The QML Result Interface is a single component for each of the output types (EDI or Script), even though different LIS/EMR vendors require different message formats and each script is customized for each customer. Within each of the two components are proprietary mapping capabilities that allow format changes through configuration options to vary the output required for the customer/vendor. This provides the flexibility to offer custom functionality but eliminates the need to maintain individual interfaces for each customer.
QML was designed to allow multiple, simultaneous outputs to one or multiple LIS/EMRs. The EDI and Script components are independent from each other and can coexist on the same system, as well as multiples of the same output type can also be configured, all without additional hardware. This allows an IDN with multiple facilities that might have multiple LIS/EMRs to maintain a single QML for all facilities, yet provide result interfaces to their respective LIS/EMRs.
View the full list of interfaced LIS/EMRs
ADAC
Cerner Classic
Cerner Citation
Cerner Millennium Lab/PC
Cerner Premier
CHCS
CPSI
Eclipsys
EHS
Engines/Repositories/EMR
EPIC EMR and LIS
Healthland
HMS
Iatrics
McKesson ALG
McKesson HorizonLab
McKesson Paragon
McKesson StarLab
McKesson StarFinancials
Meditech Magic HCA
Meditech Magic
Meditech Client Server
Misys/Quadramed
Molis
OMNILAB
OPUS Lab
Orchard
RPMS
Siemens Invision
Siemens MS4
Siemens NoviusLab
SoftLab
Sunquest AI/IGO
Sunquest ComLab
TripleG
TD Synergy
VistA
The EDI is a POCT1-A compliant HL7 result interface with optional receipt of an Application Acknowledgement containing the LIS-assigned accession number and/or reason for rejection. When the LIS/EMR cannot process unsolicited results via the EDI, results can be entered via a Script (aka Terminal Emulation) customized for each result entry screen. Both the EDI and Script options can handle unsolicited and solicited results. For more information about unsolicited and solicited results, click on the tabs below.
Unsolicited results are those for which the receiving system does not have an order and thus, upon receipt of the result, must have the capability to create an order on the appropriate patient event and post the result. Sample identification for these types of results is typically either via the patient’s medical record number or account number, unlike solicited results, where the sample is typically identified by the order/accession number. The unsolicited method of sample identification is almost exclusively used for testing performed outside the laboratory such as the point of care where there is no access to the order/accession number. A good example of this is the glucose testing performed by nursing where they only have access to the patient’s medical record or account number.
The patient ID entered/scanned on the testing device can also be validated by QML with receipt of patient information through an ADT feed. Receipt of patient registration messages is used to:
- Validate the patient ID received from the device
- Select an episode/account when the patient ID received from the device is the medical record number
- Provide the account number, medical record and other patient information in the result message to the LIS/EMR for those that require more than just a single patient identifier
- Provide data back to the device software/devices that send host-query messages to QML requesting patient information
- Pass the same ADT message received to device software that can accept patient information and then be used for creating patient lists in their devices
Solicited results are those for which the receiving system has an open order that is waiting for results to be posted. This is the processing model used almost exclusively within the laboratory. When used for point of care results, QML can provide the LIS/EMR with the order/accession number entered on the device. Upon receipt of the result, the receiving system will post the results to the existing order. This method is generally used for tests performed within the laboratory on POCT devices. A good example of this might be the AM glucose results that are performed by phlebotomy during morning draws using the same glucose meter used by nursing. The lab would probably use an already created accession number to identify these results. Thus, when the meter docks in the lab and results are sent to the LIS, they will be sent with the accession number whereas the results performed by nursing will be sent with the patient’s medical record and/or account number.
The order ID entered/scanned on the testing device can also be validated by QML with receipt of orders directly from the HIS/EMR or an LIS. Receipt of order messages is used to:
- Validate the order number entered into the device
- Select the appropriate order if the patient ID was entered into the device
- Use the ADT information for reference range processing and flagging when sending results directly to the EMR
An orders interface is not required if the order/accession number was scanned into the device. The results will be sent as a solicited result with the sample ID entered/scanned.
QML can accommodate a combination of both solicited and unsolicited results. This is beneficial in situations where some of the testing is performed using the patient ID, but other testing is performed using an order/accession number. Configuration options, not custom code, identify results as either solicited or unsolicited and are then mapped/entered accordingly.
