OpenELIS Global 2.5 Release Notes

Release Date: March 30, 2012

CONTENTS

1. Application administration

1.1 Updated test catalog template

1.2 Configuration-specific test catalog updates

1.3 Updates to ELISA algorithm

2. Workflow

2.1 Workplans

2.2 Validation of results

3. User-interface improvements

3.1 Configuration-specific sort orders

3.2 Indicator flags

4. Reporting

4.1 Patient reports

4.2 Raw data export

5. System deployment, administration, and monitoring

5.1 Deployment support

5.2 New versioning numbering scheme

6. Interoperability and standards

6.1 Analyzer interfaces

6.2. Billing information

7. Bug fixes

8. Updates

    8.1 Release 2.5.1

    8.2 Release 2.5.2

    8.3 Release 2.5.3

1. Application administration

1.1 Updated test catalog template

We have updated the test catalog template for configurable use across sites. This feature enables a given site to define the specific set of tests and test parameters that will be use in their specific configuration of OpenELIS. The updated template includes the following parameters for each test available in OpenELIS:

Test name French

Test name English

Lab Section (French)

Panel association

Test Name Abbreviation

OE 2.3 test name

Sample Type (FRENCH)

Sample type (ENGLISH)

LOINC code

Result Type

           Normal range min

Normal range max

Valid range min

Valid range max

Reference Range

Units

Select list options

Validation date

Validated by


1.2 Configuration-specific test catalog updates

We have incorporated new test catalogs using the new template in Haiti. These catalogs have been designed and validated in collaboration with specific implementations to be configuration-specific. The test catalog used at clinical sites in haiti has been aligned with the electronic medical record system (EMR) in clinical use to provide consistency across information systems. This consistency supports interoperable exchange of lab test order information and test results.

1.3 Updates to ELISA algorithm
In Cote D'Ivoire, we have begun to provide support for dynamic changes in reflex testing for the ELISA algorithm. In this initial work, we have added a new Bioline test, in addition to the existing Genie II test. During the sequence of reflex tests, the user can now switch from Genie II to Bioline through the following steps: After a Genie II test has been ordered, the Genie II will display in the results entry view for the Lab order (FIgure 1). The user can switch to the Bioline test by (1) opening the Lab Order in the “Modify sample” view, (2) removing the Genie II tsets, and (3) adding the Bioline test. When the user opens the results entry view, they will now see the Bioline test displayed rather than the Genie II test. In future work, we plan to improve the user-interface to make this feature easier to use.


Figure 1. The Genie II test in

the results entry view

2. Workflow

2.1 Workplans

We have made available a workplan module (“Plan de travail”) that enables the user to list all orders that are ready to be processed by (a) test name, (b) test panel*, or c) lab section. Figure 2 shows an example workplan by lab section. (Applies to Haiti configurations). *Included in2.5.1 release.


Figure 2. Workplan by lab section

2.2 Validation of Results

We are working towards improving the efficiency of loading test results on the validation page in our Cote-D’Ivoire configuration. As a first step, we quadrupled the number of results that load per page to approximately 240. Increasing the number of results per page allow the user to validate more results at one time before loading the next page. In our future work, we will address this problem fully by adding a new page that enables the user to filter date or lab number within a lab section to load the corresponding subset of results first for validation.

3. User-interface improvements

We have enhanced the user-interface in several places to improve usability for the end-user with the following new features:

3.1 Configuration-specific sort orders

We now support variations among configurations in the order in which test panels, sample types, and lab sections are listed in the interface and print reports. This feature enables a single site to specify the order in which sample type, test panels. and lab sections appear in the interface. Exam
ple are provided in Figure 3 and Figure 4.



                                   



Figure 3. Specified order for listing lab                  Figure 4. Specified order for listing
sections in the results entry menu      sample types on the sample entry form

3.2 Indicator flags

In Haiti, we have added indicator flags for results outside of range. We flag results values that are outside of normal range in yellow highlight and flag results that our outside of valid range in red highlight (Figure 5). In addition, when hovering over a flagged result, the user is shown text indicating the  value is outside normal/valid range. To further minimize data entry errors, we have added an alert that is activated when an invalid result value is entered. The user must dismiss the alert to continue data entry.*
*Included in 2.5.1 release.

Figure 5. An Indicator flag highlights a VGM result that is outside normal range in yellow, 

and highlights a Hemoglobine result that is outside valid range in red.


4. Reporting
We have enhanced several OpenELIS reports, including improvements to patient reports and the raw data export.

4.1 Patient reports

Patient reports can now include the following enhancements. Figure 6 shows some enhancements as they appear patient reports in the Haiti clinical configuration.
  • Results that are below the normal range minimum are marked with “B” and results that are above the normal range maximum are marked with “E”.

  • Tests that are in progress for which results have not yet been entered are marked “En cours”.

  • Reports are marked “Résultats Partials” if one or more test results have not yet been entered. When all results have been entered for an order, the report is marked “Résultats Complets”.
  • Any test that is outside of valid range is marked “En cours” to indicate re-testing.
  • Patient age is printed in years, months, or days, depending on the patient’s age at the time of specimen collection.
  • Any test that was ordered but later cancelled is marked "Annulée".*
  • Improvements have been made for easier readability of the two-column format.*

*Included in 2.5.1 release. 

Figure 6. This sample patient report marks the below average result for Neutrophiles with “B” and marks the above average results for Eosinophiles with “E”. Because the WBC test is still in process and results have not been entered, this test is marked “En Cours” and the patient report is marked “Résultats partiels”. When the WBC result is entered, the result is printed on the report and the report is marked “Résultats complets”.

4.2 Raw data export

The raw data export has been revised to address previous formatting problems with revered columns, inclusion of missing data, and exclusion of extraneous data. (Applies to Retro-CI).

5. System deployment, administration, and monitoring

5.1 Deployment support

We have made improvements to streamline deployment across multiple implementations by removing dependency on an external properties file for configuration and enabling configuration through the database upon installation.  This improvement allows for the release of a single war file that can be used in any number of implementations and configured for specific workflow within that implementation.

5.2 New versioning numbering scheme

We have developed a new versioning numbering scheme to track development and deployments. The “version number” is a string, not a number (i.e., numeric value) in the following format: Version.Pl​annedRelea​se.Unplann​edRelease (build number)
  • Each dot-separated component is an integer.
  • The starting Version for OpenELIS as of this release is “2”, and this number increments yearly (e.g., version “2” for 2012, version “3” for 2013, and so on)
  • This Planned Release of OpenELIS is “5”. We anticipate​ planned releases quarterly.  The planned release number will begin with “1” at the start of each year.  Since releases are anticipated to be quarterly, most versions will have 4 planned releases.
  • Unplanned releases may occur between planned releases when appropriate, and include urgently needed or small features, depending on needs, and timing.
  • The build number describes precisely where in the version control system the release was derived from. For projects tracked with Subversion (SVN) this would be the "Last Changed Rev:" returned by `svn info`. For projects tracked with Git this would be the tag sequence number returned by `git describe`.​ This final component of the new version numbering scheme will be displayed wherever version numbers are displayed.​ The suggested format of this component would be the value enclosed in parentheses. The format may be adjusted as needed when used in file names and system packages.

6. Interoperability and Standards

6.1 Analyzer interfaces

We have developed automated support for import of results from two additional analyzer models:
  • Cobas Taqman Viral load (CV)
  • BD FacsCANTO

At Retro-C in Cote D’Ivoire, we have included an automated viral load log calculation for results imported from the Cobas Taqman analyzer. Imported results are provided in copies/ML units. Results <200 copies/ML are reported as “LL”. Results >=200 copies/ML are reported in both copies/ML units and log units. For example, results are displayed in the following format: 6.54E2 copies/ML (2.82 log).

6.2. Billing information

As a first step towards interoperability with patient financial systems, we have added an administrative option to add a billing flag to the order form to indicate that the order has been paid in full, partially paid, or not paid. The billing flag can be turned on under the ‘Ajouter configure échantillon’ link in the Administration tab. This feature is shown in Figure 7 as it appears in the LNSP configuration in Cote D’Ivoire.

Figure 7. Payment flag option on order entry screen

7. Bug fixes  

We have fixed a number of reported bugs including but not limited to the following:
  • When editing test orders, the list of tests a user is able to add to a sample should consist only of active tests and they should be sorted in the same order as the sample entry screen.
  • Removal of duplicate messages displayed as both pop-ups and on-screen messages during searches within the application when no results are found.
  • (Retro-CI) CD4 absolute count was not updating after CD4%, Lymph%, and /or GB was updated. CD4 absolute count now dynamically updates.
  • (Retro-CI) A duplicate CD4 absolute count was created when CD4% was updated. This error has been fixed so that only one CD4 absolute count remains when updating CD4%.
  • (Retro-CI) Not all test results were importing from the Cobas Integra 400+ analyzer. For example, Trans and Gluc shows up, but not Creatinine. This problem has been fixed so that all values from the analyzer are imported into OpenELIS.
  • (Retro-CI) Fixed adverse effects attributes, the effect and the severity of the effect, on the patient view page from the ARV follow up form.
  • (Retro-CI) When searching for a patient using a lab number, the results returned more than one patient, but it actually was variations on the same patient.  This was a result of non-conformity items being added. This bug is now fixed so there is only a single patient returned per sample from patient search.
  • (Haiti Clinical) We have fixed the bug that prevented printing the normal result range for LDL and HDL tests on the patient report.
  • (Haiti Clinical) Only results that are within the valid range or that have a supervisor​’s signature are now sent to iSante.

8. Updates

8.1  Release 2.5.1

  • Haiti clinical test catalog updates (this has also been synced with iSante for the results interoperability)
  • Added the ability to apply a custom sort order to lab panels, types of samples, and lab sections for display on the UI
  • Implementation of logic for viral load test results display
  • Limit administration of test catalog within OpenELIS at the clinic
  • Update user manual for Haiti clinical
  • Several minor bug fixes

2.5.2 Release 2.5.2

  • Haiti LNSP test catalog updates  (this has also been synced with iSante for the results interoperability)
  • Improvements to the patient reports to include indicators for lab test results that are abnormal and lab test results that are from a referral to an external laboratory
  • Limit administration of test catalog within OpenELIS at LNSP
  • Several minor bug fixes

8.3  Release 2.5.3

  • Fixed bug in OpenELIS installer
  • Fixed bug in generating workplans for Mycobacteriology lab section in Haiti clinical configuration.
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