flowchart TB
  subgraph Pre-Analytical
    A[Order HIS/LIS] --> B[Specimen Collection at Location]
    B --> C[Accessioning @ Dept + WS]
    C --> D[Label/Tube Routing]
  end

  subgraph Analytical
    D --> E{Routing Engine}
    E -->|Instrument-backed WS| F[Workstation Queue]
    F --> G[Middleware ASTM/TCP]
    G --> H[Instrument]
    H --> I[Results ASTM -> Middleware]
    I --> J[Workstation Result Inbox]
    J --> K[Delta/Autoverify Rules @ Dept]
  end

  subgraph Post-Analytical
    K --> L[Tech/Path Review & Release @ WS]
    L --> M[Report Formatting Letterhead/Template by Location/Tenant]
    M --> N[Distribution HIS HL7 ORU, Portal, Fax, Email, HIE]
    N --> O[Billing / Send-outs / QC / Analytics]
  end

  classDef site fill:#e8f3ff,stroke:#8ab6ff;
  class B,A,D,M,N site;

sequenceDiagram
  participant HIS as HIS/EMR (per site)
  participant Mirth as HL7 Middleware
  participant LIS as Infinity LIS Core
  participant WS as Workstation (Dept)
  participant MW as HL7/ASTM Middleware
  participant INST as Instrument

  HIS->>Mirth: ORM^O01 (Order) [SiteCode]
  Mirth->>LIS: ORM^O01 (site-routed)
  LIS->>WS: Create Work Item(s)
  WS->>MW: Order to Instrument (HL7/ASTM/TCP/API)
  MW->>INST: HL7 ORU or ASTM O,R frames
  INST-->>MW: Results (HL7 ORM / ASTM R frames)
  MW-->>WS: Parsed Results + Flags
  WS->>LIS: Verification / Release
  LIS->>Mirth: ORU^R01 (Final)
  Mirth->>HIS: ORU^R01 (site-routed)

graph TD
    subgraph "Central LIS Single Instance"
        LIS[Core LIS System<br>Epic Beaker / Cerner / Orchard]
        DB[(Shared Database<br>Patient Index, Users, Audit)]
        MW[Middleware<br>Instrument Manager / HL7 Engine]
        ADMIN[Central Admin<br>IT, Updates, Monitoring]
    end

    subgraph "Hospital A Large Core Lab"
        A_LOC[Location: HOSP-A]
        A_DEPT1[Hematology Dept]
        A_DEPT2[Chemistry Dept]
        A_WS1[Workstation WS-01]
        A_WS2[Workstation WS-02]
        A_INST1[Sysmex XN-1000<br>Bidirectional ASTM]
        A_INST2[Roche Cobas 8000<br>HL7 Results]
        A_REF[Ref Lab: ARUP<br>HL7 Send/Receive]
    end

    subgraph "Hospital B Medium Lab"
        B_LOC[Location: HOSP-B]
        B_DEPT1[Hematology Dept]
        B_DEPT2[Chemistry Dept]
        B_WS1[Workstation WS-10]
        B_WS2[Workstation WS-11]
        B_INST1[Beckman DxH<br>ASTM]
        B_INST2[Vitros 5600<br>HL7]
        B_REF[Ref Lab: Quest<br>Portal + HL7]
    end

    subgraph "Clinic C Point-of-Care / Send-Out"
        C_LOC[Location: CLINIC-C]
        C_DEPT[Draw Station Only]
        C_WS[Workstation WS-20<br>Phlebotomy & Send-Out]
        C_REF[Ref Lab: Quest<br>Auto-Routing]
    end

    %% Data Flows
    LIS -->|HL7 Orders| A_LOC
    LIS -->|HL7 Orders| B_LOC
    LIS -->|HL7 Orders| C_LOC

    A_LOC --> A_DEPT1 & A_DEPT2
    B_LOC --> B_DEPT1 & B_DEPT2
    C_LOC --> C_DEPT

    A_DEPT1 --> A_WS1 --> A_INST1
    A_DEPT2 --> A_WS2 --> A_INST2
    B_DEPT1 --> B_WS1 --> B_INST1
    B_DEPT2 --> B_WS2 --> B_INST2
    C_DEPT --> C_WS

    %% Instrument to LIS
    A_INST1 -->|Results| MW
    A_INST2 -->|Results| MW
    B_INST1 -->|Results| MW
    B_INST2 -->|Results| MW

    %% Ref Lab Integration
    A_WS2 -->|Esoteric Orders| A_REF
    B_WS2 -->|Esoteric Orders| B_REF
    C_WS -->|All Non-POC| C_REF

    A_REF -->|Results| MW
    B_REF -->|Results| MW
    C_REF -->|Results| MW

    MW -->|Validated Results| LIS
    LIS -->|Final Report| A_LOC & B_LOC & C_LOC

    %% Central Oversight
    ADMIN -->|Config, Rules, QC| LIS
    ADMIN -->|Dashboards, TAT| DB

    %% Styling
    classDef location fill:#e3f2fd,stroke:#1976d2,stroke-width:2px,color:#000;
    classDef dept fill:#f3e5f5,stroke:#7b1fa2,stroke-width:1px;
    classDef ws fill:#fff3e0,stroke:#f57c00,stroke-width:1px;
    classDef inst fill:#e8f5e9,stroke:#388e3c,stroke-width:2px;
    classDef ref fill:#ffebee,stroke:#c62817,stroke-width:2px;
    classDef central fill:#f5f5f5,stroke:#424242,stroke-width:3px;

    class A_LOC,B_LOC,C_LOC location
    class A_DEPT1,A_DEPT2,B_DEPT1,B_DEPT2,C_DEPT dept
    class A_WS1,A_WS2,B_WS1,B_WS2,C_WS ws
    class A_INST1,A_INST2,B_INST1,B_INST2 inst
    class A_REF,B_REF,C_REF ref
    class LIS,DB,MW,ADMIN central

erDiagram
  CLIENT ||--o{ SITE : has
  CLIENT ||--o{ USER : employs
  USER ||--o{ USER_ROLE_BINDING : binds
  ROLE_TEMPLATE ||--o{ ROLE_PERMISSION : grants
  MODULE ||--o{ PERMISSION : defines

  SITE ||--o{ LOCATION : contains
  LOCATION ||--o{ DEPARTMENT : groups
  SITE ||--o{ WORKSTATION : hosts

  TEST_CATALOG ||--o{ TEST_SPECIMEN_MAP : accepts
  SPECIMEN ||--o{ TEST_SPECIMEN_MAP : provides

  TEST_CATALOG ||--o{ TEST_CONTAINER_MAP : needs
  CONTAINER ||--o{ TEST_CONTAINER_MAP : provides

  PANEL ||--o{ PANEL_COMPONENT : includes
  TEST_CATALOG ||--o{ PANEL_COMPONENT : is_component

  TEST_CATALOG ||--o{ REF_RANGE : ranges
  SITE ||--o{ REF_RANGE : overrides

  SITE ||--o{ ORDERING_LOCATION : sources
  SITE ||--o{ TEST_WORKSTATION_MAP : routes
  WORKSTATION ||--o{ TEST_WORKSTATION_MAP : targets
  TEST_CATALOG ||--o{ TEST_WORKSTATION_MAP : applies

  MIDDLEWARE_ENDPOINT ||--o{ INSTRUMENT_PROFILE : serves
  WORKSTATION ||--o{ WORKSTATION_INSTRUMENT_MAP : connects
  INSTRUMENT_PROFILE ||--o{ WORKSTATION_INSTRUMENT_MAP : connects

  REF_LAB_PROFILE ||--o{ WORKSTATION_REFLAB_MAP : connects
  WORKSTATION ||--o{ WORKSTATION_REFLAB_MAP : connects

  ORDER ||--o{ ORDER_ITEM : has
  ORDER_ITEM }o--|| PANEL : optional_panel
  ORDER_ITEM }o--|| TEST_CATALOG : atomic_test
  ORDER_ITEM ||--o{ RESULT : yields
  ORDER ||--|| ORDERING_LOCATION : placed_from
  ORDER_ITEM }o--|| WORKSTATION : performed_on

graph LR
  subgraph Tenant Context
    Client[(Client)]
    Site[(Site)]
    Client -->|has| Site
  end

  subgraph Operations
    OrderingLocation[(OrderingLocation)]
    Location[(Performing Location)]
    Department[(Department)]
    Workstation[(Workstation)]
    InstrumentProfile[(InstrumentProfile)]
    Middleware[(Middleware Endpoint)]
    RefLab[(Reference Lab Profile)]
  end

  subgraph Catalog
    Test[(TestCatalog)]
    Panel[(Panel)]
    PanelComp[(PanelComponent)]
    Specimen[(Specimen)]
    Container[(Container)]
    RefRange[(ReferenceRange)]
  end

  subgraph Security
    User[(User)]
    Role[(RoleTemplate)]
    Perm[(Permission)]
  end

  subgraph Orders & Results
    Order[(Order)]
    Item[(OrderItem)]
    Result[(Result)]
    QC[(QC Control/Rule)]
    AutoV[(Autoverification Rule)]
    Routing[(Routing Rule)]
    Report[(Report Template)]
  end

  %% Hierarchy
  Site -->|contains| Location
  Site --> Department
  Site --> Workstation
  Workstation -->|connects via| Middleware
  Workstation -->|routes to| InstrumentProfile
  Workstation -->|or send-out| RefLab

  %% Catalog links
  Panel -->|includes| PanelComp
  PanelComp --> Test
  Test --> Specimen
  Test --> Container
  Test --> RefRange
  Test -->|routed to| Workstation

  %% Orders
  OrderingLocation -->|places| Order
  Order -->|has| Item
  Item -->|is for| Test
  Item -->|or| Panel
  Item -->|performed at| Workstation
  Item --> Result
  Result --> Report

  %% Rules
  Routing -->|selects| Workstation
  AutoV -->|evaluates| Result
  QC -->|governs| InstrumentProfile
  QC -->|flags| Result

  %% Security
  User -->|bound at site| Role
  Role --> Perm
  User -->|acts in| Department
  User -->|works on| Workstation

classDiagram
  class Client {
    +client_id
    +client_code
    +name
  }
  class Site {
    +site_id
    +client_id
    +site_code
    +timezone
    +inherit_from_client: bool
  }
  class Test {
    +client_id
    +test_code
    +name
    +method
    +unit(UCUM)
    +is_calculated: bool
    +version
    +active
  }
  class Panel {
    +panel_id
    +client_id
    +panel_code
    +version
    +bill_as_panel: bool
  }
  class ReferenceRange {
    +ref_range_id
    +test_code
    +unit
    +age_min_days/age_max_days
    +sex_at_birth
    +critical_low/high
    +effective_start/end
  }
  class Workstation {
    +workstation_id
    +site_id
    +ws_code
    +is_manual: bool
    +department_id
  }
  class InstrumentProfile {
    +instrument_profile_id
    +site_id
    +vendor
    +model
    +endpoint_id
    +status
  }
  class RoutingRule {
    +rule_id
    +site_id
    +applies_to
    +criteria_json
    +action_json
    +priority
  }
  class AutoverRule {
    +autover_rule_id
    +site_id
    +criteria_json
    +action
  }
  class Order {
    +order_id
    +site_id
    +ordering_location_id
    +priority
    +status
  }
  class OrderItem {
    +order_item_id
    +order_id
    +test_code/panel_id
    +workstation_id
    +status
  }
  class Result {
    +result_id
    +order_item_id
    +value
    +unit
    +flags
    +status
  }

  Client "1" --> "many" Site
  Site "1" --> "many" Workstation
  Test "1" --> "many" ReferenceRange
  Panel "1" --> "many" Test : via PanelComponent
  Workstation "1" --> "many" InstrumentProfile
  RoutingRule --> Workstation
  Order "1" --> "many" OrderItem
  OrderItem "1" --> "many" Result
  AutoverRule --> Result

sequenceDiagram
  participant EMR as EMR / OrderingLocation
  participant LIS as Infinity LIS
  participant Route as Routing Engine
  participant WS as Workstation
  participant MW as Middleware
  participant INST as Instrument
  participant QC as QC Engine
  participant AV as Autoverification
  participant RPT as Reporting

  EMR->>LIS: Place Order (tests/panel, patient, priority)
  LIS->>Route: Resolve performer (site, test_code, time, availability)
  Route-->>LIS: Workstation selected (+fallbacks)
  LIS->>WS: Queue OrderItem(s)

  WS->>MW: Send Order to Instrument (ASTM/HL7)
  MW->>INST: Order download
  INST-->>MW: Results (raw values + flags)
  MW-->>LIS: Result message

  LIS->>QC: Evaluate control status / Westgard rules
  QC-->>LIS: In-control? (yes/no, flags)

  LIS->>AV: Apply autover rules (delta, critical, ranges)
  AV-->>LIS: Action = AutoRelease / Hold / Flag

  alt AutoRelease
    LIS->>RPT: Render report (template + letterhead)
    RPT-->>LIS: PDF/HTML
    LIS-->>EMR: ORU result (HL7) + Archive
  else Hold
    LIS-->>WS: Tech review queue with reasons
  end

flowchart TD
  A[Order Panel] --> B{Get Panel Version}
  B --> C[Expand Components]
  C --> D{Specimen/Container\nUnion + Conflicts?}
  D -- No --> E[Assign Required Specimen/Container]
  D -- Yes --> F[Prompt rules: priority, site override]
  E --> G[Create OrderItems per Test]
  F --> G
  G --> H[Route each Test → Workstation]
  H --> I[Queue for Instrument/Ref Lab]