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List: openmrs-dev
Subject: Re: Practical useage of the Obs accessionNumber field
From: Darius Jazayeri <darius () openmrs ! org>
Date: 2013-09-28 3:51:24
Message-ID: CAA-nHnc_L4z4z4FjjUsQzvDrR67gH5FJq0Enc857jvqXsL1apA () mail ! gmail ! com
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Hi Suranga,
Do you have a concrete use case for wanting to select obs by
accessionNumber? Or is it speculative? If the latter, we should hold off
until it's a concrete request.
-Darius
On Fri, Sep 27, 2013 at 8:46 PM, Suranga Kasthurirathne <
surangakas@gmail.com> wrote:
>
> Yikes, i'm sorry, I keep forgetting that the obs table can get verrrry
> large.
>
> I will add the new index... but of course, we do have quite a number of
> indexes on this table already. I hope that this will not affect the speed
> of data manipulation against the obs table......
>
>
> On Thu, Sep 26, 2013 at 11:35 PM, Burke Mamlin <burke@openmrs.org> wrote:
>
> > Suranga,
> >
> > Are we indexing the accession number in obs? If not, how well will
> > getObsByAccessionNumber() perform with 170,270,511 observations like we
> > currently have at AMPATH? :-)
> >
> > -Burke
> >
> >
> > On Thu, Sep 26, 2013 at 2:32 PM, Suranga Kasthurirathne <
> > surangakas@gmail.com> wrote:
> >
> > >
> > > Hi,
> > >
> > > Just to say that I made a pull request for accession number based
> > > retrieval here https://github.com/openmrs/openmrs-core/pull/411
> > >
> > >
> > > On Thu, Sep 26, 2013 at 8:26 AM, Friedman, Roger (CDC/CGH/DGHA) (CTR) <
> > > rdf4@cdc.gov> wrote:
> > >
> > > > Burke, I don't think it's right to say that the accession number is
> > > > defined by the lab. The accession number is the specimen ID assigned by
> > > > the facility when the specimen is sent to the lab. Inside the lab, it is
> > > > known as the client specimen number. The lab will have its own specimen
> > > > ID/accession number, known as the lab specimen number. Peoples' views may
> > > > be distorted by clinical labs or by hospital labs using on-call specimen
> > > > collectors, where the specimen is taken by lab personnel and analyzed
> > > > within the same facility. However, in many cases, the specimen will be
> > > > analyzed by an outside lab, where the facility-assigned specimen ID is the
> > > > appropriate linkage, and this is the base case, with internal labs behaving
> > > > as if the facility was its client. Best practice, similar to pharmacy, is
> > > > for the lab to have a sequential numbering system (by day, month or year)
> > > > in addition to the facility-assigned ID (which may be linked to a
> > > > department or clinic). Some labs supply pre-numbered specimen labels or
> > > > containers, which the facility can use for its ID if it wants.****
> > > >
> > > > ** **
> > > >
> > > > There are some tests that require more than one specimen. Glucose
> > > > uptake, for example, requires multiple specimens taken at timed intervals.
> > > > But the one affects that us the most is the initial TB test, which requires
> > > > 3 sputum specimens. From a lab point of view, the 3 specimens are 3
> > > > instances of the same test, but in addition there is an interpretation.
> > > > (The same can be said of rapid HIV tests, where there is a confirmatory
> > > > test, except that the tests are performed on aliquots of the same specimen;
> > > > the two tests both have results, and then the relationship of the two
> > > > becomes an interpretation.) The approach I suggest for this is to use a
> > > > base number for the facility specimen ID (eg 12345), with the specimens
> > > > having a suffix (eg 12345A, 12345B); the lab reports the 3 results
> > > > individually by their suffixed specimen ID and the interpretation under the
> > > > base number. ****
> > > >
> > > > ** **
> > > >
> > > > Frequently the facility will use a form to order tests on which the
> > > > provider can tick off multiple tests to be performed. I think we have
> > > > reached consensus that each test which requires a separate specimen
> > > > (subject to the multiple specimen test exception above) will have its own
> > > > order; if the fact that multiple tests were ordered simultaneously is
> > > > important, that will be tracked using order group. Likewise, I think we
> > > > have reached consensus that test panels which produce multiple results will
> > > > all reference the same accession number, as described earlier in this
> > > > thread. Personally, I don't think we need an obs group to tie multiple
> > > > results together, accession number is enough, but some people seem to like
> > > > obs groups.****
> > > >
> > > > ** **
> > > >
> > > > Which finally gets me around to Suranga's original question. My
> > > > understanding is that the original purpose of OBR placer order number and
> > > > filler order number was related to billing; placer order number was like a
> > > > purchase order number and filler order number was like an order number. My
> > > > understanding is that the proper place for the accession number/client
> > > > specimen ID is OBX-4. OBX-3 should be the test result name, typically
> > > > using LOINC if that is available. Note that this is NOT the same as the
> > > > test concept in the order, which may be a panel name or may be more generic
> > > > than the LOINC code (which may specify a particular test method or specimen
> > > > type). This is why it is so important that accession number be assigned
> > > > BEFORE the specimen goes to the lab, it is what allows us to tie orders to
> > > > results.****
> > > >
> > > > ** **
> > > >
> > > > Note also that that the date-time of the observation should be that at
> > > > which the specimen was taken. This should be reported back as OBX-14.*
> > > > ***
> > > >
> > > > ** **
> > > >
> > > > Although I don't see it previously in this thread, I believe different
> > > > implementations are storing lab test observations differently. Some are
> > > > using encounterless observations, while others are putting them under the
> > > > encounter where the tests were ordered (particularly if the tests are done
> > > > on-site as part of the visit). A third method (which I prefer) is to
> > > > record the lab report as an encounter, with the location identifying the
> > > > particular lab used (internal or external) and the provider being the lab
> > > > director signing the report (or a generic provider for each lab); the
> > > > encounter date is the report date (per the previous paragraph, the obs
> > > > dates may not be the same as the encounter date). This provides enough
> > > > information for the patient's doctor to get back to the right person if
> > > > s/he has questions about the results.****
> > > >
> > > > ** **
> > > >
> > > > *From:* dev@openmrs.org [mailto:dev@openmrs.org] *On Behalf Of *Burke
> > > > Mamlin
> > > > *Sent:* Wednesday, September 25, 2013 11:13 PM
> > > > *To:* dev@openmrs.org
> > > > *Subject:* Re: Practical useage of the Obs accessionNumber field****
> > > >
> > > > ** **
> > > >
> > > > The obs accession number comes from the lab and does not need to be
> > > > unique per obs. It typically would be unique to the specimen or lab
> > > > requisition. For simple labs with a single result, the accession number
> > > > may be unique per obs. Labs that are run as batteries or panels could
> > > > produce multiple results (obs) for the same specimen.****
> > > >
> > > > ** **
> > > >
> > > > -Burke****
> > > >
> > > > ** **
> > > >
> > > > On Wed, Sep 25, 2013 at 3:48 PM, Suranga Kasthurirathne <
> > > > surangakas@gmail.com> wrote:****
> > > >
> > > > ** **
> > > >
> > > > Hi,****
> > > >
> > > > ** **
> > > >
> > > > Thank you.****
> > > >
> > > > ** **
> > > >
> > > > So to reiterate, the obs.assessionNumber is intended to be a unique
> > > > identifier per obs ? In this case, we will need to do some refining of that
> > > > column in the current data model. ****
> > > >
> > > > However, this argument takes a bashing if we need to store the result
> > > > of a single lab observation as multiple OpenMRS obs (for example, Jeremy
> > > > was discussing the complexity of storing structured observations today).
> > > > ****
> > > >
> > > > I'm also having the same question Jeremy raised about OBX.3. If so,
> > > > wont the obs accession number and the obs_group_id columns be serving the
> > > > same purpose ?****
> > > >
> > > > ** **
> > > >
> > > > Um... also, I'm not sure I understand what you mean when you say "... This
> > > > could be added as an attribute of encounter or, as a workaround, using
> > > > encounter attributes...". However, creating an observation for an encounter
> > > > identifier seems to be a good way to go.****
> > > >
> > > > ** **
> > > >
> > > > ** **
> > > >
> > > > ** **
> > > >
> > > > ** **
> > > >
> > > > ** **
> > > >
> > > > On Wed, Sep 25, 2013 at 3:34 PM, Jeremy Keiper <jeremy@openmrs.org>
> > > > wrote:****
> > > >
> > > > Looking at the HL7 spec, we see a placer order number and a filler
> > > > order number in OBR (and ORC), but not on OBX. This would mean that the
> > > > accessionNumber would come from a OBR to an entire obs group, but not to
> > > > individual observations. Would OBX-3 then map to a different (new)
> > > > property of obs?****
> > > >
> > > >
> > > > ****
> > > >
> > > >
> > > > Jeremy Keiper
> > > > OpenMRS Core Developer
> > > > AMPATH / IU-Kenya Support****
> > > >
> > > > ** **
> > > >
> > > > On Wed, Sep 25, 2013 at 3:25 PM, Burke Mamlin <burke@openmrs.org>
> > > > wrote:****
> > > >
> > > > obs.accession number was added as a placeholder for accession numbers
> > > > coming from the lab. When a lab runs a test, they usually have an
> > > > accession number or requisition number that is associated with the specimen
> > > > and it's useful to carry this through into the EMR for reference.****
> > > >
> > > > ** **
> > > >
> > > > Visits will probably get an account number in the future; visit
> > > > attributes would be a closer-term workaround.****
> > > >
> > > > ** **
> > > >
> > > > Encounters should be able to store a unique ID (e.g., the MSH message
> > > > key), but don't currently. This could be added as an attribute of
> > > > encounter or, as a workaround, using encounter attributes. Prior to having
> > > > those options, you could create an observation for the encounter identfier.
> > > > ****
> > > >
> > > > ** **
> > > >
> > > > -Burke****
> > > >
> > > > ** **
> > > >
> > > > On Wed, Sep 25, 2013 at 3:10 PM, Suranga Kasthurirathne <
> > > > surangakas@gmail.com> wrote:****
> > > >
> > > > ** **
> > > >
> > > > Hi,****
> > > >
> > > > ** **
> > > >
> > > > I apologize for the multiple emails, but as you've probably noticed,
> > > > i'm battling a learning curve in exploring OpenMRS support for HL7 :-)*
> > > > ***
> > > >
> > > > ** **
> > > >
> > > > I have a question regarding the introduction of the accession number
> > > > field for the Obs table. What was the thinking behind the introduction of
> > > > this column ? was it intended to be used as an identifier for observation
> > > > groups ? I'm asking because there seems to be some folks who identify the
> > > > OBR.3 column (filler order number) with accession numbers. But on the other
> > > > hand, we do have a obs_group_id column as well, so i'm trying to understand
> > > > the difference between the two...****
> > > >
> > > > ** **
> > > >
> > > > According to my current use case, I need to come up with a way to
> > > > persist an identifier for each encounter. Since we cant specify an Id for
> > > > encounters we create on OpenMRS, I was hoping that we could use the
> > > > accession number to represent some sort of uniqueness per encounter ?*
> > > > ***
> > > >
> > > > ** **
> > > >
> > > > ** **
> > > >
> > > > --
> > > > Best Regards,****
> > > >
> > > > ** **
> > > >
> > > > Suranga****
> > > >
> > > > --
> > > > OpenMRS Developers: http://go.openmrs.org/dev
> > > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > > Manage your OpenMRS subscriptions at https://id.openmrs.org/****
> > > >
> > > > ** **
> > > >
> > > > --
> > > > OpenMRS Developers: http://go.openmrs.org/dev
> > > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > > Manage your OpenMRS subscriptions at https://id.openmrs.org/****
> > > >
> > > > ** **
> > > >
> > > > --
> > > > OpenMRS Developers: http://go.openmrs.org/dev
> > > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > > Manage your OpenMRS subscriptions at https://id.openmrs.org/****
> > > >
> > > > To unsubscribe from this group and stop receiving emails from it, send
> > > > an email to dev+unsubscribe@openmrs.org.****
> > > >
> > > >
> > > >
> > > > ****
> > > >
> > > > ** **
> > > >
> > > > --
> > > > Best Regards,****
> > > >
> > > > ** **
> > > >
> > > > Suranga****
> > > >
> > > > --
> > > > OpenMRS Developers: http://go.openmrs.org/dev
> > > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > > Manage your OpenMRS subscriptions at https://id.openmrs.org/****
> > > >
> > > > ** **
> > > >
> > > > --
> > > > OpenMRS Developers: http://go.openmrs.org/dev
> > > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > > Manage your OpenMRS subscriptions at https://id.openmrs.org/****
> > > >
> > > > To unsubscribe from this group and stop receiving emails from it, send
> > > > an email to dev+unsubscribe@openmrs.org.****
> > > >
> > > > --
> > > > OpenMRS Developers: http://go.openmrs.org/dev
> > > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > > Manage your OpenMRS subscriptions at https://id.openmrs.org/
> > > >
> > > > To unsubscribe from this group and stop receiving emails from it, send
> > > > an email to dev+unsubscribe@openmrs.org.
> > > >
> > >
> > >
> > >
> > > --
> > > Best Regards,
> > >
> > > Suranga
> > >
> > > --
> > > OpenMRS Developers: http://go.openmrs.org/dev
> > > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > > Manage your OpenMRS subscriptions at https://id.openmrs.org/
> > >
> >
> > --
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> > Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> > Manage your OpenMRS subscriptions at https://id.openmrs.org/
> >
> > To unsubscribe from this group and stop receiving emails from it, send an
> > email to dev+unsubscribe@openmrs.org.
> >
>
>
>
> --
> Best Regards,
>
> Suranga
>
> --
> OpenMRS Developers: http://go.openmrs.org/dev
> Post: dev@openmrs.org | Unsubscribe: dev+unsubscribe@openmrs.org
> Manage your OpenMRS subscriptions at https://id.openmrs.org/
>
--
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Manage your OpenMRS subscriptions at https://id.openmrs.org/
To unsubscribe from this group and stop receiving emails from it, send an email to \
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[Attachment #3 (text/html)]
<div dir="ltr">Hi Suranga,<div><br></div><div>Do you have a concrete use case for \
wanting to select obs by accessionNumber? Or is it speculative? If the latter, we \
should hold off until it's a concrete request.</div><div>
<br></div><div>-Darius</div></div><div class="gmail_extra"><br><br><div \
class="gmail_quote">On Fri, Sep 27, 2013 at 8:46 PM, Suranga Kasthurirathne <span \
dir="ltr"><<a href="mailto:surangakas@gmail.com" \
target="_blank">surangakas@gmail.com</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc \
solid;padding-left:1ex"><div dir="ltr"><br><div>Yikes, i'm sorry, I keep \
forgetting that the obs table can get verrrry large.</div><div><br>
</div><div>I will add the new index... but of course, we do have quite a number of \
indexes on this table already. I hope that this will not affect the speed of data \
manipulation against the obs table......</div> </div><div class="HOEnZb"><div \
class="h5"><div class="gmail_extra"><br><br><div class="gmail_quote">On Thu, Sep 26, \
2013 at 11:35 PM, Burke Mamlin <span dir="ltr"><<a href="mailto:burke@openmrs.org" \
target="_blank">burke@openmrs.org</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc \
solid;padding-left:1ex"><div dir="ltr">Suranga,<div><br></div><div>Are we indexing \
the accession number in obs? If not, how well will getObsByAccessionNumber() perform \
with 170,270,511 observations like we currently have at AMPATH? :-)</div>
<span><font color="#888888"><div>
<br></div><div>-Burke</div></font></span></div><div><div><div \
class="gmail_extra"><br><br><div class="gmail_quote">On Thu, Sep 26, 2013 at 2:32 PM, \
Suranga Kasthurirathne <span dir="ltr"><<a href="mailto:surangakas@gmail.com" \
target="_blank">surangakas@gmail.com</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc \
solid;padding-left:1ex"><div dir="ltr"><br><div>Hi,</div><div><br></div><div>Just to \
say that I made a pull request for accession number based retrieval here <a \
href="https://github.com/openmrs/openmrs-core/pull/411" \
target="_blank">https://github.com/openmrs/openmrs-core/pull/411</a></div>
</div><div><div><div class="gmail_extra"><br><br><div class="gmail_quote">On Thu, Sep \
26, 2013 at 8:26 AM, Friedman, Roger (CDC/CGH/DGHA) (CTR) <span dir="ltr"><<a \
href="mailto:rdf4@cdc.gov" target="_blank">rdf4@cdc.gov</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc \
solid;padding-left:1ex">
<div lang="EN-US" link="blue" vlink="purple">
<div>
<p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Burke, \
I don't think it's right to say that the accession number is defined by the \
lab. The accession number is the specimen ID assigned by the facility when the \
specimen is sent to the lab. Inside the lab, it is known as the client specimen \
number. The lab will have its own specimen ID/accession number, known as the lab \
specimen number. Peoples' views may be distorted by clinical labs or by hospital \
labs using on-call specimen collectors, where the specimen is taken by lab personnel \
and analyzed within the same facility. However, in many cases, the specimen will be \
analyzed by an outside lab, where the facility-assigned specimen ID is the \
appropriate linkage, and this is the base case, with internal labs behaving as if \
the facility was its client. Best practice, similar to pharmacy, is for the lab to \
have a sequential numbering system (by day, month or year) in addition to the \
facility-assigned ID (which may be linked to a department or clinic). Some labs \
supply pre-numbered specimen labels or containers, which the facility can use for its \
ID if it wants.<u></u><u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> \
<u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">There \
are some tests that require more than one specimen. Glucose uptake, for example, \
requires multiple specimens taken at timed intervals. But the one affects that us \
the most is the initial TB test, which requires 3 sputum specimens. From a lab point \
of view, the 3 specimens are 3 instances of the same test, but in addition there is \
an interpretation. (The same can be said of rapid HIV tests, where there is a \
confirmatory test, except that the tests are performed on aliquots of the same \
specimen; the two tests both have results, and then the relationship of the two \
becomes an interpretation.) The approach I suggest for this is to use a base number \
for the facility specimen ID (eg 12345), with the specimens having a suffix (eg \
12345A, 12345B); the lab reports the 3 results individually by their suffixed \
specimen ID and the interpretation under the base number. <u></u><u></u></span></p>
<p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> \
<u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Frequently \
the facility will use a form to order tests on which the provider can tick off \
multiple tests to be performed. I think we have reached consensus that each test \
which requires a separate specimen (subject to the multiple specimen test exception \
above) will have its own order; if the fact that multiple tests were ordered \
simultaneously is important, that will be tracked using order group. Likewise, I \
think we have reached consensus that test panels which produce multiple results will \
all reference the same accession number, as described earlier in this thread. \
Personally, I don't think we need an obs group to tie multiple results together, \
accession number is enough, but some people seem to like obs \
groups.<u></u><u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> \
<u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Which \
finally gets me around to Suranga's original question. My understanding is that \
the original purpose of OBR placer order number and filler order number was related \
to billing; placer order number was like a purchase order number and filler order \
number was like an order number. My understanding is that the proper place for the \
accession number/client specimen ID is OBX-4. OBX-3 should be the test result name, \
typically using LOINC if that is available. Note that this is NOT the same as the \
test concept in the order, which may be a panel name or may be more generic than the \
LOINC code (which may specify a particular test method or specimen type). This is \
why it is so important that accession number be assigned BEFORE the specimen goes to \
the lab, it is what allows us to tie orders to results.<u></u><u></u></span></p> <p \
class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> \
<u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Note \
also that that the date-time of the observation should be that at which the specimen \
was taken. This should be reported back as OBX-14.<u></u><u></u></span></p>
<p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> \
<u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Although \
I don't see it previously in this thread, I believe different implementations are \
storing lab test observations differently. Some are using encounterless \
observations, while others are putting them under the encounter where the tests were \
ordered (particularly if the tests are done on-site as part of the visit). A third \
method (which I prefer) is to record the lab report as an encounter, with the \
location identifying the particular lab used (internal or external) and the provider \
being the lab director signing the report (or a generic provider for each lab); the \
encounter date is the report date (per the previous paragraph, the obs dates may not \
be the same as the encounter date). This provides enough information for the \
patient's doctor to get back to the right person if s/he has questions about the \
results.<u></u><u></u></span></p> <p class="MsoNormal"><span \
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> \
<u></u></span></p> <p class="MsoNormal"><b><span \
style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span \
style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a \
href="mailto:dev@openmrs.org" target="_blank">dev@openmrs.org</a> [mailto:<a \
href="mailto:dev@openmrs.org" target="_blank">dev@openmrs.org</a>] <b>On Behalf Of \
</b>Burke Mamlin<br> <b>Sent:</b> Wednesday, September 25, 2013 11:13 PM<br>
<b>To:</b> <a href="mailto:dev@openmrs.org" target="_blank">dev@openmrs.org</a><br>
<b>Subject:</b> Re: Practical useage of the Obs accessionNumber \
field<u></u><u></u></span></p><div><div> <p class="MsoNormal"><u></u> <u></u></p>
<div>
<p class="MsoNormal">The obs accession number comes from the lab and does not need to \
be unique per obs. It typically would be unique to the specimen or lab requisition. \
For simple labs with a single result, the accession number may be unique per obs. \
Labs that are run as batteries or panels could produce multiple results (obs) for \
the same specimen.<u></u><u></u></p> <div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">-Burke<u></u><u></u></p>
</div>
</div>
<div>
<p class="MsoNormal" style="margin-bottom:12.0pt"><u></u> <u></u></p>
<div>
<p class="MsoNormal">On Wed, Sep 25, 2013 at 3:48 PM, Suranga Kasthurirathne <<a \
href="mailto:surangakas@gmail.com" target="_blank">surangakas@gmail.com</a>> \
wrote:<u></u><u></u></p> <div>
<p class="MsoNormal"><u></u> <u></u></p>
<div>
<p class="MsoNormal">Hi,<u></u><u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">Thank you.<u></u><u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">So to reiterate, the obs.assessionNumber is intended to be a \
unique identifier per obs ? In this case, we will need to do some refining of that \
column in the current data model. <u></u><u></u></p> </div>
<div>
<p class="MsoNormal">However, this argument takes a bashing if we need to store the \
result of a single lab observation as multiple OpenMRS obs (for example, Jeremy was \
discussing the complexity of storing structured observations today). \
<u></u><u></u></p>
</div>
<div>
<p class="MsoNormal"><span \
style="font-size:10.0pt;font-family:"Arial","sans-serif"">I'm \
also having the same question Jeremy raised about OBX.3. If so, wont the obs \
accession number and the obs_group_id columns be serving the same purpose \
?</span><u></u><u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">Um... also, I'm not sure I understand what you mean when you \
say "... <span style="font-size:10.0pt;font-family:"Arial","sans-serif"">This \
could be added as an attribute of encounter or, as a workaround, using encounter \
attributes...". However, creating an observation for an encounter identifier \
seems to be a good way to go.</span><u></u><u></u></p> </div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
</div>
<div>
<p class="MsoNormal" style="margin-bottom:12.0pt"><u></u> <u></u></p>
<div>
<div>
<div>
<p class="MsoNormal">On Wed, Sep 25, 2013 at 3:34 PM, Jeremy Keiper <<a \
href="mailto:jeremy@openmrs.org" target="_blank">jeremy@openmrs.org</a>> \
wrote:<u></u><u></u></p> </div>
</div>
<blockquote style="border:none;border-left:solid #cccccc 1.0pt;padding:0in 0in 0in \
6.0pt;margin-left:4.8pt;margin-right:0in"> <div>
<div>
<div>
<p class="MsoNormal">Looking at the HL7 spec, we see a placer order number and a \
filler order number in OBR (and ORC), but not on OBX. This would mean that the \
accessionNumber would come from a OBR to an entire obs group, but not to individual \
observations. Would OBX-3 then map to a different (new) property of \
obs?<u></u><u></u></p> </div>
<div>
<p class="MsoNormal"><span style="color:#888888"><br clear="all">
<u></u><u></u></span></p>
<div>
<p class="MsoNormal"><span style="color:#888888"><br>
Jeremy Keiper<br>
OpenMRS Core Developer<br>
AMPATH / IU-Kenya Support<u></u><u></u></span></p>
</div>
<div>
<div>
<p class="MsoNormal" style="margin-bottom:12.0pt"><u></u> <u></u></p>
<div>
<p class="MsoNormal">On Wed, Sep 25, 2013 at 3:25 PM, Burke Mamlin <<a \
href="mailto:burke@openmrs.org" target="_blank">burke@openmrs.org</a>> \
wrote:<u></u><u></u></p> <div>
<p class="MsoNormal">obs.accession number was added as a placeholder for accession \
numbers coming from the lab. When a lab runs a test, they usually have an accession \
number or requisition number that is associated with the specimen and it's useful \
to carry this through into the EMR for reference.<u></u><u></u></p>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">Visits will probably get an account number in the future; visit \
attributes would be a closer-term workaround.<u></u><u></u></p> </div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">Encounters should be able to store a unique ID (e.g., the MSH \
message key), but don't currently. This could be added as an attribute of \
encounter or, as a workaround, using encounter attributes. Prior to having those \
options, you could create an observation for the encounter identfier.<span \
style="color:#888888"><u></u><u></u></span></p> <div>
<p class="MsoNormal"><span style="color:#888888"><u></u> <u></u></span></p>
</div>
<div>
<p class="MsoNormal"><span style="color:#888888">-Burke<u></u><u></u></span></p>
</div>
</div>
</div>
<div>
<div>
<div>
<p class="MsoNormal" style="margin-bottom:12.0pt"><u></u> <u></u></p>
<div>
<p class="MsoNormal">On Wed, Sep 25, 2013 at 3:10 PM, Suranga Kasthurirathne <<a \
href="mailto:surangakas@gmail.com" target="_blank">surangakas@gmail.com</a>> \
wrote:<u></u><u></u></p> <div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<p class="MsoNormal">Hi,<u></u><u></u></p>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">I apologize for the multiple emails, but as you've probably \
noticed, i'm battling a learning curve in exploring OpenMRS support for HL7 \
:-)<u></u><u></u></p> </div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">I have a question regarding the introduction of the accession \
number field for the Obs table. What was the thinking behind the introduction of this \
column ? was it intended to be used as an identifier for observation groups ? I'm \
asking because there seems to be some folks who identify the OBR.3 column (filler \
order number) with accession numbers. But on the other hand, we do have a \
obs_group_id column as well, so i'm trying to understand the difference between \
the two...<u></u><u></u></p>
</div>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal">According to my current use case, I need to come up with a way \
to persist an identifier for each encounter. Since we cant specify an Id for \
encounters we create on OpenMRS, I was hoping that we could use the accession number \
to represent some sort of uniqueness per encounter ?<u></u><u></u></p>
</div>
<div>
<p class="MsoNormal"><span style="color:#888888"><u></u> <u></u></span></p>
</div>
<div>
<p class="MsoNormal"><span style="color:#888888"><u></u> <u></u></span></p>
</div>
<div>
<p class="MsoNormal"><span style="color:#888888">-- <br>
Best Regards,<u></u><u></u></span></p>
<div>
<p class="MsoNormal"><span style="color:#888888"><u></u> <u></u></span></p>
</div>
<div>
<p class="MsoNormal"><span style="color:#888888">Suranga<u></u><u></u></span></p>
</div>
</div>
</div>
<p class="MsoNormal"><span style="color:#888888">-- <br>
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<p class="MsoNormal"><u></u> <u></u></p>
</div>
<p class="MsoNormal">-- <br>
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<p class="MsoNormal"><u></u> <u></u></p>
</div>
</div>
</div>
</div>
</div>
<div>
<div>
<div>
<div>
<p class="MsoNormal">-- <br>
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target="_blank">http://go.openmrs.org/dev</a><br>
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</div>
</blockquote>
</div>
<p class="MsoNormal"><span style="color:#888888"><br>
<br clear="all">
<span><u></u><u></u></span></span></p>
<div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<p class="MsoNormal"><span><span style="color:#888888">-- </span></span><span \
style="color:#888888"><br> <span>Best \
Regards,</span></span><span><u></u><u></u></span></p> <div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<div>
<p class="MsoNormal"><span style="color:#888888">Suranga<u></u><u></u></span></p>
</div>
</div>
<div>
<div>
<p class="MsoNormal">-- <br>
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target="_blank">http://go.openmrs.org/dev</a><br>
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</div>
<p class="MsoNormal"><u></u> <u></u></p>
</div>
<p class="MsoNormal">-- <br>
OpenMRS Developers: <a href="http://go.openmrs.org/dev" \
target="_blank">http://go.openmrs.org/dev</a><br>
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<p></p>
-- <br>
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</div></div></blockquote></div><br><br clear="all"><div><br></div>-- <br>Best \
Regards,<div><br></div><div>Suranga</div> </div>
<p></p>
-- <br>
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-- <br>
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</div></div></blockquote></div><br><br clear="all"><div><br></div>-- <br>Best \
Regards,<div><br></div><div>Suranga</div> </div>
<p></p>
-- <br>
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