> ## Documentation Index
> Fetch the complete documentation index at: https://docs.blis.app/llms.txt
> Use this file to discover all available pages before exploring further.

# Label Printing

> Configure automatic specimen label printing for test orders

## Overview

bLIS can automatically generate and print specimen labels when test orders are created. This streamlines specimen collection and ensures proper labeling without manual intervention.

## How Label Printing Works

When a test order is created:

1. bLIS checks if the test spec has **Print Labels** enabled
2. If enabled, a label is queued for printing
3. Labels include:
   * Accession number
   * Patient/subject identifier
   * Test code and name
   * Barcode (if configured)
   * Collection date/time
   * Any custom fields

Labels are typically sent to dedicated label printers (e.g., Zebra, Dymo) in the laboratory.

## Configuring Label Printing

### Per Test Specification

Label printing is configured at the test spec level:

1. Navigate to **Administration** → **Test Specifications**
2. Edit the test spec
3. Configure label settings:
   * **Print Labels**: Enable automatic label printing
   * **Print Labels With Reflex**: Also print labels for reflexed tests
   * **Preferred Tube**: Default specimen container type

### Print Labels Flag

**`printLabels`** (Boolean):

* `true`: Automatically print labels when this test is ordered
* `false`: No automatic labels (manual printing if needed)

Use cases for enabled label printing:

* Tests requiring dedicated specimen collection (e.g., blood cultures)
* Tests with specific tube requirements
* Tests where pre-printed labels reduce errors

Use cases for disabled label printing:

* Tests performed on already-collected specimens
* Add-on tests to existing samples
* Tests that share specimens with other tests

### Print Labels With Reflex

**`printLabelsWithReflex`** (Boolean):

* `true`: Print labels for tests triggered by reflex logic
* `false`: Don't print labels for reflexed tests

<Info>
  Reflex tests are automatically triggered based on initial test results. For example, a positive strep screen might reflex to a throat culture. If you want labels printed for the reflexed test, enable this flag.
</Info>

## Preferred Tube Configuration

Link a **Preferred Tube** to each test spec:

* Specifies the default specimen container
* Label can include tube type information
* Helps phlebotomists collect the correct specimen

Example:

* CBC → Lavender top (EDTA)
* BMP → Green top (Heparin)
* PT/INR → Light blue top (Citrate)

This ensures:

* Correct anticoagulant for the test
* Proper specimen volume
* Reduced collection errors

## Label Content

Typical label contents include:

### Required Information

* **Accession Number**: 8-digit unique identifier
* **Patient Name/ID**: Subject identifier
* **Test Code**: Short test identifier (e.g., "CBC", "BMP")
* **Collection Date/Time**: When specimen should be collected

### Optional Information

* **Barcode**: 1D or 2D barcode for scanning
* **Tube Type**: Preferred specimen container
* **Priority**: STAT vs routine
* **Special Instructions**: e.g., "Fasting required"
* **Custom Fields**: Laboratory-specific information

### Barcode Standards

Common barcode formats:

* **Code 128**: High-density 1D barcode
* **Code 39**: Simple 1D barcode
* **QR Code**: 2D barcode for more data
* **Data Matrix**: Compact 2D barcode

Barcodes typically encode the accession number for quick scanning during specimen processing.

## Label Printers

### Supported Printers

bLIS works with thermal label printers:

* **Zebra**: ZD420, ZD620, ZT411, etc.
* **Dymo**: LabelWriter series
* **Brother**: QL series
* **Generic**: Any printer supporting ZPL or EPL

### Printer Setup

1. **Install printer** on laboratory network or workstation
2. **Configure printer settings** in bLIS:
   * Printer name/IP address
   * Label size (e.g., 2" x 1")
   * Print density
   * Connection type (USB, network, Bluetooth)
3. **Test print** to verify configuration
4. **Assign to workstations** where labels are needed

### Network vs Local Printing

**Network Printers:**

* Shared across multiple workstations
* Centralized in specimen collection area
* Requires network configuration
* Better for high-volume labs

**Local Printers:**

* Connected directly to workstation
* Dedicated to specific user/location
* Simpler setup
* Better for distributed collection sites

## Common Workflows

### Standard Order Entry

1. User creates accession
2. Adds test orders
3. For each test with `printLabels: true`:
   * Label is generated
   * Sent to configured printer
   * User applies label to specimen tube
4. Specimen collected and processed

### Batch Printing

For multiple accessions:

1. Create multiple accessions
2. Queue all labels
3. Print batch at once
4. Sort labels by patient/time
5. Distribute for collection

### Reflex Testing Example

```
Initial order: Strep Screen (printLabels: true)
→ Label prints for throat swab

Result: Positive
→ Reflex to: Throat Culture (printLabelsWithReflex: true)
→ Additional label prints for culture plate
```

Without `printLabelsWithReflex`, only the initial strep screen label would print.

## Troubleshooting

### Labels Not Printing

**Check test spec configuration:**

* Verify `printLabels` is set to `true`
* Confirm printer is configured
* Test printer connectivity

**Check printer status:**

* Printer is online and ready
* Labels loaded correctly
* No paper jams or errors

**Check print queue:**

* Labels may be queued but not sent
* Check for failed print jobs
* Retry printing if needed

### Wrong Label Content

**Verify label template:**

* Template matches laboratory standards
* All required fields included
* Barcode format correct

**Check test spec settings:**

* Preferred tube matches expectations
* Test code/name are correct
* Custom fields configured properly

### Labels Print for Wrong Tests

**Review configuration:**

* Some tests shouldn't have `printLabels` enabled
* Check for accidentally enabled flags
* Disable for add-on or reflexed tests as appropriate

### Barcode Won't Scan

**Printer settings:**

* Increase print density for darker bars
* Verify barcode symbology (Code 128, etc.)
* Ensure label size is adequate

**Scanner settings:**

* Configure scanner for correct symbology
* Test with known-good barcode
* Check for damaged scanner laser

## Best Practices

### Configuration

* Enable label printing only for tests requiring dedicated specimens
* Use `printLabelsWithReflex` judiciously (only when reflex needs new specimen)
* Link preferred tubes to all tests for guidance
* Test label printing in staging before deploying

### Label Design

* Keep labels concise and readable
* Use high-contrast text (black on white)
* Include patient name and accession number prominently
* Add barcodes in consistent locations
* Follow CAP/CLIA labeling requirements

### Printer Maintenance

* Keep printers clean and free of debris
* Replace thermal print heads periodically
* Use high-quality label stock
* Keep spare printers for backup

### Workflow

* Print labels immediately when orders are created
* Apply labels before specimen collection
* Verify labels match patient before collection
* Re-print if labels are damaged or lost

## Regulatory Considerations

### CLIA Requirements

Specimen labels must include:

* Patient identifier (name and/or unique ID)
* Date and time of collection
* Collector's initials (can be added manually)

Automated label printing helps ensure:

* Consistent labeling
* Reduced transcription errors
* Complete information on every label

### CAP Requirements

CAP accreditation requires:

* Positive patient identification
* Specimen labeling at collection time
* Labels must be permanently affixed

Using bLIS label printing:

* Ensures consistent compliance
* Provides audit trail of label generation
* Reduces human error in labeling

### Best Practice Standards

Follow industry best practices:

* Use two patient identifiers when possible
* Include visual and machine-readable (barcode) identifiers
* Prevent label switching or mix-ups
* Document label printing in LIS

## Advanced Features

### Conditional Label Printing

In some configurations, labels print based on conditions:

* Only for STAT orders
* Only during certain hours
* Only for specific organizations
* Based on custom sample fields

Contact your administrator if you need conditional printing logic.

### Multi-Label Printing

Some tests require multiple labels:

* Primary specimen tube
* Aliquot tubes
* Slide labels
* Storage labels

Configure how many labels print per test order in test spec settings.

### Custom Label Templates

Customize label layouts:

* Add institutional logo
* Include custom fields
* Adjust barcode size/position
* Localize language

Label templates are typically ZPL (Zebra Programming Language) or similar formats.

## Integration with Instruments

Labels with barcodes enable:

1. **Specimen tracking** through laboratory workflow
2. **Instrument integration** (analyzers scan barcodes to identify specimens)
3. **Error reduction** (eliminate manual entry of accession numbers)
4. **Chain of custody** documentation

When instruments scan specimen barcodes:

* Results automatically link to correct accession
* Reduces result entry time
* Prevents sample mix-ups
* Provides timestamp of analysis