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External Diagnostics Hub & Inter-Facility Referrals

This section details the External Diagnostics Hub and Referrals & Data Sharing systems in MOANA EHR. These tools govern partnerships with third-party diagnostic laboratories, radiology centers, cross-facility patient referrals, and interoperable clinical data exchanges.

1. External Diagnostics Hub Overview​

When specialized pathology, histology, or advanced imaging (such as MRI/PET scans) must be referred to partner institutions or external reference laboratories, administrators manage these relationships through the External Diagnostics Hub.

graph TD
    A[Clinical CPOE Diagnostic Order] --> B{Internal vs. External Service?}
    B -->|Internal Lab/PACS| C[Moana-LIS / Local PACS Workflow]
    B -->|External Provider| D[External Diagnostics Hub Routing]
    D --> E[1. Provider Registry & Catalog Mapping]
    D --> F[2. Sample Dispatch & Order Tracking]
    D --> G[3. HL7 / FHIR Gateway Telemetry Integration]
    G --> H[Inbound Results Verification & Longitudinal Chart Integration]

The 6 Core Hub Sections:​

SectionPurpose & ScopeKey Capabilities
1. ProvidersExternal partner directoryManage reference laboratories, specialized imaging centers, pathology institutes, contact credentials, and SLAs.
2. Catalog MappingCross-facility code translationMaps internal hospital order codes to external laboratory LIS test codes (LOINC / SNOMED CT).
3. Order TrackingSpecimen dispatch & statusReal-time tracking of sent specimens, accession barcodes, transit status, and inbound pending results.
4. Integration MonitorGateway health & latencyLive HL7 / FHIR endpoint telemetry, payload replay queues, and heartbeat metrics.
5. EDP AnalyticsDiagnostic turnaround KPIsExternal Turnaround Time (TAT), cost per test, and provider SLA compliance benchmarking.
6. Patient Registry (MPI)Identity cross-referencingNational Master Patient Index deduplication and external demographic reconciliation.
External Diagnostics Command Center, Provider Directory and Integration Telemetry
External Diagnostics Command Center, Provider Directory and Integration Telemetry🔍 Click to enlarge

2. Provider Registry & Catalog Mapping​

1. Registering an External Diagnostic Partner:​

  1. Open External Diagnostics → Providers tab.
  2. Click + Add New Provider.
  3. Specify provider legal name, specialty (Anatomic Pathology, Cytogenetics, Reference Biochemistry, High-Field MRI), facility identifier, contact dispatch email, and default transport courier.
  4. Set default turnaround time (TAT) SLA target (e.g., 48 Hours for Routine Biopsy, 4 Hours for STAT Frozen Section).

2. Diagnostic Catalog Code Mapping:​

To ensure external laboratory results automatically map back to the correct patient chart fields:

  • Enter internal test order code (e.g., LAB-HISTO-01: Endometrial Biopsy).
  • Map to the provider's external requisition code and standardized LOINC concept.
  • Define automated normal/critical reference ranges and expected report payload format (PDF document, structured JSON, or HL7 ORU_R01).

3. Order Tracking & Specimen Chain of Custody​

The Order Tracking console manages the physical and electronic chain of custody for external orders:

External Diagnostic Specimen Dispatch and Outbound Order Tracking Console
External Diagnostic Specimen Dispatch and Outbound Order Tracking Console🔍 Click to enlarge
  • Accession Barcode & Courier Manifest: Generates verifiable specimen shipping manifests with cold-chain transport requirements.
  • Status Lifecycle: Order Placed ➔ Specimen Collected ➔ Dispatched / In Transit ➔ Received at Partner Lab ➔ Analysis Ongoing ➔ Result Received & Verified.
  • Inbound Document Viewer: Clinicians can open inbound signed diagnostic PDFs and digital slides directly inside MOANA's integrated medical document viewer without downloading files to insecure local drives.

4. Cross-Facility Referrals & Clinical Data Sharing​

The Referrals & Data Sharing console manages inbound patient transfers, outbound specialist delegations, and inter-facility electronic health record sharing.

Cross-Facility Patient Referrals and Clinical Data Sharing Management Console
Cross-Facility Patient Referrals and Clinical Data Sharing Management Console🔍 Click to enlarge

1. Incoming Patient Referrals (Hospital Intake):​

  • Review Triage: Review clinical referral packages sent from rural health centers or district clinics.
  • Accept Referral: Automatically creates or updates the patient's record in the Master Patient Index and queues them for inpatient ward admission or specialist outpatient consultation.
  • Decline Referral: Rejects referral with mandatory clinical rationale (e.g., Specialty unavailable, bed capacity exceeded; redirecting to provincial center).

2. Outgoing Referrals & Specialist Delegation:​

  • Clinicians generate standardized referral summaries attaching previous progress notes, medication histories, lab panels, and DICOM imaging studies.
  • Track referral status in real-time (Pending Review, Accepted, Patient Seen, Discharged back to Primary Care).

3. Patient Consent & Cross-Facility Data Sharing:​

  • Consent Governance: View, approve, or revoke external facilities' access permissions to patient longitudinal charts.
  • Emergency Cross-Facility Breakglass: Authorizes immediate emergency record access for trauma transfers with mandatory justification logging.