Overview

Reflex Management

Reflex Management is an automation feature that allows a lab to automatically add follow-up tests based on the results of an initial test.

Think of it like a smart decision system:

• A test is performed (e.g., CBC)
• A parameter result is entered (e.g., WBC)
• If the value meets certain conditions → additional tests are auto-added

Example:
If WBC is out of normal range, the system can automatically add a Glucose test — no manual action needed.

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Related Jira Tickets

Key Features & Constraints

• Single configuration per parameter per test
  Example: You cannot create multiple reflex configs for CBC → WBC.

• Multiple reflex tests per condition
  A single trigger condition can add several reflex tests.

• Multiple trigger rules per parameter
  You can define several conditions (e.g., critical range and custom range) under the same parameter.

• Execution mode flexibility

  • Automatic – triggered via machine interfacing.
  • Manual – triggered during report entry.

• Billing control
  Reflex tests can be added to the same bill or a new bill, configurable per rule.

• Outsourced test exclusion
  Reflex logic never triggers for outsourced tests, preventing duplication.

• Support for all parameter types

  • Range – numeric values with critical, normal, or custom ranges.
  • List – predefined options with contains, exact match, and multi‑value AND/OR logic.
  • Descriptive – free‑text with the same rich matching rules as list parameters.

• Audit trail
  Every trigger action is logged with patient, bill, parameter, and timestamp.

What Is Reflex Management For?

Reflex Management is an automation feature that allows a laboratory to automatically add follow‑up tests based on the results of an initial test.

Think of it like a smart decision system:

• A test is performed (e.g., CBC)
• A parameter result is entered (e.g., WBC)
• If the value meets certain conditions → additional tests are auto‑added

Example:
If WBC is out of normal range, the system can automatically add a Glucose test – no manual action needed.

Why use it?

• Save time – eliminate manual result reviews and test ordering.
• Reduce errors – follow clinical protocols consistently.
• Improve workflow – let the system handle repetitive decision‑making.
• Ensure compliance – automatically enforce testing guidelines.

Reflex testing refers to an automated process where additional tests are ordered based on the results of an initial test. It’s like a built‑in decision tree for testing. For example, if a primary test yields results that indicate a need for further investigation, the system reflexively triggers additional tests without manual intervention.

How It Works (End-to-End Flow)

1. Configuration (One-time setup)

An admin defines rules like:

• Test: CBC
• Parameter: WBC
• Condition: Out of Normal Range
• Action: Add Reflex Test (e.g., Blood Culture)

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2. Test is Ordered

• Patient is billed for a test (e.g., CBC).
• The test may be added to an existing bill or a new bill, based on the configured settings.

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3. Result Entry

Values are entered either:

• Automatically (via machine interfacing).
• Manually (via report entry screen).

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4. Rule Evaluation

System checks:

• Does the parameter value meet any configured trigger condition?

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5. Reflex Action Triggered

If condition matches:

• Reflex test(s) are automatically added:
  • Existing bill.
  • New bill (based on configuration).

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Key Rules & Constraints

• One configuration per parameter per test
  Example: You cannot create multiple reflex configs for CBC → WBC

• Multiple reflex tests can be added
  A single condition can trigger multiple tests

• Multiple trigger rules allowed
  You can define multiple conditions under the same parameter

• Execution mode matters

  • Automatic → via interfacing
  • Manual → triggered during report entry

• Outsourced tests are excluded
  Reflex won’t trigger for outsourced workflows

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Configuration Screen – Field Breakdown

1. Test Name

• Select the main test (e.g., CBC).
• This acts as the parent container.

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2. Trigger Parameter

• Choose the parameter within the test (e.g., WBC, Hemoglobin).
• Parameter type determines available trigger options.

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Parameter Types & Trigger Logic

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1. Range Parameter

Used for numeric values with defined ranges (e.g., WBC, Hemoglobin).

Trigger Options

• Critical Range
  Fires when value falls outside critical limits.

• Out of Normal Range
  Fires when value is outside normal reference range.

• Custom Range
  User defined range (e.g., < 0.5 or > 15). It also fired when value is outside the range.

Note:

• Only one rule can be configured for Critical Range and Out of Normal Range per parameter.
• Multiple Custom Range rules can be added; however, each must have a distinct value range.

Behavior

If parameter value satisfies selected condition → reflex test is triggered

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2. List Parameter

Used when parameter values come from predefined options.

Trigger Options

• Is Not
• Contains
• Exact Matches
• Does Not Contain
• Contains Multiple Values

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Contains / Is Not / Does Not Contain

Input-based matching. A reflex test is triggered when the main test’s parameter value satisfies the configured rule i.e., it Is Not, Contains, or Does Not Contain the specified value.

Examples

• Is Not:
  Rule Value: "Negative"
  Reflex is triggered if the parameter value is anything other than "Negative"
  (e.g., "Positive", "Inconclusive")

• Contains:
  Rule Value: "Positive"
  Reflex is triggered if the parameter value includes "Positive"
  (e.g., "Weakly Positive", "Positive (++)")

• Does Not Contain:
  Rule Value: "Negative"
  Reflex is triggered if the parameter value does not include "Negative"
  (e.g., "Positive", "Reactive")

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Exact Matches

• Select from predefined dropdown values.
• Trigger when value matches exactly.

Examples

• Exact Matches:
  Predefined Values: "10", "20", "Positive", "Negative"

  Reflex is triggered only when the main test’s parameter value exactly matches the selected value from the predefined list.

  Examples:

  • If "Positive" is selected → triggers only when value is exactly "Positive" (not "Weakly Positive")
  • If "10" is selected → triggers only when value is exactly 10 (not 10.5 or a range)

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Contains Multiple Values (Advanced Logic)

Supports defining multiple input-based conditions that are evaluated together using AND or OR logic.

Each condition consists of:

• A match type (Contains / Does Not Contain)
• A user-defined value

You can add multiple such conditions, and the selected logical operator determines how they are evaluated.

Evaluation Logic:

• AND: All conditions must be satisfied for the reflex test to trigger
• OR: At least one condition must be satisfied for the reflex test to trigger

Example

Conditions configured:

1. Contains → "Negative"
2. Does Not Contain → "Positive"
3. Does Not Contain → "xyz"

• With AND logic:
  Reflex is triggered only if the parameter value satisfies all conditions:

  • Contains "Negative"
  • Does Not Contain "Positive"
  • Does Not Contain "xyz"

  Example matching value: "Negative"

• With OR logic:
  Reflex is triggered if any one of the conditions is satisfied

  Example matching values:

  • "Negative" (matches Contains "Negative")
  • "Reactive" (does not contain "Positive")

FAQs

1. What is reflex testing and how does it work?

Reflex testing refers to an automated process where additional tests are automatically ordered based on the results of an initial test. It's like a built-in decision tree for testing.For example, if a primary test yields certain results that indicate a need for further investigation or confirmation, the system can reflexively trigger additional tests without manual intervention.

2. How many reflex tests can be ordered for a single test?

You can configure multiple reflex tests for a single parameter in a test. Our system saves these configured reflex tests against a unique combination of a parameter and a test.

3. At what price are reflex tests added?

You can configure multiple reflex teReflex tests are added at the test default amount(MRP) defined by your lab.

4. Are reflex tests added to the same bill or do they create a new bill?

This can be defined at the test level. We provide the option to configure this in the reflex test configuration within the order settings.

5. Do we need the CrelioHealth interfacing app to enable reflex testing?

Yes, you need our interfacing feature to enable reflex testing, as the triggering of reflex tests occurs at the instrument level.

6. How does reflex testing work for outsourced tests?

If the test is outsourced from the billing center to the processing center, reflex tests will not be added. Our logic is designed to filter out such tests and prevent duplication.