Cases: Status and Lifecycle

Sections: Status | Lifecycle | Notes


Status

A case always has a single status at any given time which represents its current place in the LIS Interaction portion of the case’s lifecycle (see below) and determines if a case is mutable (i.e., core data changes can occur via editing), which status transitions are allowed, and how a user can interact with the case.

  • New: This is the initial status of a case when it is accessioned in Pathagility WorkPath.
    • Mutable: Yes
    • Transitions: Open, Signed
  • Open: This is the status of a case once there is any direct user interaction (e.g., view, edit) after it’s been accessioned.
    • Mutable: Yes
    • Transitions: Signed, Canceled
  • Signed: This is the status of a case once a specially-designated user with appropriate authority reviews all case data and provides final approval by signing the case.
    • Mutable: No (core data changes must occur via amendment)
    • Transitions: Released, Canceled
  • Released: This is the final/terminal status of a case that is intended for end-user (e.g., physician, patient, reference lab, originating EMR, billing partner) consumption. Distribution rules related to the delivery of end-clinician reports, discrete results, or billing messages are most frequently (and appropriately) triggered by this status.
    • Mutable: No (core data changes must occur via amendment)
    • Transitions: n/a
  • Canceled: This is the final/terminal status of a case that is not intended for end-user consumption.
    • Mutable: No (core data changes must occur via amendment)
    • Transitions: n/a

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Lifecycle

While there are no absolutes, most cases share common milestones within their lifecycle. Below is an example of such a lifecycle, with steps split out into separate categories. This list is neither intended to be exhaustively complete nor dictate a specific order of operations, although some steps cannot be realistically completed without first addressing other prerequisite steps. Every customer has their own internal processes, so in some scenarios steps listed separately here will be combined and performed as a single action, certain steps might be repeated multiple times by different parties at varying times, and other steps could be bypassed completely. When creating queues and workflows or engaging Pathagility to develop a third-party interface, this lifecycle reference can be useful when considering how various pieces and players interact.

  • Data Gathering
    1. Obtain patient data (demographics)
    2. Obtain patient data (insurance)
    3. Determine testing regimen
    4. Complete requisition
    5. Place order
  • Specimen Handling
    1. Obtain specimen
    2. Validate specimen
    3. Prepare specimen for testing
  • Testing & Results
    1. Perform testing
    2. Validate testing results
    3. Retrieve results from instruments
    4. Prepare results for LIS
  • LIS Interaction
    1. Accession case
    2. Add supplemental case data (e.g., additional demographics, updated insurance details, scanned requisition)
    3. Add case results
    4. Process case results
    5. Interpret case results
    6. Generate end-clinician report for case
    7. Review and verify all case data
    8. Sign case
    9. Release case
    10. Distribute case data

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Notes

  • Case mutability determines whether or not core data (e.g., patient, physicians, facilities, diagnosis codes, specimens, medications, panels, tests, results) can be edited, but supplemental data (e.g., queues, files, internal notes, properties, related cases) can be edited regardless of status.
  • In common parlance, the phrase ‘open cases’ often refers to case mutability and so typically includes cases with a status of New and/or Open.
  • See also: Cases: Data Elements

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