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Laboratory News
Why Labs Need to Get the Inside Scoop on "Federated Architecture" and "Health 2.0"
Progress toward full integration between the laboratory
information system (LIS) and the physicians' office electronic medical record
(EMR) is happening. That raises the stakes for hospital-based laboratories and
independent lab companies that fail to keep their information technology
current. On the other hand, several pioneering laboratory organizations are
pushing forward to develop capabilities compatible with the emerging technology
concepts of "Federated Architecture" and "Health 2.0."
Bruce A. Friedman, M.D. is a pathologist who closely tracks
these developments. He is recognized as one of the lab industry's foremost
experts on information technology (IT).
To get the inside scoop on the latest innovations in IT and laboratory
informatics, Dark Daily caught up with Dr. Friedman. He has rounded up several pathology
informatics innovators to speak at his upcoming Lab InfoTech Summit.
Friedman, who is Active Emeritus Professor, Department of
Pathology, University of Michigan Medical School,
and, President, Pathology Education Consortium,
sees two groundbreaking initiatives that he expects to significantly influence
the use of IT in pathology and lab medicine. One is "Federated Architecture"
and the other is "Health 2.0."
Federated
architecture is one approach to resolving the LIS-EMR data integration
problem. Currently, when a lab populates
an EMR using the HL7 communication standard, the data gets deconstructed and
reformatted. EMR vendors also put strict
limits on the amount of lab information the EMR can report to clinicians. The
federated architecture concept argues that laboratories should be given "white
space" in an EMR that lab professionals can format and populate as they see fit. The federated architecture can also be
applied to radiology, cardiology, and other specialties that generate complex
textual and image data that is reported via the EMR.
Friedman observes
that two laboratory sites are actively incorporating federated architecture
into pathology and laboratory information systems. At the University of
Michigan Medical School, Ulysses J. Balis, M.D., Associate
Professor of Pathology, and Director, Division of Informatics, Department of
Pathology is using federated architecture. At LabInfoTech,. Balis will discuss "The Value of a Federated Architecture in
Pathology: Test Order Entry."
For pathology test result reporting, Mark J. Routbort, M.D., Ph.D., Assistant Professor, Department
of Hematopathology, M.D. Anderson Cancer Center has already deployed a federated architecture involving
the LIS/EMR axis. With the use of
federated architecture, lab data is not replicated in the EMR database, but
only stored in the LIS database, underlying the federated architecture as a
virtual clinical database. In this
model, the EMR serves only as a reporting conduit with reports generated from
decentralized information systems only at the time of the query. Routbort will
speak on "The Value of a Federated Architecture in Pathology: Test Result
Reporting" at Lab InfoTech.
The aim of Health 2.0 is to empower the healthcare consumer to
make more knowledgeable decisions using care-based information acquired via Web
tools. "Consumers now have online access
to information that was previously unknown and inaccessible to them," said
Friedman. "Most of this information was
previously available only through physicians."
"Health 2.0: Coming Soon to a
Lab Near You" is a presentation to be delivered by Scott L. Shreeve, M.D., Chief
Executive Officer, Crossover Healthcare.
One example of how Health 2.0 is beginning to alter existing
laboratory testing practice is direct access testing (DAT). In this
arrangement, consumers order lab tests themselves and pay for them out-of-pocket. When consumers use these services, they get a
PDF file of their test results from the laboratory, which they can fold into their
PHR (personal health record). Dark Daily
has written in the past about the growing number of Web sites that allow consumers
to generate their own PHRs rather than depending on a hospital or doctor's
office to track their healthcare. Direct
access testing and PHRs are just two examples among many of the intersection of
laboratory informatics and Health 2.0.
Dark Daily readers interested to learn more about federated
architecture, Health 2.0 and similar innovations in laboratory informatics should
register for the fifth annual Lab InfoTech Summit. It will take place on April 9-11, 2008, at the Venetian Resort Hotel Casino, Las Vegas, Nevada.
Lab InfoTech Summit is a unique three-day conference designed for all clinical
laboratory professionals, including pathologists, medical technologists LIS
managers, and lab business managers.
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