message)

MSH|^~\&|LIS|LAB|EHR|HOSPITAL|20231211140000||ORU^R01|MSG002|P|2.5
PID|1||MRN12345||DOE^JOHN^||19800101|M
OBR|1|ORD001||CBC^COMPLETE BLOOD COUNT^L|||20231211120000
OBX|1|NM|WBC^White Blood Count^L||7.5|10*3/uL|4.5-11.0|N|||F
OBX|2|NM|HGB^Hemoglobin^L||14.5|g/dL|13.5-17.5|N|||F

Critical Value Management

  1.

    Critical Value Detected

    LIS identifies life-threatening result and flags for immediate notification

  2.

    Provider Paged

    Automated page sent to ordering provider with patient and result details

  3.

    EHR Alert

    Critical value banner displayed in EHR when provider accesses patient chart

  4.

    Acknowledgment Required

    Provider must acknowledge receipt and document clinical action taken

  5.

    Escalation (if needed)

    If not acknowledged within 15 minutes, escalate to attending or supervisor

  6.

    Documentation

    All notification attempts and responses logged for compliance

🚨 Critical Values

Automatic escalation for life-threatening results:

  • WBC < 2.0 or > 30.0
  • Hemoglobin < 7.0
  • Platelets < 20
  • Potassium < 2.5 or > 6.5
  • Glucose < 40 or > 500

Time is critical - these values require immediate provider action.

Technology Stack

  • Runtime: Java 17
  • Framework: Spring Boot
  • HL7 Parser: HAPI
  • Database: PostgreSQL
  • Message Queue: Apache Kafka

Safety Features

  • Order appropriateness checking
  • Duplicate prevention (same test < 24 hours)
  • Fasting requirements
  • Medication interference warnings
Edit this page