Life-Cycle-Management
With regard to life cycle management, routine data is transmitted as follows:
- Laboratories can transmit their data to ARS daily; only the difference to the previous day is transmitted.
- Only data with completed findings are transmitted to ARS (mapping via the “final” status in the DiagnosticReport resource).
- In addition, data that has undergone corrections, changes or deletions after the “final” status is transmitted. These changes are displayed via the status “amended” or “entered in error” in the DiagnosticReport resource.
In addition, laboratories can transmit a complete image of their data to ARS over a selectable time period (for the first time or again). This option is used when reconfiguring the interface at the data sender, particularly in the context of data quality management.
For each data transmission, i.e. per file/bundle resource, only the data of a single sample or a single-related group of samples (e.g. aerobic blood culture bottle and anaerobic blood culture bottle) should be transmitted. In addition to the general sample information, this also includes all other microbiological results and all information on the origin of the sample. For ARS, ALL available laboratory tests (observations) must ALWAYS be transferred with a sample. This also applies in particular to repeated transmission: the renewed transmission of a sample with a subset of laboratory tests (observations) compared to a previous transmission leads to the deletion of the laboratory tests (observations) that are no longer included.
The steps and results of microbiological diagnostics that should be transmitted to ARS are described in Semantics Section 6. "Content to be transmitted for ARS".
Illustration of the life cycle of information and data flow for various cases.
Scenario 1: Sender of the sample hospital/doctor's surgery, participant in ARS is the laboratory
Scenario 1 describes the most common case of data transmission. A sender (hospital, doctor's surgery, other sender) sends a sample including a request to a laboratory. The microbiological diagnostics are carried out entirely in this laboratory, which sends the results of the microbiological diagnostics both to the sender of the sample and, in accordance with the specifications of the FHIR interface, to DEMIS and thus to ARS.
Scenario 2: Hospital sending the sample, participant in ARS is the hospital
Scenario 3: Sender of the sample hospital/doctor's practice to primary diagnosing laboratory, forwarding of the sample to secondary diagnosing laboratory, both laboratories are participants in ARS.
Scenario 3 describes the handling of findings that are transmitted by two laboratories participating in ARS. If a laboratory specifies another laboratory (external laboratory) as the sender of the sample, the clear name of the external laboratory must be transmitted. When selecting the type of data sender, the selection “Laboratory” can be made. This information can be used to deduplicate the results of microbiological diagnostics or to supplement individual findings. This procedure for deduplication only applies if data senders are laboratories. If a data sender is a hospital, deduplication cannot be carried out using the transmitted data alone.
Only pseudonymized case data is processed in ARS. The patient pseudonym is part of the data transmission. For the pseudonymization procedure, see chapter Pseudonymization.