The Laboratory domain system – also known as a Jurisdictional Laboratory Information System (JLIS), is a provincial / territorial system that manages patient laboratory test orders and / or disseminates patient test results to clinicians. The laboratory domain system is expected to take different shapes and sizes in different jurisdictions.

A key distinction needs to be made between solutions focused on enabling a view into laboratory results and order information as a supporting set of data for results.  This is in contrast with more elaborate jurisdictional laboratory information system solutions designed to enable the management, and potentially the automation of, the workflows associated with the process of laboratory based testing.

Early generation solutions are expected, at a minimum, to be able to compile laboratory results as well as the accompanying data (such as the preceding orders) so that a view of this consolidated information can be provided to caregivers. In its simplest state, the Laboratory domain system will compile laboratory testing related events from source systems such as an order, a sample, and a result and allow for access to this data on the basis of standards-based message queries to retrieve any of this information. More advanced solutions will provide that basic capability and will also support workflow automation and business logic to manage the status of orders and result generation and will also interact with source systems in a much more proactive fashion to generate alerts and notifications or to expedite processing.

The Laboratory Domain service is expected to interact, through standards-based messaging, with laboratory systems used for generating and managing orders in facilities as well as with systems used in sampling and testing facilities to produce results. In other words users acting as clinicians and lab technicians in laboratory facilities are expected to use their local information system solutions to conduct their work. These applications, by way of being connected to an EHRi will be able to publish or promote key relevant results data to the Electronic Health Record of patients. Similarly, CPOE applications used by caregivers in hospitals, clinics will be able to promote order information to patient health records through the same type of connectivity with the EHRi.

The following EHRi Lab domain service operations represent the patient centric queries initiated by an EHR user in the context of an EHRi system.

Operations
Name	Return Type
Get Lab Order()
Get Lab Result()
List Lab Orders()
List Lab Results()

Relations
Name	Type	Begins	Ends
	generalization	Lab Domain Repository Services	EHR Data and Services

Description: This service raises an event to create a request to query the Lab domain repository to retrieve a specific lab order for a patient that matches the input criteria;

Used By: IIP Get

Uses: "JLIS Lab" domain “Lab Order Inquiry by Patient” function

Inputs:

-Client ID

-Parameters passed by EHR point of service system via EHRCS13 Get Event communication step to retrieve a the details of a specific lab order

Response:

-Details of a specific lab test order

Rationale: Satisfies the requirement for an EHR user to review the details of patient’s lab order.

Description: This service raises an event to create a request to query the Lab domain repository to retrieve a specific lab result for a patient that matches the input criteria;

Used By: IIP Get

Uses: JLIS Lab domain “Lab Test Result Inquiry by Patient” function

Inputs:

-Client ID

-Parameters passed by EHR point of service system via EHRCS13 Get Event communication step to retrieve a the details of a patient’s lab result

Response:

-Details of a patient’s lab test result

Rationale: Satisfies the requirement for an EHR user to review the details of patient’s lab result.

Description: This service raises an event to create a request to query the Lab domain repository to retrieve all lab orders for a patient that matches the input criteria;

Used By: IIP List

Uses: JLISLab domain “Search Lab Order by Patient” function

Inputs:

· Client ID

· Parameters passed by EHR point of service system via EHRCS12 List Event communication step to retrieve a list of a patient’s lab order information such as:

• Type of Lab Orders
• Date Range
• Service Location
• Ordering Physician

Response: List of a patient’s lab orders returned by the Lab domain repository that meets the input criteria

Rationale: Satisfies the requirement for an EHR user to review a list patient’s lab orders using different criteria.

Description: This service raises an event to create a request to query the Lab domain repository to retrieve all lab results for a patient that matches the input criteria;

Used By: IIP List

Uses: JLISLab domain “Search Lab Result by Patient” function

Inputs:

·Client ID

·Parameters passed by EHR point of service system via EHRCS12 List Event communication step to retrieve a list of a patient’s lab result information such as:

• Type of Lab Results
• Date Range
• Service Location
• Ordering Physician

Response: List of a patient’s lab results returned by the Lab domain repository that meets the input criteria

Rationale: Satisfies the requirement for an EHR user to review a list patient’s lab results using different criteria.