April 2008
Feature Story

Karen Wagner

Drop into a product meeting of a typical labprovider links (LPL) software vendor and you’re likely to hear the words “integration” and “usability” discussed at length. That’s because, while electronic medical records adoption has been slow, several LPL vendors are integrating their systems with such products, recognizing that they are the wave of the future. Vendors are also focusing on upping their offering of sophisticated yet user-friendly system functionality, which they say allows outreach labs to be competitive with larger, national laboratories.

The challenge with LPL systems is getting physicians to use them, says Aurel Kleinerman, MD, chief executive officer of Mitem Corp. The problem isn’t that physicians are computer-phobic, but that the systems are inefficient, he says, which is why many physicians continue to use pencil and paper. Dr. Kleinerman is working on a new user interface for Mitem’s Blue Iris eLaborate LPL system that will improve the electronic order-entry process. “The usability portion is what we’re working on; [we] hope to have a product by the middle of the year,” he says.

Offering LPL products that are sophisticated enough to meet physicians’ changing needs is key, asserts Joe Nollar, president of eTeleNext. Laboratories are looking for functionality that will allow them to customize reports using such elements as images, graphs, and tables, he explains. “Lots of traditional lab systems don’t handle images. And, for esoteric testing, like in the pathology market, images are increasingly desired on reports.”

Recognizing the value of enhanced usability, CareEvolve has simplified the order-entry module of its LabEvolve system by adding the ability to order laboratory, pathology, and radiology tests from the same menu. The system will then create separate requisitions. “This is enabling outreach programs to market more than just their lab and path services, giving them an advantage over [national labs],” says Brian Jones, the company’s vice president of sales and marketing.

CareEvolve, Jones continues, has developed relationships with several of the top 15 EMR vendors, including eClinical­Works and GE Healthcare. CareEvolve has gone through the certification and QA process with those vendors. “Because of this, we can implement these interfaces extremely quickly,” says Jones. “The first step is to set up secure communications with the physician’s office with either a VPN or, preferably, one of our file-based communication technologies. A vendor like GE can receive our HL7 results file and be able to read it into its application immediately, rather than having to go through weeks of development time.” So it can take as little as two weeks to get the order processed and less than a week to deliver the results, Jones adds.

“It’s been a very big focus of our business development group to get these types of relationships that benefit our laboratory customers as well as decrease our implementation time,” he says.

The No. 1 request from clients is to be able to integrate lab orders and results within their EMRs, says Michele Judge, director of clinical services for Emdeon Business Services. Emdeon’s Clinician LPL system has been able to interface with EMRs for the past several years. “What we’re doing [now] is enhancing some of those connection options for the vendors,” she explains. “Today we have vendors that actually embed a portion of our application into their EMR so that it’s seamless to the user.”

Emdeon is also enhancing Clinician with cumulative reporting. Users will be able to perform a trend report across different laboratories, Judge says. And Emdeon is expanding its secure messaging capabilities to include non-physicians, such as nurses. Both capabilities will be available later this year, she adds.

Lifepoint Informatics, formerly Labtest.com, expanded its product line with an EMR component about two-and-half years ago, says Jack Redding, president of Lifepoint. Physicians view EMRs as a way of leveraging their investment in LPL systems, he explains. Since they already have a system for ordering tests and receiving results, they want to integrate an EMR with the LPL system, rather than pay for a separate system.

Lifepoint’s EMR component has “helped the hospitals be more competitive with the national laboratories,” Redding says. Hospitals can offer the complete inpatient and ambulatory procedures medical record, he adds, while national laboratories provide only outpatient results for the tests they perform.

In addition to desiring EMR integration, physicians want to incorporate into their workflow such capabilities as printing requisitions for various departments and laboratories, and Telcor provides both, says Mitchell Fry, the company’s senior vice president.

Laboratories with patient service centers, on the other hand, want to be able to process orders and accept patient payments, which is a different type of workflow than in the physician’s office, he explains. Consequently, Telcor has introduced a patient service center module, called Quick-PSC. The module, a component of its Outreach Information System, allows users to retrieve orders from the company’s Quick-Req product or any other LPL and enter new orders. Telcor plans to integrate Quick-PSC with its billing information system, says Fry, so users will be able to make account inquiries and collect payments within the PSC module.

The new module, along with Quick-Req, can also be integrated with the billing information system to improve workflow in additional ways, Fry says. “While it can be used to print requisitions and advanced beneficiary notices and scan insurance cards, these documents can also be electronically transferred to the billing information system,” he explains. “So billing personnel can resolve errors within the billing information system without having to search for paper documents.”

Atlas Medical, which offers the LabWorks LPL system, recently developed a workflow management system. The product, Lab OuterWare, promotes order entry from the physician’s office, says Robert Atlas, president and CEO of the company. The system allows physician office staff to enter up to 90 percent of laboratory orders, taking the onus off laboratory personnel, he says.

In addition to an EMR component, Lab OuterWare includes an automatic client customer service module, Atlas continues. The module allows lab personnel to flag any customer service issue and address it electronically with the physician’s office using the company’s integrated InfoLink capability. The company also plans to integrate e-prescribing and eligibility checking into Lab OuterWare this year. “This is the kind of workflow we believe labs really need,” Atlas says.

A disease-management feature that can show a patient’s risk profile for various diseases as well as a treatment plan is in the works as well. Rather than offer tests as commodities, Atlas says, forward-thinking labs will someday use such features to brand their services. “This is really where we’re focusing a lot of attention in 2008.”

Looking to the future, Care­Evolve’s Jones predicts that “ultimately, EMR vendors will be providing lower cost, ASP [application service provider]-configured systems.” Laboratories, he adds, are recognizing that the Web-based solutions are reliable, secure, and less costly than investing in the server technology required by in-house systems.

CAP TODAY’s survey of laboratory-provider links software on pages 72–86 includes systems from the aforementioned vendors as well as from several other companies. Vendors supplied the information listed. Readers interested in a particular LPL system should confirm that it has the stated features and capabilities.