QC across 4 labs · today
HCMC-1 · HCMC-2 · Hanoi · Da Nang · on-prem residency; this view anonymized read replica (Azure SG)
QC across 4 labs · todayHCMC-1 · HCMC-2 · Hanoi · Da Nang · anonymized read replica Levey-Jennings · live QC chartsClick any chart for Westgard rule evaluation Hold queue · 11 patient resultsAwaiting pathologist sign-off · click for sample-level detail Analyzer fleet · 12 instruments liveMixed Roche / Sysmex / Abbott / Mindray / legacy RS-232 Audit trail · last 24 hoursAppend-only · ISO 15189 evidence pack ready HL7 v2.5 message inspector · MSH·PID·OBR·OBXLive MLLP stream from Cobas-HCMC-1 · LOINC + delta check applied per OBX segment Autoverification decision tree · sample SMP-44820CLSI AUTO-10 ruleset · 7-step cascade · decision in 230msQC samples evaluated
3,842
all in <1 s
QC-fail detection lag
42 s
was 4–6 h
Held patient results
11
awaiting review
Released before fail
0.3%
was 8.0%
Levey-Jennings · Cobas-HCMC-1 · Glucose (L2)
+3SD
mean
−3SD
Westgard
1₃s triggered at 09:42 — last 2 points outside ±3SD. Auto-hold applied to all patient results from this analyzer / test family.Hold queue · awaiting pathologist
Glucose · 4 samples · HCMC-11₃s
HbA1c · 2 samples · Hanoi2₂s
WBC · 3 samples · Da NangR₄s
Sodium · 2 samples · HCMC-24₁s
Westgard rule legend
1₃sReject. One control measurement > ±3SD from mean. Random error.
2₂sReject. Two consecutive controls exceed same ±2SD limit. Systematic error.
R₄sReject. One control > +2SD and another < −2SD within run. Random error.
4₁sWarning. Four consecutive controls on same side of mean > 1SD. Systematic shift.
10xWarning. Ten consecutive controls on same side of mean. Bias.
Glucose L2 · HCMC-1
1₃s at 09:42 — auto-hold active
HbA1c L1 · Hanoi
4₁s warning — drift below mean
WBC · Da Nang
in control
Sodium · HCMC-2
4₁s warning
Held patient results · awaiting sign-off
| Sample | Patient | Test | Lab | Rule | |
|---|---|---|---|---|---|
| SMP-44821 | P-7820 | Glucose | HCMC-1 | 1₃s | |
| SMP-44822 | P-7821 | Glucose | HCMC-1 | 1₃s | |
| SMP-44823 | P-7822 | Glucose | HCMC-1 | 1₃s | |
| SMP-44824 | P-7823 | Glucose | HCMC-1 | 1₃s | |
| SMP-44901 | P-7901 | HbA1c | Hanoi | 2₂s | |
| SMP-44902 | P-7902 | HbA1c | Hanoi | 2₂s |
Analyzer fleet · live
| Analyzer | Lab | Family | Status | HL7 msg/h | Last QC |
|---|---|---|---|---|---|
| Roche Cobas 8000 | HCMC-1 | Biochemistry | QC hold | 412 | 09:42 fail |
| Sysmex XN-3000 | HCMC-1 | Hematology | OK | 286 | 10:14 pass |
| Abbott Architect i2000 | HCMC-2 | Immunology | OK | 198 | 10:08 pass |
| Mindray BS-2000M | Hanoi | Biochemistry | QC review | 274 | 09:58 warn |
| Legacy RA-1000 (RS-232) | Da Nang | Biochemistry | OK | 92 | 09:30 pass |
Audit trail · last 24h (append-only)
2024-09-19 10:14:22 system QC PASS · Sysmex-HCMC-1 · WBC L1 · 286 patient results unblocked
2024-09-19 10:08:11 system QC PASS · Architect-HCMC-2 · TSH L1
2024-09-19 09:58:44 system QC WARN · Mindray-Hanoi · Glucose L2 · Westgard 4₁s — review queued
2024-09-19 09:42:08 system QC FAIL · Cobas-HCMC-1 · Glucose L2 · Westgard 1₃s — 4 patient results auto-held
2024-09-19 09:41:55 dr.tran RELEASED SMP-44520 with comment "verified on Sysmex XN-3000"
2024-09-19 09:35:02 dr.tran SIGNED OFF batch 2024-09-19-001 (124 results)
2024-09-19 09:30:14 system QC PASS · RA-1000-DaNang · ALT
2024-09-19 09:22:01 tech.le RECALIBRATED Cobas-HCMC-1 · Glucose L2 reagent lot 4421
2024-09-19 09:18:33 system Evidence pack generated — ISO 15189 export ready
Inbound MLLP frame · Cobas-HCMC-1 → AraLIS · ORU^R01
0x0B START · field-sep | · component-sep ^ · subcomp & · escape \ · repetition ~MSH|^~\&|COBAS|HCMC-1|ARALIS|HCMC-CENTRAL|20240919094218||ORU^R01^ORU_R01|MSG-44820-001|P|2.5
PID|1||P-7820^^^HCMC^MRN||Nguyen^Van^A||19780414|M|||***REDACTED***||||||||||||||||||
PV1|1|O|OUTPT^^^HCMC-1|||||Dr.Tran^Minh^^^^Dr||||||||||||||||||||||||||||||||||
OBR|1|ORD-44820|ACC-9921|2345-7^Glucose [Mass/volume] in Serum or Plasma^LN|||20240919093800||||||||||||||||F
OBX|1|NM|2345-7^Glucose [Mass/volume]^LN||6.2|mmol/L|3.9-5.6|H|||F|||20240919094218|COBAS-HCMC-1
OBX|2|NM|4548-4^Hemoglobin A1c/Hemoglobin.total in Blood^LN||7.2|%|4.0-5.6|H|||F|||20240919094218|COBAS-HCMC-1
NTE|1||Auto-held: upstream QC fail (Westgard 1.3s) on analyzer · pathologist review required
Parsed OBX-1 · Glucose · click any field for spec
| OBX.n | Field | Value | Spec |
|---|---|---|---|
| OBX-1 | Set ID | 1 | SI · required |
| OBX-2 | Value Type | NM | ID · table HL70125 |
| OBX-3 | Observation ID (LOINC) | 2345-7^Glucose^LN | CWE · LOINC v2.76 |
| OBX-5 | Observation Value | 6.2 | varies · per OBX-2 |
| OBX-7 | Reference Range | 3.9-5.6 | ST · mmol/L |
| OBX-8 | Abnormal Flags | H | ID · table HL70078 |
| OBX-11 | Result Status | F | ID · table HL70085 |
Autoverification cascade · SMP-44820 · Glucose 6.2 mmol/L
CLSI AUTO-10 reference framework · 7 sequential checks · short-circuit on first FAIL · final decision: HOLD
step 1 specimen.hil_index() < thresholdsPASS
step 2 analyzer.last_calibration < 24hPASS
step 3 qc.westgard.cascade()FAIL · 1.3s
↳ 2.2s skipped (parent failed)SKIP
↳ R.4s skippedSKIP
step 4 range.absolute_critical_check()— (not evaluated, halted at step 3)
step 5 delta.vs_prior_result(window=90d)— (not evaluated)
step 6 consistency.vs_panel(HbA1c, BG)— (not evaluated)
step 7 demographic.age_sex_match()— (not evaluated)
Delta check (would have run as step 5)
Patient P-7820 · prior Glucose 5.8 mmol/L on 2024-08-22.
Current 6.2 mmol/L · delta +0.4 threshold ±1.5 mmol/L · would have PASSED.
Current 6.2 mmol/L · delta +0.4 threshold ±1.5 mmol/L · would have PASSED.
Final decision: HOLD
Reason:
Reason:
QC.WESTGARD.1.3s · cascade halted at step 3 of 7 · decision time 230ms