In a mad dash to qualify for the HITECH Act electronic medical records adoption incentives, physician electronic medical record (EMR) usage has surged. Clinical laboratories must be agile and responsive in developing and implementing connectivity strategies to interface with hundreds of individual EMRs and electronic health record (EHR) software products or risk losing providers and market share. Labs need the right technology in place to seamlessly integrate EMRs and EHRs into their existing processes to remain competitive. Labs can set themselves apart by providing connectivity solutions that allow providers to stay on top of critical patient health and medical record data and enable them to meet the meaningful use requirements for incentive payments available for electronic medical record adoption.
With a robust, reliable and unlimited integration platform, regional, anatomical pathology, molecular, specialty and hospital-based outreach labs can be more responsive to EMR interface requests to solidify provider relationships and lock in new and repeat client business. Labs that have a viable and easily implementable strategy have a better chance to compete and be successful in this demanding market. Both providers and labs are motivated to get on the EMR bandwagon. Providers are aware of the need to provide electronic results to qualify for Stage 1 meaningful use stimulus incentives. Stages 2 and 3 have even tougher requirements that encompass computerized and integrated provider ordering (CPOE) along with structured results reporting.
The difficulty labs face is that each EHR and laboratory information system (LIS) has its own interface requirements. Adding to this is the reality that providers, who typically use multiple labs on a regular basis, are unable to support the connectivity needed on their end, as they don’t maintain dedicated IT staff. In addition, it is difficult for these providers to afford the connectivity fees that EMR vendors are setting. Without being connected, they are not eligible for the incentive payments.
Lab Data at the Center of Care
There is no denying that clinical laboratory test data is essential in medical care decision making with up to 70% of medical decisions based on laboratory results.1 Laboratory data is needed for every aspect of care, from screenings, diagnosis and treatment protocols to effective follow-up care.
An obvious solution is for labs to make one connection from their LIS to a connectivity hub which can distribute data to an unlimited number of EMRs and support provider direct order entry. Making this connectivity available to providers is an efficient and cost effective option to maximize EMR usefulness and meet meaningful use criteria. However, as obvious as this solution is, it is not initially simple for labs to achieve.
One of the biggest obstacles that labs face in providing this connection is that there are so many disparate EMR solutions. National labs such as Quest Diagnostics and LabCorp have taken a proactive approach in enabling EMR connectivity, but smaller labs have a lot of catching up to do. Labs need to create stronger provider connections to secure their digital foothold by integrating their lab data with EMR systems being used in their marketplace.
Interface Alternatives
In addition to EMR integration, there are ongoing government-based HIT initiatives spanning the care continuum that also require connectivity for data sharing and have labs rethinking their existing point-to-point interfaces. Local HIEs and RHIOs, which have the capacity to manage and store data electronically, often assist healthcare providers with healthcare IT adoption and require the same patient data being transmitted between the labs and the EMRs and rely on an interoperability platform to connect multiple HIT systems. Having one feed to get the information from the lab to the EMR, RHIO or HIE is the most efficient way to go.
Labs that offer EMR connectivity find themselves supporting multiple interfaces to meet EMR integration demands. The HHS Certified Product List contains more than 400 ambulatory EHR products and labs need to accommodate these systems and the diverse functionality they offer.
Most small to midsized labs do not have deep IT resources or qualified internal technical expertise for interface programming and implementation. Labs are unable to absorb the steep cost (average interface engine cost $200K+) associated with building, implementing and maintaining the complex point-to-point interface engines needed to serve multiple EMR vendors and HIEs. Once built, specially trained and certified IT staff is needed to properly implement and operate these engines, even the open source offerings, and provide reliable interfaces which can be required 24/7. Implementation alone often requires a deep team of IT specialists that most labs cannot supply. Home grown systems are usually not scalable or portable and may not be able to keep up with EMR interface demand causing the lab to lose clients and negatively impact outreach growth.
In dealing with these issues, lab managers have recognized that existing legacy point-to-point interfaces are no longer a viable operating strategy for the long term. Successful labs have realized that developing and supporting IT solutions are not their area of expertise and have engaged connectivity and integration specialists for cost effective, reliable interface solutions. A vendor-neutral partnership strategy establishes a collaborative environment in which product solutions and operating platforms from EMR/EHR to LIS and HIE/RHIO can coexist within a small technology footprint, minimizing ongoing maintenance and IT personnel requirements. Working with available lab IT resources, the strategic partner provides domain expertise, hands-on experience and the manpower needed for every phase of the EMR integration process.
Providing a virtual integration platform utilizing a “hub and spoke” structure that requires only a single interface to a lab’s LIS reduces implementation time, effort and cost and enables a lab to connect with every EMR in their provider community. A dedicated connectivity vendor facilitates lab order processing, reduces EMR implementation time and cost and provides a reliable connection between its LIS and the vast array of EMRs they have to accommodate. The vendor also provides consistent and top-notch support and maintenance, freeing lab IT personnel to focus on core functions and other IT challenges such as the ICD-10 and HIPAA ASC X 12 version 5010 transitions.
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One Lab’s Story
Lenco Diagnostic Laboratories Inc. is a full-service clinical reference laboratory located in Brooklyn, N.Y., that handles close to 2,000 orders per day. Lenco’s team of highly dedicated specialists provide high quality services, competitive pricing, best in the industry turnaround times and a first-time right service attitude, taking great pride in continuously meeting the needs of its physician clients and their patients. Lenco’s laboratory services include basic and specialty diagnostic testing, from blood counts to genetic testing for rare diseases.
Lenco has developed a state-of-the art IT department that enables their clients to access patient results from anywhere there is a secure Internet connection. For the past seven years, Lenco has used Lifepoint Informatics Web Provider Portal to give their providers access to concise, up-to-the-minute patient information across multiple care settings anytime and from anywhere. As more of Lenco’s physicians and healthcare providers began to implement EMRs, Lenco needed to seamlessly connect with these disparate systems.
Lenco recognized that they had to take a proactive approach to quickly enabling these EMR interfaces to solidify their provider relationships, lock in repeat business, attract new providers and continue their high service standards. They needed to implement an across the board solution that would eliminate the complexity of EMR interfacing and support all of their providers, from single physician to large group practices, and help them to achieve meaningful use.
They implemented Lifepoint’s EMRHub solution to retain existing clients, compete for new business and secure their lab’s foothold in provider-side EMR systems. Implementing EMRHub requires only one connection from Lenco’s LIS to distribute lab data to an unlimited number of EMRs and support provider direct order entry. Utilizing EMRHub as their virtual integration platform, Lenco is more responsive to EMR interface requests to continue to support and attract providers. Lifepoint was able to provide rapid implementation for the EMR connections to meet Lenco’s client demand and within 3 months had successfully completed over 100 EMR interfaces, including eClinical Works, Allscripts, Practice Fusion, CureMed, OmniMD, SpringCharts, MDLand, GE Centricity and others.
Implementing successful EMR/EHR interfaces is not a simple process considering the number of systems in the market and the unique ways vendors address HL7 standards. According to Feliks Pinkhusovich, Lenco CIO, “Lifepoint’s EMRHub eliminated building and maintaining custom point-to-point interfaces that we previously relied on. Our IT staff is now more focused on building our outreach business. We benefit from Lifepoint’s vendor neutral approach that allows us to process clinical messages and lab orders with our existing LIS and provider EMRs. The combination of Software as a Service (SaaS) delivery and rapid implementation has delivered substantial cost savings.”Dennis Yurovsky, VP of Operations at Lenco agreed and added, “Partnering with Lifepoint has helped us to establish a strong presence with providers and drastically reduce the cost of lab to EMR interfacing. Providing Lifepoint’s Cloud-based single interface, virtual integration platform has strengthened our client connection and enabled us to focus on outreach success.”
“We recognize that as more of our providers adopt and implement EMRs their demands on our IT capabilities will increase. We are seeing stand-alone portals and point-to-point interfaces being replaced with bi-directional and fully integrated electronic connectivity options which we can now offer. Fewer of our providers are filling out manual lab orders and we offer providers a quick and efficient way to get them up and running with Lifepoint handling our EMR integration. This has added to our outreach success,” commented Tom Asher, VP of sales at Lenco.
Lenco has this advice for other labs: “Look at the EMR integration challenge as an opportunity to deliver connectivity solutions that other labs are not capable of providing and do this now. Partnering with a vendor that knows your pain points and how to eliminate them makes good business sense and enables you to connect and compete in your market.”
Emily Ruffing is marketing director, Lifepoint Informatics, Glen Rock, N.J.
Reference
1. College of American Pathologists. Resources for the Public. Available at: http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt{actionForm.contentReference}=publicResource%2Findex.html&_state=maximized&_pageLabel=cntvwr. Accessed 7/27/12
