EMR-Link Help -- Results Builder Tool

Results Builder Tool Help

The EMR-Link Results Builder Tool simplifies the creation and maintenance of your lab results cross-reference mapping. This tool is delivered as an Excel spreadsheet that contains an EMR Observation term database, a lab compendium, and a set of built-in macros to assist in the process of mapping and maintaining your EMR to lab cross-reference file. It also simplifies the management of the flowsheet views that rely on the incoming lab data.

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Overview

Preconfigured mapping files -- The Results Builder comes pre-configured with a set of cross-reference files. In most cases the mapping includes hundreds of terms. This saves an enormous amount of work when setting up and configuring new interfaces.
Mapping Dialog -- The Results Builder comes with a built-in code mapping tool. Just double click on the observation term you want to map and a smart search dialog pops up to assist with mapping the obs term to the correct lab result in the compendium. If you prefer to map the other direction by starting with the lab code and searching for a corresponding EMR Obs term, simply go to the Compendium worksheet and double click on the row you want to map. Another search dialog pops up but this one helps you find the right EMR Observation Term.
Create Lab Kit -- Once the mapping is complete you can create a LinkLogic Lab Interface Kit for import into the EMR including the lab cross-reference file. This kit contains the lab results cross-reference file.
Import a Cross-Reference file -- If you already have an existing cross-reference file you can import it into the tool and merge the data into your mapping spreadsheet. The import process will highlight any invalid mappings in your file and if your file contains mappings that are not currently known by the tool, they will be automatically added to the master Result Map so that they become part of all future lab kits.
Import a Lab Compendium -- The Results Builder Tool is delivered to you with a current lab compendium. Unfortunately, the labs are constantly adding and dropping codes. Over a period of just a few months it's possible that some of the lab codes in your mapping file have become obsolete. For proper maintenance you'll want to import a current compendium on a regular basis.
Import an Obs-Term Kit -- The Results Builder Tool is delivered to you with a current list of GE Observation Terms. GE updates this list periodically and you'll want to update your tool with the most current set of terms as they become available on the GE Support web site.
Validate your map against the lab compendium -- Running the validation is a good way to ensure that your cross-reference file is correct and doesn't contain ineligible duplicates or obsolete codes. Lab vendors continually add and drop lab codes. The only way to ensure your mappings stay correct is to validate your code map against a current lab compendium. A validation is run automatically when you create a lab kit.
Create and export flowsheet views -- Since incoming lab results are typically pushed to your EMR flowsheet it's logical that you might want to manage your flowsheet views in the same file as you manage your lab result mappings. This way you can see exactly which lab codes and obs terms are feeding your flowsheet value. Once you have selected which rows you want to include in your flowsheet view you can export it as a kit which can then be imported into the EMR.
Import existing flowsheet views -- If you already have flowsheet views created in your EMR and want to see what codes are mapped to feed the flowsheet data you can export the flowsheet view as a kit and import it into the Result Builder Tool. Each flowsheet view displays as a column in the Result map with a marker in each row that corresponds to the appropriate EMR Obs term (and lab code). If a flowsheet item is not currently mapped it is highlighted in red so it's easy to see which terms need to be mapped to complete the flowsheet.
Matchup lab codes from an HL7 file -- If you have an HL7 Lab Results file and want to quickly see what lab codes and obs terms it contains you can import it into the Results Builder Tool. It will tag each row in the compendium and Result Map where there is a matching code.
Matchup lab LOINC to EMR Codes -- Several of the Observation Term EMR Codes are LOINC-based. This option will walk through the lab compendium and attempt to automatically map a lab LOINC value to a matching EMR Code that starts with "LOI-". Note that it will only map the lab code if it is not already mapped and if the matching obs-term is not already mapped. This process may take several minutes to complete...depending on the size of the lab compendium.
Volume information -- One of the things that the labs provide as part of the Lab Results implementation is a Utilization Report that indicates how many times each test has been ordered over the last 6 months to 1 year. Ignis imports this utilization data into the Results Builder Tool. This allows us to sort the data based on usage and make sure that any high-volume tests are mapped. If there are a lot of tests to be mapped this allows you to focus on the most import (high volume) tests first.
Sorting Options -- When reviewing the mapping data it's often useful to sort it in different ways. Since not everyone is familiar with Excel the tool provides some quick sort options that can be selected directly from the toolbar.
CCC Mappings -- Because many clinics use CCC forms it's often important to make sure incoming lab results map to the same obs terms used on the CCC forms. The Results Builder Tool includes a column that tags all the rows used by CCC so that when you perform your mapping you can ensure you use the same term. The CCC column is hidden by default but can be made visible by selecting the "Show/Hide CCC column" from the EMR-Link Results Toolbar.

Functional Details

Preconfigured mapping files

One of the most time-consuming tasks when implementing a lab results interface is the mapping of the lab codes to the EMR Observation terms. This task is not only tedious but also requires some amount of clinical knowledge so it generally requires someone from the clinic to take on this chore.
The Lab Results Builder comes preconfigured with mapping tables that already cover the most frequently ordered tests. Most of the maps cross-reference over four hundred terms. For LabCorp, the tool has over 1000 terms mapped.

Mapping Dialog

Although the Lab Results Builder comes preconfigured with hundreds of terms already mapped there are still cases where some of the lab codes needed are not mapped. This is particularly true for specialty clinics that use more of the non-standard results.
The Lab Results Builder has a built-in code mapping dialog that can be invoked by just double clicking on the row you want to map. The dialog uses the string from the cell you clicked on so it makes sense to click on the EMR Name cell when invoking the code mapper on the Results Map worksheet.
When the dialog pops up, it highlights the row you want to map and also displays the data from that row at the top of the dialog. You can change the mapping row without exiting the dialog by using the up and down arrows at the top of the dialog where the current row information is displayed.
The search can be modified by simply typing in what you want and pressing "Enter" on your keyboard (which actives the search button) or you can quickly seed the search string by double clicking on the "EMR Name" or "EMR Description" fields at the top of the form.
The search uses the string in the Find field as well as the EMR Code to perform the search. In some cases the EMR Code is a LOINC which may find a match if the lab has provided LOINC information. (LabCorp generally does.)
The search results are displayed int the listbox at the bottom of the form and a counter indicates the number of matching rows found. To map the data simply select the desired row in the list box and then click the "Map It" button. A double-click on the row will also work.
Whenever a row is mapped the code mapper automatically selects the next row in the worksheet.
In some cases it makes more sense to map from the Compendium rather than the Result Map. On the Result Map you know the EMR Obs Term and you want to find a matching lab results. But quite often you know the lab result and need to find a valid Obs Term to map to. If that's the case then you can move to the Compendium worksheet to perform the mapping. A double-click brings up the code mapper and the features are the same as the Result Map code mapping dialog.

Create Lab Kit

Generates a LinkLogic lab kit for import into Centricity EMR. The kit includes a cross-reference file for mapping the lab codes to the EMR Observation terms.
A validation is run against your mappings when the kit is exported to ensure the resulting cross-reference file does not contain unwanted duplicates or mappings to obsolete codes.
The lab kit is written into a subfolder of the current working directory and will overwrite an existing kit of the same name.
The lab kit folder name is based on the Lab and region (E.g. "Quest (DAL) Irving, TX - Lab Kit". For labs with no region such as LabCorp, it's just "LabCorp - Lab Kit"
The cross-reference file only includes rows from the spreadsheet that have a non-null value in the "x-ref" column. The x-ref column provides a way for you to exclude specific maps. This is handy when there are duplicates and you're not always sure which one to use.
LinkLogic allows different lab codes to map to the same EMR code but does not accept duplicate lab codes mapping to different EMR codes. I.e. a many-to-one mapping is okay, but a one-to-many is not valid. The export macro checks for the one-to-many condition and creates an "Errors" worksheet listing the duplicate rows. The duplicates are not included in the cross-reference file.

Import a Cross-Reference file

This functionality allows you to import an existing cross-reference file into the Results Builder tool.
The cross-reference file is imported into it's own worksheet and expanded out so that you can see, not just the labcode and emr code, but the associated description for each as well. (The descriptions are read from the compendium and Result Map.)
During the import, the compendium is searched for each lab code. If no match is found then the code is tagged as invalid and highlighted in red in the newly created cross-reference spreadsheet.
The Result Map is also searched and if the imported cross-reference file contains a valid lab code mapping that is not in the Result Map, then the new found mapping is added to the Result Map worksheet. The text is highlighted in blue to make it easy to spot the new additions.

Import a Lab Compendium

The Results Builder Tool ships with a current lab compendium. Unfortunately, the lab codes and descriptions change frequently and the lab vendors provide revised compendiums on regular frequency. Monthly is typical. By updating your Results Builder with a current lab compendium on a regular basis you ensure that your mapping file always contains the right lab codes.

Import an Obs-Term Kit

The Results Builder Tool ships with a current dictionary of GE Observation terms. GE updates the set of Obs-Terms every couple of months. By updating your Results Builder with a current set of Obs-Terms on a regular basis you ensure that your mapping file always contains the complete set of available Observation terms.

The ResultsBuilder tool will tell you (upon login) if there is a new set of Observation Terms available. You can select "Download new Obs-Term kit" from the EMR-Link Results Toolbar menu to get the latest set of Obs-Terms.

Validate your map against the lab compendium

Any time you update to a new compendium or modify the Result Map worksheet you should run a validation to reveal any obsolete codes or duplicate mappings.
You can easily correct or update invalid mappings using the mapping dialog and then re-generate your cross-reference file.

Create and export flowsheet views

Flowsheet views can be created by simply labeling a column with the flowsheet name and then putting an 'x' in each row of that column to mark the data you want to include in your view.
When exporting flowsheet views you simply indicate which columns to include and they get exported as a flowsheet kit which can then be imported into the EMR.

Import existing flowsheet views

If you're not starting from scratch and already have flowsheet views created in your EMR you can export them as a kit and then import that kit into your Results Builder.
When you import a flowsheet kit, it results in a new worksheet being create in the Results Builder. You can then selectively transfer a specific flowsheet to the Results Map worksheet.
During the transfer it looks up the corresponding Observation Term for each flowsheet entry and marks it in a new column on the Result Map. If a corresponding Obs term cannot be found it is marked as such on the flowsheet worksheet.

Matchup lab codes from an HL7 file

If you have an HL7 lab results file and you want to know what lab results are in the file and which codes are mapped you can run the Matchup from an HL7 file function.
When the function executes it walks through the file and finds the lab codes from each OBX record. It finds the matching lab code in the Compendium and tags that row so you can see which code was used. If that code is not mapped to an EMR term then the tag will show up in red.
When starting the function you also have the option of picking a column on the Results Map worksheet to use as a marker for each lab code found that has a corresponding EMR term mapped.

Matchup LOINC to EMR Codes

Several of the Observation Term EMR Codes are LOINC-based. This option will walk through the lab compendium and attempt to automatically map a lab LOINC value to a matching EMR Code that starts with "LOI-". Note that it will only map the lab code if it is not already mapped and if the matching obs-term is not already mapped. This process may take several minutes to complete...depending on the size of the lab compendium.

Volume information

The Results Builder tool is generally delivered to you with a year's worth of volume information included. The volume column indicates how many times a given results was sent to your clinic.
The volume column shows up in the compendium and can also be transferred to the Result Map. The transfer process looks to see if the lab code is mapped and if so, it copies the volume for that specific result code into the corresponding row on the Result Map worksheet. If, the lab code cannot be found on the Result Map that means that it has not been mapped and the volume number will change to red on the compendium worksheet.

Sorting Options

Excel has some great built-in sorting features but not everyone knows how to use them and, if you do the sort incorrectly, you can mess up the data so that columns are no longer correctly aligned. To help out, the Results Builder includes a set of commonly needed sorting options. Just select Sorting Options and pick the method you want to use.
With the exception of the "sort by selecting a column" options all other sorts only apply to the Result Map worksheet. The sort by selecting a column options will also work on the Compendium.

CCC Mappings

The CCC column tags those EMR terms that show up on CCC forms. This can help users of CCC forms know which terms to use when mapping the lab codes so you stay consistent in your EMR Observation terminology.

Reference Information

This section provides quick help for each EMR-Link function/macro available in the Results Builder Tool.

Export Options

Export Lab Kit

This function creates a LinkLogic Lab Interface Kit from the data in the Result Map worksheet. The Lab Interface Kit consists of an .ikt, .lst, .xrf file and is created using the contents of columns A and F.

The key element of the kit is the .xrf file which contains the cross-reference data. If you already have an existing LinkLogic interface you may not need the entire kit. You should still export the kit and can then use only the .xrf file contained in the kit.

Only rows that contain a value in column B (x-ref?) will be included in the kit.

When this function executes it will popup a dialog that provides you with an option to set the lab kit name. The name you enter will become the LinkLogic "Relationship" name when the kit is imported into the EMR.

The Lab Interface Kit is written into it's own folder which is created in the same directory as your Results Builder Tool.

Be sure to always run a validation before exporting the lab interface kit. The validation will check to make sure your Results map contains no obsolete codes and also points out any duplicate codes and which can also cause problems with the lab results import process.
Export Flowsheet Kit

This function creates a Flowsheet kit from a selected column in the Result Map worksheet. The custom list kit consists of a .ckt and .lst files.

Only rows that contain a tag in the selected Flowsheet column (e.g. an 'x' or a number '03') will be included in the kit.

When this function executes it will popup a dialog asking you to select one or more columns containing your Flowsheet Views.

The Flowsheet kit is written into it's own folder which is created in the same directory as your Results Builder Tool.
Export Results Builder to Backup

This function creates a backup image of your Results Map and Compendium worksheets and writes the contents to a file located in the same folder as your Results Builder tool.

Use this function when you want to upgrade to a newer version of the Results Builder Tool. Use this Export function to save the data out of your old tool and then use the corresponding Import function to pull the data into your new tool.

Import Options

Import Cross-Reference File

This function is used to import an existing cross-reference file into the Results Builder Tool. The import action creates a new worksheet displaying the contents of the cross-reference map. In addition to the codes, the worksheet will show the corresponding lab names and EMR Obs Term descriptions.

During the import the function performs a lookup on both the lab code and EMR code from the file. A tag is placed in the compendium to show which lab codes are used and another optional tag can be written into the Result Map to show which EMR terms are used.

If a lab code from the cross-reference file cannot be found in the compendium then the new worksheet will indicate this with red text for that lab name.

If a particular mapping pair from the file is not currently mapped in the Result Map worksheet then that map is added to the worksheet and highlighted in blue to indicate that this is a new mapping.

The function will only accept files with the .xrs or .xrf suffix.
Import Flowsheet Kit

This function is used to import an existing EMR flowsheet into the Results Builder Tool. The import action creates a new column on the Result Map worksheet for each flowsheet view in the kit.

The function wil only accept files with the .ckt suffix.
Import Lab Results Compendium

This function is used to import a Lab Compendium into the Results Builder Tool. When a compendium is imported it replaces the current compendium worksheet data. The Result Map is not modified during the import.

Updated Compendium data is available by request through Ignis Systems Support.

When this function executes it will popup a dialog asking you to browse to the compendium file.

The Results Compendium data is contained in a file with a .cmp suffix and this function will only accept files with the .cmp suffix.
Import EMR Observation Terms

This function is used to import a new copy of the GE Observation Term kit into the Results Map Tool.

The function saves all current mapping, volume and flowsheet data and then automatically restores the mappings once the new Obs Term kit has been imported.

NOTE: This import function does not import the entire Obs Term Kit. It contains a filter that limits the import to only those terms that are applicable for lab results. As new functionality is added the filter will be relaxed to increase the number of terms available for mapping.
Import Results Builder Backup

This function is used to Initialize the Result Map worksheet from a previously saved Results Builder backup file. (See "Export Options>Export Results Builder Backup") This import function differs from the others in that it not only replaces the Results Map worksheet but also replaces the Compendium.

When you create an Results Builder Backup file it saves your current Result Map and Compendium so when you restore it using this function it replaces both worksheets and sets the state of the Welcome page to match.

The primary use for the backup file is to allow customers an easy way to upgrade to new versions of the Results Builder Tool without losing or having to recreate your Result Mapping data. Use the Export function to save your current data and then import it back into your new tool using this Import function.

Transfer Compendium Volumes

This function takes the values in the Volume column of the Compendium and copies them to the Volume column of the Results Map worksheet. It does this by finding the matching lab code.

If no matching code is found then it means that lab result is not mapped and the volume value on the Compendium worksheet is set to red. If you later map that lab test and re-run this volume transfer function, the volume value gets set back to black.

Validate Master Result Map

This function is used to verify that your Result Map worksheet is up-to-date with the current lab compendium. It walks through the entire compendium matching those codes and descriptions against those in your Result Map worksheet.

When you run the validation it will mark deleted codes in red. Changes to test descriptions are orange, and new codes added to the Result Map worksheet are blue.

Since the purpose of the validation is to check your codes against a current compendium you should run this whenever you import a new compendium (See "Import Options>Import Compendium") or make any changes to your Result Map.

Sorting Options

by Lab Code

This function sorts the Result Map worksheet based on column A, the Lab Order Code. This sort option only applies to the Reslt Map worksheet. If another sheet is active this switches to the Result Map by default.
by Lab Test Description

This function sorts the Result Map worksheet based on column B, the Lab Result Name. This sort option only applies to the Result Map worksheet. If another sheet is active this switches to the Result Map by default.
by Volume (descending)

This function sorts the Result Map worksheet based on column L, the Volume. This sort option only applies to the Result Map worksheet. If another sheet is active this switches to the Result Map by default.
by EMR Name

This function sorts the Result Map worksheet based on column G, the EMR Name. This sort option only applies to the Result Map worksheet. If another sheet is active this switches to the Result Map by default.
by EMR Description

This function sorts the Result Map worksheet based on column I, the EMR Description. This sort option only applies to the Result Map worksheet. If another sheet is active this switches to the Result Map by default.
by Selecting a Column (ascending)

This function sorts the active worksheet in ascending order based on a column you select. This sort option only applies to the Result Map and Compendium worksheet. If another worksheet is active, the sort is ignored.
by Selecting a Column (descending)

This function sorts the active worksheet in descending order based on a column you select. This sort option only applies to the Result Map and Compendium worksheet. If another worksheet is active, the sort is ignored.

Show/Hide CCC Column

This function can be used to show or hide the CCC column (column "M"). If the CCC column is currently hidden and you select this, then it will become visible. If the CCC column is visible and you select this, then it will become hidden.

Lab Results Builder Help

Brings up this online help page. Since this page is maintained on the EMR-Link web server it can be updated with new information and corrections on a regular basis. This Help file is currently aligned with Result Builder Tool version 2.21.