News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Innovative clinical laboratories are not only rethinking traditional LIS-to-EHR interfaces with their client physicians, but they are also helping to streamline physicians’ workflow

Most clinical laboratories and anatomic pathology groups would welcome a fast (“easy-on”), cheap, and effective method that enables electronic lab test ordering and lab test reporting between physician’s offices and medical laboratories.

The goal is to create the seamless interface between the electronic health record (EHR) systems of office-based physicians and the laboratory information systems (LIS) of clinical laboratories. Labs want a way to electronically receive lab test orders from physicians in a format that is easily digested by the lab’s LIS, and perhaps their hospital’s information system (HIS), and which also allows the lab to match the orders accurately and seamlessly with specimens as they arrive.

Next, the clinical lab needs an equally seamless way to electronically transmit the medical laboratory test results back to physicians so that this lab test data automatically and accurately populates the physicians’ EHRs.

What frustrates clinical labs is the need to deal with the hundreds of different EHR products that are used by office-based physicians. Typically, a lab must develop a custom interface with each EHR product to allow the lab’s LIS to electronically accept lab test orders and electronically deliver lab test results back to the EHR of each client physician.

Complexity of LIS-to-EHR Interfaces

How complex is it to create these LIS-to-EHR interfaces? Several LIS vendors have told Dark Daily that they regularly see clinical labs that have developed unique interfaces between their LISs and more than 100 different EHR products used by their client physicians. And that was just to conform to Meaningful Use (MU) stage one requirements. The criteria for MU stage 2 are even more challenging—plus many fewer EHR vendors have obtained MU stage 2 certification for their EHR products.


Many electronic health records (EHR) systems do not support optimal workflow in physicians’ offices. This is particularly true for medical laboratory test ordering and lab results reporting, notes Eric Reynolds (pictured above). He is Vice President of Clinical Services at Emdeon Inc., and works with clinical laboratories to provide informatics solutions that help improve workflow in physicians’ offices in ways that benefit medical laboratories. (Photo copyright The Dark Report.)

“The challenge of a quick, inexpensive, and functional LIS-to-EHR interface is complicated by another factor,” stated Eric Q. Reynolds, Vice President of Clinical Services at Emdeon, Inc., a company that provides revenue, payment cycle, and clinical solutions that connect payers, providers, and patients. “The ideal interface for lab test ordering and lab test reporting should support optimal workflow. This is true both for the clinical lab that receives the physician’s lab test orders, and for the EHR in the physician office that receives the lab test results as they are transmitted back from the lab.”

Unfortunately, only a handful of EHR products are good at supporting optimal workflow for lab test orders and lab test reporting. “This complicates the work that medical laboratories must do to enable these functions,” observed Reynolds. “EHR vendors are going to focus on their customer, the physician. The lab, and the business and clinical rules it has in order to optimally process orders and results, are often an after-thought or simply ignored in the native order designs of EHRs.”

Defeating the Purpose of the Electronic Interface

“It is not uncommon for us to see situations where, the lab test reports come back to the physicians’ EHRs, but are then stored in a secondary location within the EHR, in effect separately from the patient-centric screens the physician uses to view all data needed for diagnosis and treatment of a patient,” noted Reynolds. “In these situations, physicians may require the staff to print out the lab test results, which defeats the purpose of an electronic interface.”

To help solve these problems for medical laboratories and physicians, a new type of integration solution is emerging. It is called a “clinical information exchange” and it is designed specifically to optimize the workflow from physician to clinical lab and back to physician through advanced and scalable application programming interface (also known as API) and web services technology.

Dramatic Workflow Improvements for Clinical Labs and Physicians

Two early users of a clinical information exchange system are the North Memorial Medical Center Laboratories. They reported dramatic improvement in the workflow of electronic lab test ordering and lab test reporting.

“Using Emdeon Clinical Exchange, we now get specimens from our client physicians that are bar-code ready,” stated Patti Smith, BA, CLS (ASCP), Laboratory Manager at North Memorial Health Care. “This allows us to put those samples directly on our laboratory automation line while eliminating the manual entry step for our staff. Additionally the clinical exchange provides the correct insurance information for that patient upfront. The downstream effect of that is we have a cleaner bill and that allows us to get the bill out to the client quicker.”

North Memorial Medical Center is a two-hospital system with a 518-beds in Robbinsdale, MN, and 130 beds in Maple Grove. Together, the clinical laboratories in the two hospitals run about 1.6 million tests each year.

Physicians Are More Productive, Helping the Lab Outreach Program

Improved workflow on the physician’s side of the interface has produced equally significant benefits. “Since we began using the clinical exchange system, physicians tell us that the time required to receive and read lab test results has been significantly shortened,” said Adam Grau, Manager, Sales and Business Development at North Memorial Health Care. “This improvement has not gone unnoticed by physicians in our community. We actually have physicians knocking on our door to learn how they can utilize our laboratory. That’s never happened in the past.”

Recognizing the strong interest pathologists and clinical laboratory directors have in optimizing workflow and boosting the efficiency of LIS-to-EHR interfaces used for lab test ordering and test results reporting, Dark Daily has published a white paper, Integrating Clinical Laboratories into Healthcare Networks: Using Clinical Exchange and Elegant Workflow Design to Enhance Service Value and Reduce Costs.

The white paper identifies the specific challenges faced by physicians and medical laboratories when they work together to develop electronic interfaces for lab test ordering and lab test reporting. It also describes why many EHR systems are unable to deliver an optimized workflow for physicians, along with solutions—including clinical information exchanges—that labs can introduce to improve physician ease of use and productivity when ordering lab tests and accessing lab test results. The white paper is available for immediate download at this link. (Or copy and paste this URL into your browser:

Related Information:

Integrating Clinical Laboratories into Healthcare Networks: Using Clinical Exchange and Elegant Workflow Design to Enhance Service Value and Reduce Costs

Many Physicians Deciding Not to Proceed with EHR Adoption in a Development That Could Affect Clinical Laboratories Offering LIS-to-EHR Interfaces to Doctors

Big EHR Companies Like Allscripts, Cerner, and EPIC Posting Major Gains in Revenue and Operating Profit as Providers Address Stage Two of Meaningful Use

Connecting Your LIS and EHR

Laboratory Interoperability Best Practices: Ten Mistakes to Avoid