Lab Reporting Practices - EPLHA.05
PLIS uses standardized laboratory data nomenclature, such as LOINC codes and display names. However, there are variations in reporting of these attributes by different laboratory information systems (LIS). The following are some known laboratory reporting variations that may be reflected in your laboratory data.
PLIS accepts and displays abnormal flag codes as sent by the LISs. Labs send abnormal flags for chemistry and hematology results, but not necessarily for microbiology cultures and never for pathology reports.
Analytical reference ranges are not standardized across reporting laboratories.
In some cases, comments related to a specific battery result that should be sent as part of the result are sent as discrete batteries.
Some LIS send comments at the specimen level, which will appear against every battery that is collected on that specimen. Specimen level comments on each battery may be duplicated if multiple tests were collected on a single specimen. Comments that may apply to a single battery will appear on all batteries for that specimen.
Corrected flags are sent in the message when previously reported results have changed for chemistry, hematology and may be sent for microbiology tests by some, but not all, performing labs.
Pathology amended/corrected reports are not flagged.
While the pCLOCD coding system has been adopted as the standard for PLIS, laboratories use a number of local codes such as XXX or XBC codes.
The creation of local codes is necessary when the definition of the “test” does not meet the specifications required for LOINC. The use of local codes is in part due to LIS configuration limitations and the creation of “tests” that have been set up to ensure all relevant laboratory data is captured.
The reporting lab and the performing lab are the same unless otherwise noted in the ‘observation annotation’.
Notes: The performing lab will be identified in the observation annotation when the reporting lab enters the contents from an out-of-province test into their LIS.
The following have not been standardized across laboratories and result in inconsistencies in Laboratory reports:
- specimen description,
- site description, and
- specimen type terminology and usage.
This is most prevalent in microbiology and pathology reporting.
The clinical content of non-discrete lab data (i.e., text based laboratory reports such as pathology) appears as a string of text with line breaks.
Note: The presentation of pathology reports is adequate for interpretation by clinical end users, but is not considered acceptable for consumption by non-healthcare professionals (e.g., patients).
PLIS may translate units of measure sent from LIS to the Uniform Coding of Units of Measure (e.g., giga/L has been changed to 10*9/L).