Physicians now make extensive use of electronic health records to provide medical care for their patients. This has increased the demand for the creation of a lab order interface.

Initially, many hospital laboratories could create a single interface to connect to the hospital’s EHR. However, the CDC’s statistics reveal that 85.9% of physicians with consulting offices use an EHR system, while 79.7% use an EHR certified by health regulators.

As a result, there’s a rapid increase in demand for electronic test orders and the electronic delivery of results. Today, laboratories are faced with the need to handle electronic connections to many disparate EHR systems.

With the extensive use of EHRs to make electronic orders for tests comes several challenges. Many of these challenges occur when a laboratory or radiology department has to interface their LIS to multiple EHRs. Examples include:

  • Truncated test results
  • Undisplayed comments
  • Rejected results caused by mismatched patient identifiers
  • Undetected errors that occur because interface logs were not monitored

One of the best ways to overcome these challenges is to let a third-party vendor create an interoperability interface between the lab LIS and the multitude of EHRs used to send order requests electronically. The interface can take these test orders and transform them into a single stream received by a single LIS interface.

The following best practices may be adopted when developing interfaces to send and receive lab orders and test results.

1. Develop Standardized Test Definitions

There must be clearly defined terms in test requests and results for true interoperability between laboratory and clinical information systems. Lab technicians and clinicians can easily infer what a test report means on paper from many years of experience. But computers can’t use experience without prior programming.

A good example of this scenario occurs when a glucose level is stated as 120 mg/dl; many clinicians would infer that the result is for a plasma or serum sample rather than a urine sample. However, unless artificial intelligence or machine learning algorithms are used, the lab information system will not conclude that the result wasn’t from a blood glucose tolerance test.

To transmit test orders and results without ambiguity, we need to ensure that both sending and receiving systems can correctly interpret all values. The lab LIS and the doctor’s EHR must agree on and use the same catalog for all potential test orders and possible results. Before building any interfaces, it is essential to compare the list of test codes in the EHR and LIS and determine if any tests are missing. Where possible, let the interface use a standardized coding system.

2. Use LOINC to Identify Test Names

LOINC stands for Logical Observation Identifiers Names and Codes. It is a standardized coding system for identifying observations, tests, and events. Support for this coding system has become widespread in EHR and LIS systems since it became a mandatory part of the Health Information Technology (HITECH) framework. The LOINC naming system should be the foundation of a reliable test definition strategy. Every interface development effort should implement LOINC coding for future tests to optimize EHR to LIS functionality.

3. Train Users on LOINC Nomenclature

Due to the rich and complex nature of LOINC, it requires some education for practical use. So developers and users who are not familiar with this standardized way of coding medical observations must take the time to study the LOINC catalog. The LOINC website has useful instructional material to help users improve their proficiency and understanding of their terms and codes. Also, labs should encourage all reagent and instrument vendors to provide LOINC codes with their supplies.

Contact Us for More Information About Lab Order Interfaces

Give us a call at Lifepoint Informatics by dialing 877.522.8378 to discover how to implement effective lab order interfaces. Contact us today to book a free consultation or watch a free demo of a successfully deployed lab order interface.