The results of the multitude of tests sent to laboratories are the triggers for the en- tire care plan. They are the foundation of treatment
decisions and the clinical pathways pa-
tients will be sent on.
The importance of laboratories makes
the disconnect between them and electronic health records—the anointed hubs
of clinical and financial activity—all the
more frustrating. But disconnect there is
and with rapid advances in lab capabilities, patient well-being could be at risk.
Molecular and genetic information now is
being sent to physicians, but they may not
fully understand the messages that signal
certain propensities to disease, or may not
understand that even something as simple
as glucose levels are not measured as they
once were.
“Fifteen years ago, when EHRs first
started coming on the scene, I would ask
EHR vendors about how they could connect to labs, and they told me ‘Oh yeah, we
can interface with them, no problem,’ ” says
Karen Williams, the laboratory manager at
Internal Medicine of Northern Michigan, a
Petoskey-based group practice of 11 physicians that operates its own lab. “But their
idea of an ‘interface’ was that they could
display results. They didn’t understand
laboratory workflow and the complexity of
the information coming from the labs. And
15 years later, they still don’t seem to have
a good handle on it.”
must import to the EHR in a structured
format; lab results must comply with the
LOINC vocabulary; and support for the
2. 5. 1 messaging standard from Health Level Seven International is required.
That bodes well for the future, but the
situation on the ground indicates that re-
liable lab/EHR connectivity is going to be
a long time coming. And the disconnect
is becoming an ever-growing problem as
clinical tests become more refined and
molecular and genetic testing come online
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Meaningful Use
The EHR meaningful use incentive program was supposed to address that disconnect, and to some degree it has. Stage
1 treated lab connectivity with kid gloves:
optional menu items required the import
of at least 40 percent of lab data that could
be represented in a numeric or structured
format, as well as lab results be reportable
to public health agencies. Stage 2, however, ramps things up considerably.
Core measures require that more than
30 percent of lab orders be initiated in the
EHR; more than 55 percent of lab results
