Lab display in CPRS question: How is order defined?

[Kevin Toppenberg]

My CPRS is displaying my labs in a mixed up order, compared to the way a usual CBC is displayed.  It is this way for all my panels. Here is an example.  The differential (the part with the %'s) should always come at the bottom.

The order of the display comes from the RPC call, which is also out of order.  

ORWLRR INTERIMG

Called at: 5:20:34 PM

 

Params ------------------------------------------------------------------

literal 28090

literal 3151030.102202

literal 1

literal 1

 

Results -----------------------------------------------------------------

15^CH^3151030.102201^70^BLOOD^^0^^^3151030.102201

5076^NEUTROPHIL %^    55.8^^%^41.0 - 77.0

5077^LYMPHOCYTE %^    29.1^^%^14.0 - 48.0

5078^MONOCYTE %^    11.4^^%^4.0 - 13.0

5079^EOSINOPHIL %^     2.6^^%^1.0 - 8.0

5080^BASOPHIL %^     0.9^^%^0.0 - 1.5

5516^IMMATURE GRANULOCYTE AUTOMATED^     0.2^^%^0.0 - 1.0

2^RBC^    4.23^^M/mm3^3.70 - 5.10

3^HGB^    12.7^^gm/dL^12.0 - 16.0

4^HCT^    38.7^^%^37.4 - 48.3

5^MCV^    91.5^^fL^81.0 - 102.0

6^MCH^    30.0^^pg^26.9 - 35.0

7^MCHC^    32.8^^g/dL^29.5 - 33.5

416^RDW^    42.4^^fL^38.6 - 53.8

9^PLT ^     193^^K/cumm^137 - 397

1^WBC^     4.2^^K/uL^3.8 - 12.8

Report Released Date/Time: Oct 31, 2015@00:35

Comment: 

    

   Test performed by PathGroup Labs 

   658 Grassmere Park Suite 101, Nashville, TN 37211 

   Mary Mayo, Ph.D., Medical Director 

Performing Lab: PATHGROUP

                PathGroup 5301 Virginia Way Brentwood, TN 37027

 

Elapsed Time: 217 ms

I have tried tracing through the code, but am having a hard time following the minimally commented code.

Here is a dump of the definition of this CBC/ 

Record# 276, in FILE: 60

   .01-NAME : CBC & MORPHOLOGY (WITH DIFF)

     1-TEST COST :

     2-SYNONYM :

       Multiple Entry #1

       .01-SYNONYM : LMH-CBCD

       Multiple Entry #2

       .01-SYNONYM : PG-CBCWD

     3-TYPE : INPUT (CAN BE ORDERED)

     4-SUBSCRIPT : CHEM, HEM, TOX, SER, RIA, ETC.

     5-LOCATION (DATA NAME) :

     6-ACCESSION AREA :

       Multiple Entry #69

       .01-INSTITUTION : Family Phys of Greeneville (`69 in #4)

         1-ACCESSION AREA : PATHGROUP ACCESSION (`39 in #68)

     7-UNIQUE ACCESSION # :

     8-UNIQUE COLLECTION SAMPLE : YES

     9-LAB COLLECTION SAMPLE : BLOOD   (`3 in #62)

    10-REQUIRED TEST :

    13-FIELD :

    14-PROCEDURE (SNOMED) :

    15-*QUICK INDEX :

    16-EXTRA LABELS :

    17-HIGHEST URGENCY ALLOWED : STAT (`1 in #62.05)

    18-FORCED URGENCY :

    51-PRINT NAME : CBC+DIF

    52-Reserved :

    53-PRINT CODE :

    54-PRETTY PRINT ENTRY :

    55-PRETTY PRINT ROUTINE :

    56-PRINT ORDER :

    64-NATIONAL VA LAB CODE : Hemogram Manual (`2679 in #64)

  64.1-RESULT NLT CODE : Hemogram Manual (`2679 in #64)

  64.2-CATALOG ITEM : YES

    98-EDIT CODE :

  99.1-*BATCH DATA CODE :

  99.2-EXECUTE ON DATA REVIEW :

   100-SITE/SPECIMEN :

   110-GENERAL PROCESSING INST. :

   200-LAB TEST INCLUDED IN PANEL :

       Multiple Entry #2

      .001-NUMBER : 2

       .01-LAB TEST : DIFF COUNT (BLOOD) (`274 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #6

      .001-NUMBER : 6

       .01-LAB TEST : WBC (`1 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #7

      .001-NUMBER : 7

       .01-LAB TEST : RBC (`2 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #8

      .001-NUMBER : 8

       .01-LAB TEST : HGB (`3 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #9

      .001-NUMBER : 9

       .01-LAB TEST : HCT (`4 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #10

      .001-NUMBER : 10

       .01-LAB TEST : MCV (`5 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #11

      .001-NUMBER : 11

       .01-LAB TEST : MCH (`6 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #12

      .001-NUMBER : 12

       .01-LAB TEST : MCHC (`7 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #13

      .001-NUMBER : 13

       .01-LAB TEST : RDW (`416 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #14

      .001-NUMBER : 14

       .01-LAB TEST : PLT  (`9 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #15

      .001-NUMBER : 15

       .01-LAB TEST : NEUTROPHIL % (`5076 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #16

      .001-NUMBER : 16

       .01-LAB TEST : LYMPHOCYTE % (`5077 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #17

      .001-NUMBER : 17

       .01-LAB TEST : MONOCYTE % (`5078 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #18

      .001-NUMBER : 18

       .01-LAB TEST : EOSINOPHIL % (`5079 in #60)

       .02-AP MULTIPLY FACTOR :

       Multiple Entry #19

      .001-NUMBER : 19

       .01-LAB TEST : BASOPHIL % (`5080 in #60)

       .02-AP MULTIPLY FACTOR :

   300-COLLECTION SAMPLE :

       Multiple Entry #1

       .01-COLLECTION SAMPLE : BLOOD   (`3 in #62)

         1-FORM NAME/NUMBER :

         2-CONTAINER : LAVENDER

         3-MIN VOL (in mls.) :

         4-MAX. ORDER FREQ. :

       4.5-SINGLE DAY MAX ORDER FREQ :

         5-WARD REMARKS :

         6-LAB PROCESSING INSTRUCTIONS  :

         7-REQUIRED COMMENT :

       500-SAMPLE WKLD CODE :

   310-GENERAL WARD INSTRUCTIONS :

   320-REQUIRED COMMENT :

   400-DATA NAME :

   410-INPUT TRANSFORM :

   411-DATA TYPE :

   412-CULTURE ID PREFIX :

   500-VERIFY WKLD CODE :

 500.1-ACCESSION WKLD CODE :

   501-*ASK AMIS/CAP CODES :

   503-COMBINE TEST DURING ORDER :

   504-CIS TEST CODE :

   505-SITE NOTES DATE :

   506-DEFAULT SITE/SPECIMEN CPT :

   507-HCPCS CODE :

   508-AMA COMPLIANT/BILLABLE PANEL :

 22700-TMG DEFAULT SPECIMEN SOURCE : Blood venous (`11 in #64.061)

 22701-TMG DEFAULT TOPOGRAPHY : BLOOD (`70 in #61)

Any ideas how to get the display order to be proper?

Thanks

Kevin

[Kevin Toppenberg]

Oh brother... I decided to try tracing it again, and think I figured it on.  The short, but incomplete answer is field 56 PRINT ORDER.

Longer answer:

Lab results do not appear to be stored by panels.  So when a CBC is received, it's various parts are stored by date.  And because they are not stored as a group, one can't store relative print order *as a group*.  Instead priority is specified per result item.

When getting labs to display in CPRS, the RPC call looks for all labs resulted on a given date.  And for each individual lab result (e.g. WBC), it will look up that result's display priority.  So if a WBC has a priority of 10, and Hgb has priority of 15, then WBC will be shown first.  And since a WBC and a potassium probably won't be resulted at the exact same time, they will never be displayed together.  And thus I don't need to worry about the relative display priorities of those two.    

Weird, but I guess workable.

Kevin

[Kevin Toppenberg]

I wrote this code to edit the sequence displays, while showing the panel as a group.  It uses the TMG library.

FIXDISP  ;"ROLL AND SCROLL UTILITY TO ADJUST RELATIVE DISPLAY ORDERS OF LABS

  WRITE "Utility to alter display order of labs.",!

  WRITE "First we must locate sample to labs to reference.",!

  NEW X,Y,DFN,DIC

PKPT ;  

  SET DIC=2,DIC(0)="MAEQ",DIC("A")="Select patient with sample labs: "

  DO ^DIC WRITE ! QUIT:+Y'>0

  SET DFN=+Y

  NEW LRDFN SET LRDFN=+$GET(^DPT(DFN,"LR"))

  IF LRDFN'>0 DO  GOTO FDSPDN

  . WRITE "That patient does not have any labs!  Quitting",!

PKLB ;  

  SET DIC="^LR("_LRDFN_",""CH""," SET DIC("A")="Enter exact DATE/TIME of lab: "

  DO ^DIC WRITE !

  IF Y'>-1 GOTO PKPT

  NEW RDT SET RDT=+Y

  NEW DT SET DT=9999999-RDT

  NEW PANEL,MENU,SEQ,CT,INPUT

  NEW DA,DR,DIE SET DIE=60,DR=56,DIE("NO^")="OUTOK"

MNU1

  DO GETARR(.PANEL,DFN,DT)

  SET MENU(0)="Pick item to alter display order"

  SET CT=1,SEQ=""

  FOR  SET SEQ=$ORDER(PANEL("SEQ",SEQ)) QUIT:SEQ=""  DO

  . NEW IDX SET IDX=0

  . FOR  SET IDX=$ORDER(PANEL("SEQ",SEQ,IDX)) QUIT:IDX'>0  DO

  . . NEW ITEM SET ITEM=$GET(PANEL(IDX)) QUIT:ITEM=""

  . . NEW ORDER SET ORDER=$PIECE(ITEM,"^",3)

  . . IF ORDER="" SET ORDER="?"

  . . SET MENU(CT)=" Seq# "_ORDER_" -- "_$PIECE(ITEM,"^",2)_$CHAR(9)_+ITEM

  . . SET CT=CT+1  

  SET INPUT=$$MENU^TMGUSRI2(.MENU,"^") 

  IF INPUT="^" GOTO PKLB

  WRITE INPUT

  IF $DATA(PANEL("B",+INPUT))=0 WRITE !,"NO DATA!",! GOTO MNU1

  SET DA=+INPUT

  WRITE "Edit 'PRINT ORDER' to alter display sequence...",!

  DO ^DIE WRITE !

  GOTO MNU1

FDSPDN ;  

  QUIT

  ;

GETARR(OUT,DFN,DT)  ;"USED BY FIXDISP ABOVE

  KILL OUT NEW TEMP

  DO INTERIMG^ORWLRR(.TEMP,DFN,DT,-1,1)

  MERGE TEMP=@TEMP KILL TEMP(1)

  NEW CT SET CT=1

  NEW IDX SET IDX=0

  FOR  SET IDX=$ORDER(TEMP(IDX)) QUIT:IDX'>0  DO

  . NEW LINE SET LINE=$GET(TEMP(IDX))

  . IF +LINE'>0 QUIT

  . NEW IEN60,NODE,SEQ SET IEN60=+LINE,NODE=^LAB(60,IEN60,.1),SEQ=$PIECE(NODE,"^",6)

  . SET OUT(CT)=$PIECE(LINE,"^",1,2)_"^"_SEQ

  . SET OUT("B",IEN60)=""

  . SET OUT("SEQ",+SEQ,CT)=""

  . SET CT=CT+1

  QUIT

  ;

Kevin

[Christopher Edwards]

Kevin:

Just so you know that people read this and appreciate your work. I did read it and like how you walk through you troubleshooting steps (and dead ends) it helps me better understand other parts of the system i don't keep in my brain at all times.

Your work is appreciated, even when I/we don't comment!

Christopher Edwards
cje...@gmail.com

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[Kevin Toppenberg]

Thanks for listening.  I worry sometimes that I am driving others crazy... :-)

Kevin