Item Dictionary Synchronization

The Item Dictionary Sync Interface allows for the addition of a new item from a vendor to be added to the Item Dictionary if it does not already exist. This is helpful if a vendor has new item which requires addition to the dictionary in that it facilitates automatic update, alleviating the tedious manual update.

Pros/Cons

Pros

This makes sense for groups who can't/don't focus on ConnectR errors as it ensures patients' interfaced results make it to the EHR

Cons

OID Build: During the Build of the OID. The IC/Client begin with both the Utilization and Compendium from the Vendor or in many cases these days Vendor (s). The Utilization allows the client to see all the test ordered in the last year and how many times. From this, the client is deciding, not so much on what they “expect” will be ordered, but also..the exact test they want to allow the users to order. This is often based on Insurance, Lab Vendor Practices or preferring to order one Lab from one vendor over another vendor. Auto-Filer completely takes this control away from the client during the build and after Go-Live as even though the wrong Order has been placed an resulted…it is more difficult to monitor when they are auto-filing in.
Auto-file descriptions are often times just codes that appear in the patients chart with no description of the exact order until the admin staff enters the proper information in the corresponding dictionary
During the build of the OID there are numerous other fields that must be considered and built…often built with an “Apply Below” function of SSMT so that all items in a particular class…say Chemistry have the same behavior for say, RPL, When to Charge, Specimen sources, etc. Once these have been loaded and a new order is auto-filed in…it will not be in this class and will not be a part of these needed defaults.

Best-Practice Approach

Train staff to monitor ConnectR at least 2 times a day (or via autonotification) to work any result errors
Have vendor call-in critical results

Approach

The Item Dictionary Sync utilizes the ACS_ImpSetOrderResulWSync stored procedure which will need to be installed to the AE-EHR Works database.
Creation of an additional interface is required and as such a separate dictionary target should be created. Make sure to give the target a descriptive name – "Test LabCorp Dictionary Target" for instance.
An interface mapping will need to be created between the Result Source (ORU message) and the Dictionary Target (ACS_ImpSetOrderResultWSync). The interface mapping can either be created from scratch or imported in (after exporting from the Allscripts ConnectR Interface library).
The interface mapping facilitates the addition of the new item with a parent classification specified in the mapping as shown below:

The item classification will need to be added to the Item Dictionary via TWAdmin as shown below:

The original Results interface target should lag behind the new Dictionary target. This way, new items will be added to the dictionary before the result is filed.

!!!!GOTCHA!!!! It is important to take into consideration any prefixing or suffixing of Orderable and Resultable codes to uniquely identify them. For instance, a Orderable and Resultable code may be prefixed with an 'L' for LabCorp. As such, the interface mapping should concatenate prefixes or suffixes as appropriate in the QC_Entrymnemonic, QC_EntryCode, QODE_EntryMnemonic, and QODE_EntryCode fields:

ACS_ImpSetOrderResultWSync Message Description and Data Types

1.	QC_Entrymnemonic 	 c255 		Orderable Entry Mnemonic 
2.	QC_EntryCode 		 c255		Order Code 
3.	QC_Entryname 		 c255		Item Master Entry Name 
4.	QODE_Entrymnemonic 	 c255		Result Mnemonic 
5.	QODE_EntryCode		 c255		Result Code 
6.	QODE_EntryName		 c255		Result Name 
7.	AnswerType 		 c255 		Result Answer Data Type
8.	QC_ParentName 		 c255		Order Class Category ie. MRI, Lab etc. 
9.	CharInAnswer		 c255
10.	DecimalInAnswer          c255 
11.	SetOrder 		 c255
12.	V4OrderingAuthority 	 c255		Ordering Auth
13.	OrderAlwaysDisplayDetail c255 		Always display order detail when ordering
14.	CommMethDE 		 c255 		2 for interface 3 for Manual 
15.	OnHoldFlag 		 c255		On hold pending activation flag 
16.	CPT4CodeMN 		 c255		CPT code for MN checking 
17.	SpecimenLabel 		 c255 		0 for none, otherwise specify the id for specimen label entry
18.	IsSynched 	         c255 		'N' --Y or N set to Y if the result interface is using the AltQoClass mapping, otherwise set to N 
19.	PerfLocName 		 c255		Performing Location of Vendor being filed 
20.	TestFlag 		 c255
21.	Status 			 c255

ACS_ImpSetOrderResultWSync Interface Mapping Example

ACS_ImpSetOrderResultWsync
[1]-QC_EntryMnemonic
   (If OBR.1-[11]-Verified by.1.1.0 = 'G' Then (OBR.1-[29]-Parent Number.1.1.0 _ 'L')) | (OBR.1-[4]-Universal Service ID.1.1.0 _ 'L')
[2]-QC_EntryCode
   (If OBR.1-[11]-Verified by.1.1.0 = 'G' Then (OBR.1-[29]-Parent Number.1.1.0 _ 'L')) | (OBR.1-[4]-Universal Service ID.1.1.0 _ 'L')
[3]-QC_EntryName
   (If OBR.1-[11]-Verified by.1.1.0 = 'G' Then OBR.1-[29]-Parent Number.1.2.0) | OBR.1-[4]-Universal Service ID.1.2.0
[4]-QODE_EntryMnemonic
   OBX.1-[3]-Observation Identifier.1.1.0 _ 'L'
[5]-QODE_EntryCode
   OBX.1-[3]-Observation Identifier.1.1.0 _ 'L'
[6]-QODE_EntryName
   OBX.1-[3]-Observation Identifier.1.2.0
[7]-AnswerType
   'Numeric'
[8]-QCParentName
   'LabCorp'
[9]-CharInAnswer
   '0'
[10]-DecimalInAnswer
   '0'
[11]-SetOrder
   '0'
[12]-V4OrderingAuthority
   '5' 
[13]-OrderAlwaysDisplayDetail
   'N'
[14]-CommMethDE
   '3'
[15]-OnHoldFlag
   'N'
[16]-CPT4CodeMN
[17]-SpecimenLabel
   '0'
[18]-IsSynched
   'Y'
[19]-PerLocName
[20]-TestFlag
   'N'
[21]-OrderIsInactiveFlag
[22]-Status
   '0'

SQL Stored Procedures

These are provided as-is with no warranty whatsoever. Please review the SQL code enclosed and have a certified SQL Server DBA apply the appropriate procedure to your Works database.
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