A considerably large amount of information used by physicians for medical decision-making is produced in the lab. Consequently, a major portion of the clinical data populating EMRs comes from the lab. It is therefore inevitable for lab managers today to effectively integrate data from one information system to another via EMR within the rest of the health organization or network. With clinical results being such a key component of the EMR, the laboratory information system (LIS) is the critical link in the flow of data throughout the healthcare continuum.
Electronic transmission of lab test results is an important part of clinical data. On March 1, the Centers for Medicare and Medicaid Services (CMS) together with the ONC released new guidance, clarifying that the Clinical Laboratory Improvement Amendments (CLIA) -federal law that regulates standards and quality assurance of all clinical laboratories, whether commercial labs, hospital labs, or doctors’ in-house labs- has permitted the electronic exchange of lab data. Although considered a mature sector, labs of all types and sizes continue to evolve their communication and integration strategies both internally and via critical outreach to physician practices and healthcare organizations. While IT innovation closes the remaining direct communication gaps between lab devices and the LIS, the growing challenge today and on the horizon is integration between the LIS and the EMR. In an evolving lab/client world where each situation is different, the approaches to LIS client outreach vary from situation to situation as well.
With more physician practices making the move from paper-based records systems to electronic systems, physicians expect to be able to easily access all patient information, including clinical and pathology test results, in a central location with a global means of communication from one system to another. One of the items in the ONC guidance is the encouragement of labs to use a particular standard method and vocabulary when exchanging lab data (HL7 2.5.1 as the transport standard, with LOINC as the test-identification vocabulary).
Regardless of the way of managing reports by an EMR system and its ability to report information directly to patients, either by secure email or by a Personal Health Record (PHR), the CLIA rules and the guidance from the ONC has helped pave the way for these tasks. Soon availability of accurate and meaningful health information for patients and physicians will be securely available on a wide scale.
