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LIS experts on HL7, AI, home-test results, and more
November 2024—Lab data displays, IT demands that outrun resources, at-home test results, and HL7 are some of what came up on Sept. 20 when CAP TODAY publisher Bob McGonnagle spoke online with pathologists and industry executives about laboratory information systems.
“It’s fire and forget,” said Ulysses G. J. Balis, MD, of the University of Michigan, about the lack of feedback from the EHR that a clinician has seen and understood a complex result. “Loss to follow-up is a real possibility,” he said.
Their conversation follows.
I’ll start with an overview of topics covered in last year’s roundtable on laboratory information systems. One is a need to integrate data between the LIS and EHR. We are still living in a world where dollars and staff are short and demands are diverse. Some clinicians want something concise; others want something complex and don’t want anything left out, which makes it difficult to simplify reporting. Ulysses Balis, can you comment on these dilemmas that everyone who does laboratory informatics faces?
Ulysses G. J. Balis, MD, associate chief medical information officer; A. James French professor of pathology informatics; director, Division of Pathology Informatics; and director, computational pathology laboratory section, Department of Pathology, Michigan Medicine, University of Michigan: The cumulative demands on the system, the lab, and the enterprise generally exceed available resources. We’ve shifted from generating simple lab results to the need for increasingly complex panels, molecular workflows, and derivative data, combined with downstream uses of that data, such as AI, where you need a specific format. Michigan is an exception to the rule in that we have retained ample technical resources to build such compound panels and interfaces. You have a growing queue of asks to the lab and the informatics group supporting the lab for data products, not just for the raw results but also the derivative data products that one generates with such results. These requests can take a long time to be realized or can’t be realized at all.
I see the list of requests growing faster than they’re getting resolved. I don’t know how we’ll solve this other than perhaps having standards for implementation of interfaces. We have HL7, and we know HL7 is almost a standard, but each place implements it slightly differently. Australians and New Zealanders have locked it down; I wish we could do that. The need and opportunity here is having one true interface implementation standard so we don’t have to do a complex dance of unit, load, and integration testing for every new lab or lab panel result requested, recognizing that the overhead needed to do this task has already become unsustainable.
Continue reading …
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