Health IT Policy Committee Information Exchange Workgroup Meeting
Note about this meeting: The Workgroup will be hearing testimony from invited experts and stakeholders in the area of electronic exchange of laboratory information. They met on October 20, 2009. Here is a link to their agenda.
CALL TO ORDER
• Judy Sparrow, Office of the National Coordinator for Health Information Technology. Overview (warning: PPT file)
Overview of Meeting
• Deven McGraw, Chair, Information Exchange Workgroup
• Micky Tripathi, Co‐Chair, Information Exchange Workgroup Background
• Angela Brice-Smith, Centers for Medicare & Medicaid Services
• Kelly Cronin, Office of the National Coordinator for Health Information Technology
Part I: Business Issues related to the Electronic Exchange of Laboratory Data
• Mike Nolte, GE Health Systems
• Vasu Manjrekar, eClinicalWorks
• Phil Marshall, WebMD
• Tim Ryan, Quest Diagnostics
• Susan Neill, Texas Department of State Health Services
Part II: Business Issues related to the Electronic Exchange of Laboratory Data
• Laura Rosas, New York City Primary Care Information Project
• Sarah Chouinard, Primary Care Systems, Inc. and Community Health Network of West Virginia
• Raymond Scott, Axolotl Corporation
• Areg Boyamyan and Jim Timmons, Foundation Laboratory
Regulatory and Policy Issues
• Joy Pritts, Georgetown University Health Policy Institute
• Don Horton, LabCorp
• Jonah Frohlich, California Health and Human Service Agency
• Walter Sujansky, Sujansky & Associates
Public Comment
Some excerpts:
Laura Rosas, New York City Primary Care Information Project (PDF file):
“Unfortunately, electronic lab interfaces have proved to be one of the greatest barriers encountered in this project. Through great effort on the part of our EHR vendor, commercial laboratories, and the PCIP’s dedicated staff, we have managed to provide electronic lab interfaces to approximately two-thirds of our practices over a period of two years. It has proven nearly impossible under current processes to ensure that practices have an electronic laboratory interface at the same time that they go “live” on their EHR. Many of these practices waited months before they had an electronic interface, and subsequently needed to create complicated “workarounds” in the interim. On average, implementing, testing, and validating a lab interface for a PCIP practice takes about 10-14 weeks.”
Jonah Frohlich, California Health and Human Service Agency (PDF file)
“There is virtually no standardization of lab messaging in the industry today. In my experience working on ELINCS projects – initiatives that use highly constrained HL7 messages or “implementation guides” to support electronic lab results delivery – all hospitals needed considerable outside technical assistance to comply with the standard. Labs required assistance to adopt the LOINC coding scheme; a standard naming system for lab tests, and labs were unprepared to adopt SNOMED or UCUM; standard coding schemes for results and units of measures. The lab information systems the hospitals operated had internal “proprietary” codes for test names, and they had little expertise to “map” these codes to LOINC. These labs relied heavily on external technical assistance to do the necessary mapping for the most frequent 95% of reported tests as required by ELINCS – approximately 150 of the thousands of reportable tests in their databases.”
Vasu Manjrekar, eClinicalWorks (PDF file)
“Despite a concentrated effort on the part of eClinicalWorks and its Reference Lab partners over past several years, it has been difficult to provide electronic laboratory interface at go “live” on their EHR. Many of these practices wait months before they get an electronic interface, and subsequently needed to create “workarounds” in the interim. On average, implementing, testing, and validating a lab interface for a practice with National Reference Lab companies take about anywhere from 4-14 weeks.”
