Integrating LabXpert Automation with FHIR-based Systems (beta)

LabXpert Automation can integrate with any clinical system that supports the HL7® FHIR® standard. This allows lab results and test orders to be exchanged with electronic medical records (EMRs), national health registries, or other FHIR-compliant platforms.

This guide outlines how to connect Automation to a FHIR server, map resources, and handle basic workflows.

🔗 Supported FHIR Resources

Resource	Purpose
Patient	Used to match or create lab patients
ServiceRequest	Represents incoming test requests
Observation	Transmits individual lab results
DiagnosticReport	Summary document referencing observations

🌐 Setting Up the Integration

To begin, go to the Systems section in Automation and click ➕ Add.

1. Select: FHIR-Compatible System
2. Enter Base URL: e.g., https://fhir.myemr.org/fhir
3. Authentication: Provide Bearer token, basic auth, or client credentials (depending on server configuration)
4. Test Connection: Confirm that Automation can reach the /metadata endpoint

✅ A successful ping to /metadata confirms a valid FHIR server.

🧩 Resource Mapping

Before Automation can send or retrieve data, resource mapping must be configured:

Patient Matching

• Automation Source: Patient name, ID, sex, DOB
• FHIR Matching: Uses /Patient?identifier=... or /Patient?name=...&birthdate=...

If no match is found, Automation can optionally create a Patient resource using the supplied data.

Order Retrieval (ServiceRequest)

• Automation periodically queries:

  GET /ServiceRequest?status=active&performer=AutomationOrg

• Mapped fields:

  • subject → Patient
  • code → test type or panel
  • identifier → internal request ID

Sending Results (Observation + DiagnosticReport)

After a test completes:

1. Create Observations for each result:

   {
     "resourceType": "Observation",
     "status": "final",
     "code": { "coding": [{ "system": "http://loinc.org", "code": "718-7", "display": "Hemoglobin" }] },
     "valueQuantity": { "value": 13.5, "unit": "g/dL" },
     "subject": { "reference": "Patient/123" },
     "effectiveDateTime": "2024-01-02T12:00:00Z"
   }

2. Bundle Observations into a DiagnosticReport:

   {
     "resourceType": "DiagnosticReport",
     "status": "final",
     "subject": { "reference": "Patient/123" },
     "result": [
       { "reference": "Observation/ob1" },
       { "reference": "Observation/ob2" }
     ],
     "code": { "text": "CBC Panel" }
   }

3. POST to:

   POST /DiagnosticReport

🔐 Security & Authentication

Automation supports:

• Bearer Tokens (preferred)
• Basic Auth
• Mutual TLS (on request)

For systems using OAuth2, you must obtain a token externally and configure it under the system settings.

🧪 Testing the Integration

To test the FHIR setup:

• Use sample patients and requests in the FHIR server
• Run a simulated test in Automation and verify that:
  • Observations are created
  • DiagnosticReport is submitted
  • The order status can be updated (e.g., from active to completed)

✅ Best Practices

• Prefer LOINC codes for lab tests
• Ensure timezone consistency (UTC preferred)
• Configure retry logic for network outages
• Regularly validate FHIR responses for changes in server behavior

🛠️ Custom Mappings & Extensions

You may define custom extensions if needed. For example, to link to a lab sample barcode:

{
  "resourceType": "Observation",
  "extension": [{
    "url": "http://labxpert.com/fhir/StructureDefinition/sample-id",
    "valueString": "SMP-000123"
  }]
}

Contact support for help registering or validating custom extensions.