Interface Scheme between Lis system and his system

Back scene  
Hospital Information Systems mainly include his (Hospital Information System) system, Lis (Laboratory Information System) system, and PACS (Picture Archiving and Communication System) system. His system focuses on management and billing, and provides interfaces for data interaction with professional systems. As a professional information system, lis and PACS focus on communicating with medical equipment to complete the storage, statistics, and analysis of inspection data and image data. Because his system developers generally do not develop lis and PACs on their own, hospitals usually entrust third-party professional companies to develop and implement lis and PACS systems. Hospital and related information system developers (his system, Lis system, and PACS system developers) should pay sufficient attention to data exchange and sharing between different systems.  
The following focuses on the implementation scheme of Data Interaction Between lis and his systems, and discusses how hospitals, his system developers, and Lis system developers coordinate and cooperate in the implementation of his and Lis systems.

Definition
 
Some concepts and functions related to his and Lis systems are briefly described before specific discussions.  
1. Inspection doctor's advice refers to the test items prescribed by doctors for the treatment of patient diseases, such as blood routine, urine routine, liver function, two-half, glucose tolerance, etc., which can be a single item, it is also a combination of projects where the doctor's advice is written in the patient's medical records.
2. Electronic Inspection doctor's advice refers to the inspection doctor's advice that the nurse enters into the medical records through the computer system in order to charge the patient, thus, according to the specifications of the charging unit, stored in the computer system, electronic inspection doctor's advice. For example, in the medical records, the doctor's advice is written as "liver function and blood sugar", and the electronic doctor's advice is "liver function" and "Blood Sugar ".
3. The inspection application form refers to the document issued by the doctor and used by the nurse as a result of sampling and finally provided to the inspection technician for inspection operations. There is a unique serial number on the inspection application form. It contains patient information and information about the items to be tested by the patient.
4. An electronic inspection application form refers to an inspection application form stored in LIS or his system. It can be formed in multiple ways: a) independently completed by the LIS System: The inspection application form is entered into the LIS system by the nurse or the laboratory; B) completed by the his system, the nurse enters the inspection doctor's advice into his system, and his system automatically converts the electronic inspection doctor's advice (manual adjustment allowed) into an electronic inspection application form according to the set rules, or the nurse enters the test application form into his system; c) the LIS system and his system work together. The nurse first enters the test order into his system, the LIS system then automatically converts the electronic inspection orders in his system (manual adjustment allowed) into electronic inspection tickets according to the set rules.  
5. Relationship between electronic doctor's advice and electronic application form there is a certain relationship between them. Generally, one or more electronic inspection orders correspond to one electronic inspection application form, for example, the above two electronic doctor orders "" and "Blood Sugar" correspond to an electronic application form, but there are a few exceptions, for example, the electronic inspection doctor's advice "glucose tolerance check" should apply for a three to five electronic inspection application form. For this reason, in the process of switching from electronic inspection doctor's advice to electronic inspection application form, in addition to setting conversion rules, manual adjustment is also required to meet the actual work needs.
6. the test sample refers to the patient sample, such as blood, urine, stool, and cerebrospinal fluid, that is collected by the nurse for inspection by the laboratory. A sample corresponds to a test application form, the two are in a one-to-one relationship.
7. The inspection report is a written report that is issued to the clinical department and contains the test results after the Department accepts the test application, completes the sample test, and reviews the results.
8. electronic inspection reports are inspection reports stored in the computer system, which can be conveniently queried for reading and printing.
9. the test fee is charged for the patient. The fee is calculated based on the doctor's advice. If the hospital has his system, the his system calculates the fee based on the electronic doctor's advice. When the his system starts charging there are generally three situations: a) charges immediately after the electronic inspection of medical orders; B) the inspection department is charged after receiving the inspection application form or electronic inspection application; c) the Inspection Department is charged only after the inspection report or electronic inspection report is released to the clinical department.  
10. Patient information refers to the natural attributes of a patient, such as the medical record number, name, gender, and date of birth. It is stored in the his system and is generally obtained through the medical record number.  
11. Doctor's advice interface refers to the interface provided by his and Lis vendors for mutual interaction between his and Lis systems. Program , Databases and related documents. It is determined by three parties, namely the hospital, his system, and Lis system, which must be observed in the system implementation process.

interface solution

solution 1

workflow:
1) a nurse uses the his system to enter the doctor's advice, the inspection doctor's advice is electronically stored in his system.
2) the nurse samples the Doctor's test application form, then, the test application form and its unique sample are sent to the laboratory.
3) the laboratory uses the LIS system to enter the medical records, dates, execution units, and other information on the test application form. The LIS system uses these characteristic information to read and display the relevant electronic inspection orders from its system, the lab displays the inspection items in the current inspection application form and The electronic inspection doctor's orders are checked one by one, and the his system will be notified to charge for the inspection after confirmation.
4) the laboratory will pre-process the samples and perform on-board inspection until the inspection results are obtained.
5) the laboratory uses the LIS system to review the inspection results. After confirmation, the inspection report is released. If necessary, the electronic inspection report is returned to the his system.

comment:
1) the hospital's business process is not ideal, because the inspection department reads the electronic inspection form from the ward, instead of the electronic inspection form it wants, it must convert the electronic inspection form to the electronic inspection form through careful manual comparison, the comparison should have been completed by the ward. The comparison is cumbersome, error-prone, and consistent. The solution to the plugging cost is not guaranteed by * reasonable operation procedures, but by * personal responsibility, it is not easy to determine the responsibility when a problem occurs;
2) The his system vendor needs to compile an electronic inspection report query program;
3) The LIS system manufacturer has implemented different interface programs for different his systems. due to unreasonable operation procedures, the interface program must handle various nonstandard operation details, some existing problems cannot be overcome.
4) during implementation, inter-department coordination is difficult and the program debugging cycle is long.
5) during maintenance, strengthen coordination between lis and his systems.
6) this solution has been implemented in the Third Hospital of North medicine, but the user needs to change.

solution 2

workflow:
1) a nurse uses the his system to enter the doctor's advice, the inspection order is electronically stored in his system;
2) the nurse uses his system to print the inspection application form and sample the form, then, the test application form and its unique sample are sent to the laboratory. It is worth noting that the inspection application form here is not written by the doctor. It is formed by the his system according to the set rules by the electronic inspection doctor's advice. The conversion process allows the nurse to adjust it. It has a unique serial number, you can use a bar code.
3) use the LIS system to enter the unique serial number on the application form, you can use a bar code reader. The LIS system uses the serial number to read the corresponding electronic inspection application form from his system and displays the application form. After the inspection department confirms the application, it notifies his system to charge for the inspection. It is worth noting that the laboratory does not need to compare the results.
4) the Laboratory conducts sample pre-processing, performs on-board inspection, and obtains the test results.
5) the laboratory uses the LIS system to review the test results. After confirmation, the inspection report is released. If necessary, the electronic inspection report is returned to the his system.

rating:
1) the hospital's business process is ideal, the solution to the plugging cost problem is ensured by * reasonable operation procedures, and the responsibility is easily determined when any problem occurs.
2) the his system vendor needs to prepare the conversion procedure from the electronic inspection doctor's advice to the electronic inspection application form and the query procedure of the electronic inspection report;
3) The LIS system vendor must implement different interface programs for different his systems. Because the operation process is reasonable, no insurmountable problems exist;
4) implementation is relatively easy;
5) maintenance is relatively easy;
6) This solution has not yet been implemented by hospitals, but the three hospitals of Beijing Medical University have already approved the solution.

solution 3

workflow:
1) a nurse uses the his system to enter the doctor's advice, the medical doctor's order is electronically stored in his system.
2) the nurse uses the LIS system to print the test application form and sample the form, then, the test application form and its unique sample are sent to the laboratory. It is worth noting that the inspection application form here is not written by a doctor. The LIS System reads the electronic inspection doctor's advice from his system and converts the form according to the set rules. The conversion process allows the nurse to adjust the form, it has a unique serial number and can be represented by a bar code.
3) the laboratory uses the LIS system to enter the unique serial number on the inspection application form. The bar code reader can be used. The LIS system uses the serial number to read and display the corresponding electronic inspection application form from the LIS system, the Inspection Department will notify his system to charge for inspection after confirmation. It is worth noting that the laboratory does not need to compare the results.
4) the Laboratory conducts sample pre-processing, performs on-board inspection, and obtains the test results.
5) the laboratory uses the LIS system to review the test results. After confirmation, the inspection report is released. If necessary, the electronic inspection report is returned to the his system.

rating:
1) the hospital's business process is ideal, the solution to the plugging cost problem is ensured by * reasonable operation procedures, so it is easy to determine the responsibility if any problem occurs.
2) his system vendors are almost unchanged;
3) Lis system vendors need to develop different interface programs for different his systems. Due to reasonable operation procedures, there will be no insurmountable problems;
4) implementation is relatively easy;
5) maintenance is relatively easy;
6) This solution is not implemented in hospitals currently.

solution 4

workflow:
1) nurses use the LIS system's nurse station program to enter the test application form. The test application form is electronically stored in the LIS system.
2) nurses use the LIS system nurse station program to print the test application form and sample, and then send the test application form and its unique corresponding samples to the laboratory. It is worth noting that the test application form is printed and output by the LIS system instead of written by the doctor. It has a unique serial number and can be represented by a bar code.
3) the laboratory uses the LIS system to enter the serial number on the inspection application form. The bar code reader can be used. The LIS system uses the serial number to read and display the corresponding electronic inspection application form from the LIS system, the Inspection Department will notify his system to charge for inspection after confirmation. It is worth noting that the inspection department does not need to perform the comparison work. The detailed record of the inspection fee is sent to the his system by the LIS system;
4) the Laboratory conducts sample preprocessing and Computer tests until the test results are obtained.
5) the laboratory uses the LIS system to review the test results. After confirmation, the inspection report is released. If necessary, the electronic inspection report is returned to the his system.

Rating:  
1) the business process obtained by the hospital is the most ideal. The solution to the problem of plugging charges is ensured according to * reasonable operation procedures, so it is easy to determine the responsibility in case of problems;
2) his system vendor is almost unchanged;
3) Lis system vendor completes all inspection-related work;  
4) implementation is relatively easy;
5) Easy Maintenance;  
6) This solution is implemented at the shaoyifu Hospital in Hangzhou, Zhejiang Province.  

Solution 5
  
Workflow:
 
1) The nurse samples the Test Application Form issued by the doctor, and then sends the test application form and the unique corresponding sample to the laboratory. It is worth noting that the nurse is not required to enter the doctor's advice or test application form;  
2) The laboratory uses the LIS system to enter the inspection application form. After confirmation, the system will be notified to charge for the inspection. It is worth noting that the inspection department does not need to do the comparison work, and the detailed record of the inspection charge is sent to the his system by the LIS system;
3) The Laboratory conducts sample preprocessing and machine-based inspection until the inspection results are obtained;
4) The laboratory uses the LIS system to review the inspection results. After confirmation, the inspection report is released. If necessary, the electronic inspection report is returned to the his system.  

Rating:
1) the business process obtained by the hospital is ideal and highly operable;  
2) his system vendor has not changed much;
3) The LIS system vendor has not changed much;  
4) implementation is relatively easy;
5) Easy Maintenance;  
6) this solution has been implemented in many hospitals, including Beijing Sino-Japanese Friendship Hospital, Beijing Railway General Hospital, Changchun baishenyi First Hospital, and Jilin Chemical Hospital.  

Others:  
During the implementation of a specific project, there are also some other data exchange solutions for different his and Lis systems and different hospital business processes, but they are basically similar to the above solutions.  
There are multiple solutions to achieve data sharing and exchange. For example, his and Lis system vendors jointly design an intermediate database and exchange information with the other system through the intermediate database. You can also disclose the database information to the other party, allow the other party to read the relevant information, and allow the other party to write the information into its own database if necessary.

implement

when implementing the his or lis system, the hospital must consider the data exchange between the two systems. No matter which system is used first or at the same time, you should clarify the interface scheme and corresponding development fee when negotiating the contract, so as to avoid coordination issues during API development in the future. The doctor interface can be completed only when the hospital, his, and Lis vendors work together. Generally, both his and Lis vendors need to make necessary functional modifications to their respective systems, and design the database structure for information exchange if necessary. In order to develop the doctor's advice system, both parties have a certain amount of development workload, and it is difficult for the independent party to complete the doctor's advice interface.
if one of the systems is first mounted and the other is mounted, the hospital should call his and Lis vendors, discuss the development details of the doctor's interface and determine the business requirements, implementation progress, and development costs of both parties. We recommend that you sign an Implementation Memorandum of Understanding for the interface.
before connecting the two systems, ensure that the two systems run stably and stably independently.