Ken Willett CEO/CTO of Ignis Systems Corporation
A recent posting on Michigan Health Connect indicates that while this state-wide HIE is handling 820,000 lab results per month, it is only handling about 5000 orders per month. This 160-fold disparity highlights the issues with trying to use HIEs for bidirectional lab communications.
Lab results distribution is a relatively straightforward problem for an HIE. The format standards are relatively mature, and technology exists for routing data through a network to the correct ordering provider, based on identifiers in the message itself. The results may or may not be mapped to a standard vocabulary; many EHRs have not made this a requirement for lab data. However, with LOINC adoption increasing, result code mapping will also become a straightforward exercise.
Standardizing orders is much more difficult, because it’s not just a data routing and formatting problem. Most EHRs don’t create a complete order that’s ready to send to the lab. And many legacy Lab Information Systems don’t accept unsolicited inbound orders, because they require manual patient registration before the order can be accepted.
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