iSTAT Flagged results with *** and <> in Epic Beaker

Hi Jose, Ask if the interface engine can translate the *** or < > as TNP or Test Not Performed. Sometimes the interface engine team will accommodate and sometimes they will not. 

We were not able to change the Pend either.  Telcor appends a comment to the data stream that states "Outside measuring range" or "Test error".  The Epic user will need to click on the Pend and Result Details to see the narrative.

We had a similar scenario going from Pweb to Cerner and then moving to QML to Epic.  In the old system we could translate the tests that failed but it is not possible with QML to Epic.

Users are instructed to repeat the test/panel if they obtain a failed test result.  It will NOT be uploaded into he EMR.

Hi Jose, We handle this differently. Any i-STAT result that is suppressed, gives an asterisk, is not sent to the chart because Abbott informed us that if any analyte (component) of the panel is suppressed, we should not send any of the additional panel results to the chart that did read - as there could have been some kind of "electrical sensor or internal QC error".  All suppressed panels are flagged in our system and not sent to EPIC.  We do indeed send the greater than or less than results, for example, a potassium that is greater than 9.0.  

Hello Everyone,
Your feedback is greatly appreciated. Users are instructed to repeat the test/panel using another cartridge and a fresh specimen. If the result is still suppressed, they send a specimen to laboratory for analysis. According to the iSTAT operator's manual, "If the specimen's integrity is not in question, the results that are not suppressed should be reported in the usual manner". 

Vicky McArdle, what are the consequences of leaving these tests forever pending? Do they accumulate in an outstanding list or error log that later needs to be cleaned up manually?

Jose,  The "Pend" is not a pending like you are thinking of.  It is just what they put in place of the result on the display.  We use unsolicited orders, so nothing stays on an outstanding list or error log when this occurs.

Danialle - yikes, that would be very concerning to me (that Abbott advised that all results be discounted if any one test is suppressed with the 3 asterisks).  We have always reported the other tests without asterisks, as per what Jose described above, taken from the iSTAT Manual.  Plus, even if you do not send the results to your LIS, the operator can still see the results and potentially act on them.  I would really challenge the Abbott representative that claimed that to be true.  That sounds like very dangerous chemistry for them to be standing behind.  If that is truly the case, it should be easy enough for them to configure the device to block all of the results from view.

We do the same as Danialle, any * on any analyte means none of the cartridge results will cross to EPIC and needs to be repeated.  It's been our process here and we teach it when we train new operators and annual competencies.  We do report out > or < results but no *.  We were also told that Abbott will not stand behind any results that have an * on the cartridges and since we're pediatrics I'm of the mindset that better safe than sorry.

Hello,
Our process with a result of "***" is to not report any of the panel and operators are trained to this.  We use EPIC with RALs. RALs will suppress the results and I do not have any problems with that.  I am having a difficult time with the "<>" errors. If I get a PCO2 <15 then my calculated test such as HCO3, BE and SO2 will be "<>". I do want to report this gas out with the PCO2 < 15 and no results for the calculations but on the other hand if my PCO2 is "<>" is do not want to report it at all and we are not able to get EPIC to automatically verify these result without any errors or going to a Workqueue. Does anyone else use EPIC with RALs.