Good morning,

S:  I wanted to provide another touch base on this ticket I submitted previous:   https://oncprojectracking.healthit.gov/support/browse/CHM-122?filter=-2 (CHM-122).

B:  The previous ticket I asked about how to deal with non-numeric values for labs that included examples such as "> 500" or "See Comment."  The response is posted in the ticket, please review the previous ticket for details.  

A:  I was able to follow up with the vendor related to the response in that ticket to follow up with the non-numeric values pulling in the Hybrid QRDA1 files.  I am interpreting the outcome of the previous ticket was to alter the logic to exclude non-numeric values and include the "next" available value that is a numeric value.  

My vendor's response to the ticket is as follows:

"The ticket indicates that EHR vendors should include data that yields a numeric result; however, the data model in how the Lab Result is stored stores the text string "SEE COMMENT". If this is the result of the earliest lab result found, then that is what should be sent."

R:  My vendor is stating that since the logic of the measure is not indicative of taking the "next" value they can't change the logic behind which lab values are pulled.  They suggest that the logic to be updated to indicate what should be done with values such as "> 500" or "SEE COMMENT."  Potentially different approaches could be taken based on what the value is.  

If the value is ">500" then perhaps the logic indicates to have the vendor drop the ">" or "<" sign to provide a value that is numeric.  

If the value is "SEE COMMENT" or "CANCELED" or something along those lines then perhaps the logic could indicated for reviewing the next value....if the next value is numeric pull that one in the report.  

I guess my hopes are that the logic gets updated to account for these scenarios in a way that they can apply it to all of their health systems.  Please reach out with questions and concerns so this can get resolved quickly.