Tests

Select the button to copy the test list and make edits.

Select a module from the drop-down list to specify the type of module.

• General: Select this option to utilize the default options in the system. This is the default drop-down list option.
• Hematology: Select this option to access the Hematology module settings. See the Hematology Settings topic for more information.
• Microbiology: Select this option to access the Microbiology module settings. See the Microbiology Settings topic for more information.
• AP: Select this option to access the Anatomic Pathology module settings. See the AP Settings topic for more information.
• Toxicology: Select this option to access the Toxicology module settings.

Select this checkbox to make the test unsearchable in the various test search boxes in Order Patient Samples.

Select an option from the drop-down list to specify how the test can be entered. Select one of the following choices:

• Enterable as numeric and text/choice list: Select this option for the test to be entered as numeric and text/choice list.
• Enterable as numeric only: Select this option for the test to be entered as only numeric.
• Enterable as text/choice list only: Select this option for the test to be entered as text/choice list only.
• Non-enterable: Select this option for the test to be non-enterable.
• Enterable as numeric and choice list: Select this option for the test to be entered as numeric and choice list.
• Enterable as choice list only: Select this option for the test to be entered as only a choice list.

Select this button to display the Choice List pop-up.

• Enter a value in the Result Value field, then select Add to add the value.
• Select SNOMED Codes to assign SNOMED codes to choice list answers.
• Select the Add Default Value checkbox to add the Default column to the table. Select the option button in this column for one of the options to designate which option is selected by default when the choice list first displays. For Microbiology tests with a Multiselect Pre-Defined Text enterability, you can select multiple options to be default choice list responses.
• Select the Execute Reflex checkbox to tell the system that when the result for a toxicology screening test is final and approved and is one of the defined results, the confirmatory order choices defined in the Confirmatory Reflexes section (see below) will automatically be added to the order, copying all sample and collection information and orders for the confirmatory order choice(s) sent to the PRSQRL platform. This setting is only available with a Toxicology module license and for Screening test types. 
• Use the Sort column to drag options into the desired order of display in the drop-down list on the results pop-up.
  
• Select X to remove the value from the pop-up.
• Select Save to save the added value, or select Cancel to not add the value.

This is a default LOINC for the test as a whole.

Select in the search-as-you-type field to select the observation method for the test.

Select Round or Truncate from the first drop-down list to specify how the system treats results.

• Round: Select to round the result to the number you specify in the second drop-down list. For example, if you select to Round the result to 2, an actual result of 3.56789 would result to 3.57.
• Truncate: Select to truncate the result to the number you specify in the second drop-down list. For example, if you select to Truncate the result to 2, an actual result of 3.56789 would result to 3.56. The numbers beyond the precision length are dropped for the reported value.

Select a value (0, 1, 2, 3, 4, 5, 6, 7, or 8) from the second drop-down list to specify the precision range of the test. Select Not applied if there is no precision to be applied.

Select a value (0, 1, 2, 3, 4, 5, 6, 7, or 8) to specify the precision range of the test. Select Not applied if there is no precision to be applied.

In the field, enter a value to set the order in which the test will appear on the toxicology report. The higher the number, the higher the test will appear on the list of tests on the report.

Enter a unit in the field.

Select in or enter text in the search-as-you-type field to search for and select UCUM units.

Select this checkbox if the test results are non-reportable.

Select the button to open the Billing Codes for Test pop-up, where you can assign billing codes at the test level. Billing codes at the test level are cumulative with other order choice-level billing codes that are ordered on a patient.

Default CPT Codes: Select or begin typing in this search-as-you-type field to search for and select the default CPT codes to assign to this test. Select the Select checkbox to remove the CPT Code from the list.

Default Charge Codes: Select or begin typing in this search-as-you-type field to search for and select the default charge codes to assign to this test. Select the Select checkbox to remove the charge code from the list.

Select this checkbox to have the reference range and units always report what was received from the instrument in OBX-6.1 (units) and OBX-7.1 (reference range).

When this checkbox is not selected for a test, the reference range and units always report what is configured on the test setup.

Select one of the following options from the Hematology Sector drop-down list:

• Hemogram: The test appears in the Hemogram panel.
• Automated Differential: The test appears in the Automated Differential panel.
• Manual Differential: The test appears in the Manual Differential panel.
• Morphology: The test appears in the Morphology panel.
• Images: The test appears in the Images panel.

This section appears if Microbiology is selected from the Module drop-down list.

Select one of the following options from the Microbiology Test Type drop-down list:

• Antibiotic
• Clinical Information Test
• Culture Test
• Isolate Auto ID
• Isolate Test
• Susceptibility Panel
• Culture Observation
• Isolate Observation
• Isolate Organism
• Organism Quantification
• Organism Semi-Quantification

Fields and options become visible depending on which option you select from the drop-down list. See Microbiology Settings for more information.

This section becomes visible after you select Toxicology from the Module drop-down list and select Screening from the Test type drop-down list.

Select to expand the section and its options for configuring the confirmatory tests or order choices to reflex after the screening test result is received:

• Add: Select the button to insert a section for a testing facility.
• Testing Facility: Select or begin typing in the search-as-you-type field to search for and select a testing facility to assign to the test(s). This field is required.
• Department: Select or begin typing in the search-as-you-type field to search for and select a department from the testing facility to assign to the test(s). 
• Order Choice: Select or begin typing in the search-as-you-type field to search for and select the order choice the confirmatory test(s) (defined below) will be reflexed to. When the screening test is final/approved, the confirmatory order choice you define here will be added to the order, copying all sample and collection information and orders for the confirmatory order choices sent to the PRSQRL platform. (Use the Execute Reflex setting in the Choice List pop-up explained above to set this feature.) This Order Choice field is required.
• Confirmatory Test: Select or begin typing in the search-as-you-type field to search for and select the active toxicology confirmatory tests to reflex after the screening test result is received.
• Delete: Select the X button in the top-right corner of each testing facility section to remove the section from the screening test.

This section becomes visible after you select Toxicology from the Module drop-down list and select Confirmatory from the Test type drop-down list.

• Add: Select to add a consistent medication(s) section.
• Copy: Select the button to duplicate the current consistent medication(s) section.
• Testing Facility: Use the search-as-you-type field to search for and select a testing facility to attach to the test. This is a required field.
• Department: Use the search-as-you-type field to search for and select a department associated with the selected facility to attach to the test.
• Medication Identity: Use the search-as-you-type field to search for and select active medications that this test represents. 

  • A list of medications you selected displays. Clear the medication's Select checkbox to remove it from the list.

    Note

    Only assign medications that this test represents. Do not include medications that are not this test, regardless if they are related.

• Metabolite Identity: Use the search-as-you-type field to search for and select active metabolites associated with the medication to attach to the test.

  • A list of medication metabolites you selected displays. Clear the metabolite's Select checkbox to remove it from the list of medication metabolites.

    Note

    Only assign metabolites that this test represents. Do not include metabolites that are not this test, regardless if they are related.

• Delete: Select the X button in the top-right corner of each medication identities section to remove the section from the test. 

Select the Add Identifier button to display a block with multiple fields in it.

• Enter a value in the Outbound Identifier field to use when sending outbound messages. If this field is empty, the Inbound Identifier field is used instead.
• Enter a value in the Inbound Identifier field to use when parsing inbound messages. This is a required field.
• Select in or enter text in the Instrument Type search-as-you-type field to search for and select an instrument type. Select the blue link to select the instrument type. Select X to remove the instrument type from the field. You may also search manually by selecting the magnifying glass icon.
• Select the X to remove the block from the section. The Confirm pop-up appears. Select Yes to remove it, or select No to keep it in the section.

Select Add Delta to add a delta. Sort the floating deltas by selecting the equal sign at the right end of each delta box and dragging it to the desired order.

• Select Testing Sections to restrict a delta configuration to a specific testing section and to display the Delta Testing Sections pop-up. Enter text in the search-as-you-type field to search for and select a testing section. Select Save to save changes, or select Cancel to close the pop-up without making changes.
• Select the Compare against all results checkbox to have the delta compare to all previous results for the test.
• Select Add Delta Criteria to add another delta criteria to the test's testing sections.
• Select either Exceeds, Within, or Compare from the drop-down list to specify if the delta criteria should flag when the value field is exceeded, within the limits of, or compared to the values specified in the From and To fields.
  • Exceeds or Within: When you select Exceeds or Within as the boundary, you see the following options:
    • The result type of Numeric Value is required and can't be changed.
    • Enter a delta value in the value field. 
    • Select either % or Units from the drop-down list to specify the type.
    • In the Match when the delta result is section, select Positive Change and/or Negative Change to have the delta value flag when the result value changes positively or negatively from a previous result value.
    • Enter a value in the Hours or Days field to specify the number of hours or days the lookback of results should occur. 
    • From the Hours or Days drop-down list, select whether the value should be in hours or days.
    • Select the Requires Documentation checkbox to require documentation of delta failures before they can be approved.
    • Select the equal sign to drag the delta box to the desired sort order.
    • Select the X to remove the delta criteria blocks from the section. The Confirm pop-up appears. Select Yes to remove it, or select No to keep it in the section.
  • Compare: When you select Compare as the boundary, you see the following options:
    • From: The From fields designate the historical result(s) used in the comparison to establish the delta criteria. Select the type of value to compare. Options are Numeric, Qualitative (choice list or textual result fields), and Consistency (only available for Toxicology module).
      • For Numeric value types, select an optional prefix (<, <=, =, >, >=) and then enter a value. Note that for numeric comparison values, using a prefix will apply comprehensively (e.g., a comparison value set to >=10 will apply to results like >=10, >10, 10, and 11, as well as any prefixed numeric result that may include it like >5, >15, and <20).
      • For Qualitative value types, enter the qualitative value.
      • For Consistency value types (Toxicology module only), select Consistent or Inconsistent from the drop-down list.
    • To: The To fields designate the current result used in the comparison to establish the delta criteria. Select the type of value to compare. Options are Numeric, Qualitative (choice list or textual result fields), and Consistency (only available for Toxicology module).
      • For Numeric value types, select an optional prefix (<, <=, =, >, >=) and then enter a value. Note that for numeric comparison values, using a prefix will apply comprehensively (e.g., a comparison value set to >=10 will apply to results like >=10, >10, 10, and 11, as well as any prefixed numeric result that may include it like >5, >15, and <20).
      • For Qualitative value types, enter the qualitative value.
      • For Consistency value types (Toxicology module only), select Consistent or Inconsistent from the drop-down list.
    • Enter a value in the Hours or Days field to specify the number of hours or days the lookback of results should occur. 
    • From the Hours or Days drop-down list, select whether the value should be in hours or days.
    • Select the Requires Documentation checkbox to require documentation of delta failures before they can be approved.
    • Select the equal sign to drag the delta criteria block to the desired sort order.
    • Select the X to remove the delta criteria blocks from the section. The Confirm pop-up appears. Select Yes to remove it, or select No to keep it in the section.

Select Add Reference Range to add a reference range.

• Enter values in the From Age and To Age ranges followed by selecting Hour(s), Day(s), Week(s), or Year(s) from the drop-down lists.
• Select in or enter text in the Race/Species and/or Ethnicity/Breed search-as-you-type fields to search for and select either a race/species or ethnicity/breed.
• Add values in the Approval Low, Critical Low, Low, High, Critical High, and Approval High fields for both Female and Male.
• Select Use range when no age/DOB is specified for the patient checkbox to use the determined range when no age or date of birth is available for the patient.
• Select Testing Sections to display the Reference Range Testing Section Locations pop-up. Enter text in the search-as-you-type field to search for and select a reference range. Select Save to save changes, or select Cancel to close the pop-up without making changes.
• Select an option from the Endpoint type drop-down list to specify the type of endpoint style. Select either Double endpoint inclusive, Single endpoint high exclusive <, Single endpoint high inclusive < =, Single endpoint low exclusive >, or Single endpoint low inclusive > = from the drop-down list.

Select Normal Values to add normal values on the Qualitative Normal Values pop-up. Enter a value in the Normal Value field followed by selecting Add.

Select Critical Values to add critical values on the Qualitative Critical Values pop-up. Enter a value in the Critical Value field followed by selecting Add.

Select Abnormal Values to add abnormal values on the Qualitative Abnormal Values pop-up. Enter a value in the Abnormal Value field followed by selecting Add.

Enter text in the Normal displayed range override field to specify the override used for normal range values.

Select Save to save the changes on the pop-ups, or select Cancel to close the pop-ups without making changes. Select X to remove the values from the pop-ups.

Select Add Threshold to add the following thresholds:

• Testing Facility: To restrict a threshold to a specific testing facility, select the testing facility from the search-as-you-type field.
• Department: To restrict a threshold to a specific department, select the department from the search-as-you-type field.
• Instrument Type: To restrict a threshold to a specific instrument type, select the instrument type from the search-as-you-type field.
• Sex: To restrict a threshold to a specific sex, select either Male, Female, Unknown, M/F, or F/M from the drop-down list to specify the sex.
• Race/Species: To restrict a threshold to a specific race or species, select the race or species from the search-as-you-type field.
• Ethnicity/Breed: To restrict a threshold to a specific ethnicity or breed, select the ethnicity or breed from the search-as-you-type field.
• Result Min: Enter the minimum result in the field. Any result value above this value will meet the conditions of the threshold. A value must be entered for either the Result Min or Result Max field. 
• Result Max: Enter the maximum result in the field. Any result value below this value will meet the conditions of the threshold. A value must be entered for either the Result Min or Result Max field. 
• Report Numeric Value: Select this checkbox to display the measured numeric value next to the interpretation on the report. When this checkbox is selected, the text "<Num Result>" will display in the Result As field. You can add the interpretation or text before or after the "<Num Result>".
• Update Qualitative Result: From the drop-down list, select an option to report along with the rest of the threshold's custom Result As text. The choice list options available are the same options (and their values) configured and saved in the Choice List in the Test Details section of Test setup. Flags and Execute Reflex information are inherited from the choice list option you choose.
• Result As: Enter the value to report when the minimum and/or maximum result is met. This is a required field.
• Flag: Select either Normal, Abnormal, Abnormal Low, Abnormal High, Critical, Critical Low, or Critical High from the drop-down list to specify the type of flag.
• SNOMED Code: Select the SNOMED code from the search-as-you-type field.
• Reference Range Override: Enter the reference range override in the field.
• Execute Reflex: Select the checkbox to tell the system that when the result for a toxicology screening test meets this threshold, the confirmatory order choices defined in the Confirmatory Reflexes section (see above) will automatically be added to the order, copying all sample and collection information and orders for the confirmatory order choice(s) sent to the PRSQRL platform. This setting is only available with a Toxicology module license and for Screening test types. 

Thresholds will be evaluated after formulas have been run on the results, but before result evaluation rules are run on the results. If a test has multiple thresholds, then they will be evaluated in their sort order. In order for the threshold to be applied, the Sex, Race, Ethnicity, Instrument Type, and Testing Facility conditions must all be met or be blank and the result's numeric value must fall within the Result Min and Result Max conditions.

If multiple thresholds apply to the result, then the one that was first in the sort order will be used. When a threshold is applied, the result will be reported as the threshold's Result As value and the severity will be changed to the severity specified in the threshold's Flag field. If a SNOMED code has been selected, then the SNOMED code will also be added to the reported result. If a reference range override is specified, then the reported reference range will be overridden with the specified value.

The Reported Result column on the Work in Progress page shows what will be reported when the result is approved.

Enter the formula ID to assign to the test in the Formula ID field. See Formulas for information on how to set up formulas.

If configuring a toxicology confirmatory test, you'll see a Normalized Value Formula field. Select in or enter text into the search-as-you-type field to search for and select a formula the system will use to calculate the normalized result value for the test. You can't select a normalized value formula that contains the test's formula ID. If the toxicology confirmatory test does not have a normalized value formula assigned, the field will be null on Advanced Review Results. The system will process the formula when receiving confirmatory workflow test results. 

Define Westgard Rule evaluations for QC results. The following rules are available: 1 _2S, 1 _2.5S, 1 _3S, 1 _3.5S, 2 _2S, 4 _1S, R _4S, 10 _1S, 10 _X, and 7 _T. Select the appropriate checkbox to add the rule(s). Westgard Rules will be evaluated when a numeric result is received/entered and when approving results.

Enter text in the Name field to filter the table by a specific order choice name. Select Show active only so the table only displays active order choices.