TOXICOLOGY - WORKFLOW IMPLEMENTATION TOOL - TRANSMISSION OF FORENSIC TOXICOLOGY DIAGNOSTIC FINDINGS FROM LIMS TO MDI CMS

Sep 13, 2026

Workflow implementation guidance for medical examiners and coroners (MECs) in medicolegal death investigation (MDI) offices, supporting data sharing partners, case management system (CMS) and IT vendors. The template aligns to the HL7 MDI FHIR Implementation Guide and provides a project-team action plan with an end-to-end toxicology workflow: identifying LIMS/CMS data domains, mapping fields to MDI FHIR profiles and custom terminologies, optionally authoring a local IG using FSH, and executing interoperability testing for report delivery into the MDI CMS.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages3

Reading Time1 min

AccessFree to download

Workflow Implementation Tool: Toxicology

Transmission of Forensic Toxicology Diagnostic Findings from LIMS to MDI CMS

Toxicology Lab Reporting Use Case

Objective 1: Data Domain Identification

Objective 2: FHIR Mapping of Data Fields

Objective 3: (Optional) Implementation Guide Authorship

Objective 4: Interoperability Testing

WORKFLOW IMPLEMENTATION TOOL: TOXICOLOGY Guidance: The purpose is to assist Medical Examiners and Coroners (MECs) working in Medicolegal Death Investigation (MDI) offices, data sharing partners, case management system (CMS) and IT vendors in mapping a workplan and timeline for workflow implementation. This template aligns with HL7® MDI FHIR® IG (Health Level Seven Medicolegal Death Investigation Fast Healthcare Interoperability Resources Implementation Guide) and contains embedded links to content referenced in the IG for developer use. Use this template to build an action plan with your project team. Plans may evolve over the course of the project, so feel free to revisit this document and update as needed. WORKFLOW: TRANSMISSION OF FORENSIC TOXICOLOGY DIAGNOSTIC FINDINGS FROM LIMS TO MDI CMS The MDI office is populating their CMS with the postmortem toxicology results directly from the Laboratory Information Management System (LIMS) TOXICOLOGY MDI OFFICE Toxicology Lab Reporting: In many MDI offices forensic toxicology lab results are reported in PDF or paper format. To modernize the toxicology reporting workflow, these offices collaborate with their case management system (CMS) vendors, laboratory/laboratory information management system (LIMS) vendors, and the MDI technical support team to implement FHIR. Toxicology Lab Reporting Use Case: The toxicology lab reporting workflow begins when the MDI offices send lab orders during the death investigation. At a high level, the workflow follows these key processes. 1 Once the case is initiated and toxicology tests are deemed necessary, the MDI office sends lab orders to the lab. 2 Specimens are collected according to guidelines and transported to the lab. 3 The lab receives the orders and analyzes the samples for drugs, substances, and other relevant factors. 4 A toxicology report is generated, detailing the substances found, their concentrations, and potential implications. 5 The toxicology report is sent to the MDI office that requested the lab tests. 6 The MDI office receives the report and stores it to the MDI CMS for further investigation. Implementation includes steps 4 to 6 of the Use Case. Objective 1: Data Domain Identification: Toxicology/laboratory data elements to be exchanged between LIMS and CMS are identified. TASKS | TASK | RESOURCES NEEDED | TIMELINE | PERSON(S) RESPONSIBLE | NOTE | | --- | --- | --- | --- | --- | | 1.1 Define use case data Create synthetic data or use existing synthetic data available in Raven that includes decendent, death information, death certification review, etc. | Data elements for forensic toxicology profiles Forensic
Toxicology Profiles | 2 weeks | LIMS vendor | MEC/Partners can use this column for their internal tasks (if needed) | | 1.2 Atadkysour owto gettno sciem-sppleetciiof | | | | | | Progress Measure/Evaluation:
• LIMS data element document (in Excel) for the use case that includes
• A set of named fields
• Category/Subdomain
• Description of the field
• Data type/format | | | | | Objective 2: FHIR mapping of data fields from LIMS, including identification of site/jurisdiction specific custom profiles. This is an enhancement of the Excel file created in Objective 1 using the data domain but describing the data elements as FHIR resource and terminology. • Create FHIR data from vendor’s system data (from task 1 .1) . FHIR data must conform to existing MDI FHIR IG / US-Core Profiles • Create custom profiles or terminologies for data elements when the data elements are not captured in existing profiles. TASKS | TASK | RESOURCES NEEDED | TIMELINE | PERSON(S) RESPONSIBLE | NOTE | | --- | --- | --- | --- | --- | | 2.1 FHIR Forensic Toxicology profile review
Review the MDI FHIR Forensic Toxicology profile and do the data analysis with the data elements obtained from 1.1 | MDI FHIR IG Forensic Toxicology Profiles | 1 week | LIMS vendor with TA
provi

FAQs

What organizations and systems does this workflow implementation tool support?

It supports MECs and MDI offices, along with data sharing partners and CMS/IT vendors, mapping a workflow and timeline for implementation.

What are the main steps in the toxicology lab reporting use case?

After initiating the case, the MDI office sends lab orders, specimens are collected and analyzed by the lab, a toxicology report is generated, sent back to the MDI office, and stored in the MDI CMS.

What do Objectives 1 and 2 cover in the implementation plan?

Objective 1 identifies toxicology/laboratory data elements exchanged between LIMS and CMS. Objective 2 maps those fields to MDI FHIR profiles, including site/jurisdiction custom profiles and terminologies when needed.

Sep 13, 2026

Upload by Stanford