How do people use investigations
Investigations can be linked to products - ie if you invoice say 'Albumin Assay' which has an investigation "Bloggs Lab Test" linked to it, then the investigation gets automatically created.
However as I have discovered (see http://www.openvpms.org/forum/investigation-template-type ) no trace is left in the investigation record of the fact that what was wanted from the Bloggs Test Lab was an Albumin Assay rather than some other test.
How do people use this facility without it having a trace of what test was needed? Do you create a different investigation type for each test for each lab?
If this is indeed the case, I am faced with having not 7 different investigation types (one per lab used) but around 250 (one per product that has an investigation attached). [Note that I am converting an RxWorks system for an existing practice.]
As I see it there are 3 possible solutions to the problem:
- the above - create one investigation type per test - brute force and crude
- Tim A's suggestion - give the act.patientInvestigation archetype an optional product node - probably the correct way to go but a reasonable amount of work
- my suggestion - use the Notes field of the investigation. Currently this gets populated with just the investigation type - ie 'Bloggs Test Lab' in the above example. However, as shown in the snippet below, this is redundant information - the investigation type is already displayed. My suggestion is that the Notes field be set not to the Investigation type, but rather the name of the product that generated the investigation - ie 'Albumin Assay'.
Q1 - how do people currently handle this problem - do you really have one investigation type per test?
Q2 - if my suggestion (ie initially set the Notes field to the product name rather than the Investigation Type) were adopted, would this screw anyone up?
Regards, Tim G
Re: How do people use investigations
Hi Tim,
Currently we type the test/s requested into the notes field to address this problems. Your suggestion of setting the notes field to the product name would be helpful here. The only place it would fall down is in cases where we invoice multiple tests under the one investigation.
For example. If I send blood to idexx and request a Test A and Test Y on the same form. You would still need to manually add some information to the notes field.
I guess a workaround for this is when requesting mutliple tests then generating a seperate form and investigation number for each test.
Re: How do people use investigations
Adrian(?) - I think that the 'multiple tests' question can be resolved by considering the following:
From my point of view (the programmer), it is cleanest to generate one investigation per test - then the results come back and get loaded each to their own test. However, I have no experience with what happens in the real world, and it may be that if you send off to Bloggs Labs, 5 separate requests for the one animal (with presumably one blood/whatever sample) they say - NO you have to submit one form with one sample and tick the boxes for the 5 tests you want. So the one investigation per test will not really work well here.
I also don't know what the docload program does if you specify no-overwrite and it finds another result document with the same investigation number. I suspect it just versions the previous one down. However, this is not really true - we have the result of test A for investigation 123 and then the result for Test B for the same investigation - not a new version of the result for Test A.
This implies that you do really want one investigation per test - unless the lab sends back one pdf file (or whatever) with the results of all requested tests.
This suggests an alternative approach: separate products for each test (so they get charged correctly), but one zero-charge product per lab - with the investigation linked to this. But this also could have disadvantages.
Yet another approach for the multiple test case is to automatically generate one investigation per test, and then if the lab would rather you submit one request, delete all but one of the investigations and edit the note field on the remaining one to add it the other tests.
Alternatively you could leave all the investigations there, but only send off one form to the lab (but with multiple boxes ticked) when the results come back then: if one combined - load this and note on the other investigations 'see inv # 122345' and change their status to received or completed.
However, I take it that you do agree for the non-multiple test senario, there is no downside in putting the product name in the Notes field of the automatically generated investigation. [I want to ask Tim A to sneak this into 1.7]
Regards, Tim G
Re: How do people use investigations
I'm not so keen on putting the product name in the notes field. I'd prefer a relationship back to the product that generated the investigation.
Coding wise, they are much the same.
-Tim A
Re: How do people use investigations
Tim - are you sure they are much the same? You also have to add the code so that a manually created investigation can have a product added to it. If you make it a 'one investigation can be linked to multiple products' set up [which makes sense as it fits the 'one investigation for multiple tests' senario] then you have to add the 'add/delete product to investigation' facility and possibly a note field for each linked product.
However, if you reckon it is roughly the same code, can you give me a price for the upgrade - don't cost in the CSH mods and a sample investigation template - I will do those.
Regards, Tim G
Re: How do people use investigations
If I understand correctly, all you want is for the product that generates the investigation at charging to appear in the investigation. If you create the investigation manually, or edit it, you would be able to assign whatever product you like.
The product would be an optional field (i.e participation node) of the investigation act.
-Tim A
Re: How do people use investigations
Yes Tim - that would do it for me. Having just looked at the other participation architypes, I now understand that this is a very simple linkage (unlike the entity relationship ones which can have other fields).
I suspect that those who may want to have multiple tests in one investigation might like the Investigation to Product link to have min/max cardinality 0/-1 rather than 0/1.
Regards, Tim G
Re: How do people use investigations
Is there a scenario where multiple products are useful?
From a charging perspective, a product can only be associated with 0..1 investigation.
There's also the issue of how to process multiple products within the investigation template.
Re: How do people use investigations
Tim - we do really need input from the real vets - I suspect that it is not uncommon for there to be a requirement for multiple tests done on one sample sent to one lab.
I can conceive of three ways of handling this:
As I indicated in earlier discussion, the optimum approach will also depend on how the results come back from the lab. If a request for multiple tests comes back with one result set, then it is better to have one investigation (ie 1 or 2 above) - if you use 3 above, then you have to have some procedure for entering the one result set against multiple investigations.
The above discussion is not really complete as it does not fully address the charging side. It preferable to invoice multiple tests separately so that the customer sees what is being done for their money. We also need to bear in mind that the investigation itself is just a way of tracking things. If we did not have the 'create investigation when this product invoiced' facility, then the process would be as follows:
The 'create investigation when this product invoiced' facility adds the benefit that the investigation gets created automatically, but results in the problem of what to do about the case where multiple tests are to be done by one lab. Should one then use approach 3 above (ie multiple investigations, one test per investigation), or should you then delete all but one of the investigations to the one lab and manually add the other tests onto the remaining investigation.
Can the real vets please speak up, us two Tims are simple programmers and need guidance in this matter as to how to craft things to be optimum for the real world.
Regards, Tim G
Re: How do people use investigations
Hi,
I am told I am a real vet so here goes.
It is common for us to submit one lab request (form and investigation number) with multiple tests.
Likewise in the case of in house lab machines (e.g. IDEXX) it is common for us to run a variety of different tests under one investigation number.
There are too many different combinations of tests that could be sent to a lab so looking at the suggested methods above I like the suggestion that...
1) You create an investigation (with a unique investigation number)
2) You add one or more tests to this investigation.
3) The notes field of the investigation has information about the tests requested for that investigation (so when we are in the notes screen we know what investigation to open to look at results for a particular test).
4) Bonus marks if we can invoice items as we add them from an investigation.
Other comments:
- A form for each test and new investigation number for each test seems a waste of paper and a recipe for disaster with the labs.
- Lab results for multiple tests come back in one file from the lab.
Let me know if I am missing something.
Re: How do people use investigations
I consulted with our practive manager in Hong Kong and she replied as follows:
"Hi Tim, I can see where you're coming from, but in reality, most tests we invoice for have one set of results - I can think of maybe one on that list that differs, but in those unusual cases, we can manually add the extra results when they come in. What I don't want to do is to rely on the vets to both invoice and create an investigation as I know this would never get done and we'd lose results all over the place.
In 99% of cases, one invoice item will result in one set of results."
So Tim A - as far as the Hong Kong push is concerned, we are happy with the one product per investigation.
Regards, Tim G
Re: How do people use investigations
I've created http://www.openvpms.org/project/investigation-product for this.
Regards,
-Tim A