CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
Raymond D. Aller, MD, and Hal Weiner
ONC interoperability project underway, with CAP input
Sunquest offering new version of lab system
AP-Visions releases pain-management module
SCC software secures ONC HIT certification
ONC interoperability project underway, with CAP input
The Lab US Realm Pilot Project doesn’t exactly evoke Lincoln’s Gettysburg address. But the project—a collaborative effort between public and private sector participants to address challenges in LIS and EHR interoperability—is a tangible example of government by the people, for the people.
The endeavor, an initiative under the Office of the National Coordinator Standards and Interoperability Framework, asks medical laboratories to voluntarily participate in pilot testing a suite of updated implementation guides for HL7 version 2.5.1. The CAP is partnering with the ONC to provide insight into trends and directions in the technical lab arena and field participant inquiries about CLIA and regulation conformance that arise during the pilot tests, which, as of CAP TODAY press time, were slated to end Sept. 30.
“This initiative is piggybacking on the fact that, for the first time, we have a harmonized set of implementation guides addressing interactions between LIS and EHR systems,” says Caroline Coy, Health IT program analyst in the ONC’s Office of Standards and Technology. “The goal of this pilot is to test the guides in real-world settings. We’re hoping participants can provide feedback on their experience and inform us of any changes that could be made to improve the efficiency of the guides.”
Response to the project has been positive, reports Coy, who notes that submissions for participation are due June 20. “There were indications from participants in some of our previous labs initiatives that this [pilot] would be a welcome addition, and that’s proven to be true,” she says.
Pilot participants are testing the ONC’s Lab Orders Interface (LOI) implementation guide, which addresses standards for ordering lab tests in ambulatory settings; Lab Results Interface (LRI) guide, which focuses on reporting lab results to electronic health record systems; and Laboratory Test Compendium Framework (eDOS) guide, a standardized method of communicating a laboratory’s directory of services.
While the pilot largely addresses communication standards, the eDOS sets the stage for further development of vocabulary standards, such as the LOINC and SNOMED terms that make up the codes. “The eDOS enables labs to communicate naming codes for their tests to EHR users electronically,” explains Walter Henricks, MD, vice chair of pathology and laboratory medicine and medical director of pathology informatics at the Cleveland Clinic. Dr. Henricks is a member of the CAP Clinical Informatics Steering Committee, for which he is involved in overseeing the College’s advisory role in the pilot.
Pilot participants are required to demonstrate basic functionality of the LOI and LRI guides for a proposed use case. In other words, laboratories will need to show that their lab information system can receive and consume a lab order conforming to the LOI base profile and generate a lab test result conforming to the LRI base profile that can be received and consumed by the EHR, according to the S&I Framework wiki. Participants are also required to create an eDOS, generate eDOS messages, and show that messages have been successfully consumed and incorporated by the EHR.
In a first, anatomic pathology use cases are included in the updated guides. This is significant, says Carolyn Knapik, manager of strategic initiatives in health IT at the CAP, because “agencies nationwide are working on standardizing AP reports so they can be used for various analytics.”
“The inclusion of AP is a first step in addressing variation in the use of the HL7 NTE segment,” adds Coy, referring to a common format for including comments in pathology reports.
Dr. Henricks concurs. “Instead of columns of numbers and reference ranges or discrete data elements with occasional comments, as with some clinical pathology reports, AP reports are generally paragraphs of text, not further structured. So they don’t fit into the HL7 model in the same way that numerical results do.”
Dr. Henricks stresses that labs should prepare to adopt the new guides, regardless of whether they participate in the pilot. The guides eventually will inform criteria for health information technology certification under the Centers for Medicare and Medicaid Services’ Merit-Based Incentive Payment System, or MIPS.
“First, laboratories should explore and understand what the implementation guides are and where they fit into the data-exchange process,” he says. “Second, lab IT departments can engage with their LIS vendors about [vendors’] readiness to support the guides. LIS interfaces will need to be implemented with different specifications, which could be a fair amount of work and cost. Vendors should be aware that their clients may be asking for these changes.”
Overall, Dr. Henricks is enthusiastic about the Lab US Realm Pilot Project and other S&I Framework initiatives. “The fact that ONC is engaging with stakeholders and with CAP is extremely positive,” he says. “Labs that participate in the pilot will have more input into the process. Will it be perfect out of the gate? No, but [these initiatives] present a substantial step forward in standardizing laboratory interoperability.” — Charna Albert
Sunquest offering new version of lab system
Sunquest Information Systems has reported the general release of Sunquest Laboratory version 8.0.
Among the new features in version 8.0 are significant enhancements to the system’s blood bank application. The new version provides a module for emergency release of blood to patients. This module includes workflows for when a patient’s blood type is known or not known, massive transfusions, and support of special transfusion requirements, such as irradiated blood, in an emergency. The system also offers redesigned screens to improve operational efficiency when cross-matching blood, as well as temperature tracking of blood units entered into inventory or returned to inventory.
In an unrelated announcement, Sunquest detailed the enhanced synoptic reporting capabilities for its Sunquest PowerPath version 10.2 anatomic pathology system, which was slated for release at CAP TODAY press time.
Among the synoptic reporting functionality in this latest version of PowerPath are a simplified user interface that includes a progress bar and section-completion indicators; capability for side-by-side worksheet editing and real-time report preview; features to quickly add, sort, duplicate, and delete worksheets; conditional logic; and auto-text support.
“Continued improvement to this functionality enables labs to more readily adopt and/or improve their utilization of synoptic reporting in support of College of American Pathologists cancer checklists,” Sunquest said in a statement.
Sunquest Information Systems, 877-239-6337
AP-Visions releases pain-management module
AP-Visions LLC has introduced its xP/M pain-management module.
The product, a plug-in module for AP-Visions’ xLab laboratory information system, is specifically designed for highly complex laboratories. “This allows AP-Visions laboratory customers that are currently doing moderately complex lab testing the option to add drugs-of-abuse and pain-management reporting,” according to a statement from the company.
AP-Visions, 714-306-0996
BBCS awarded contracts
Blood Bank Computer Systems recently announced that it is installing its software at Vascular Solutions and SunCoast Blood Bank.
Vascular Solutions, Minneapolis, has selected BBCS’s ABO Express centralized blood banking software to support the development of its RePlas freeze-dried plasma product. Vascular Solutions is collaborating with the U.S. Army to develop RePlas for the treatment of battlefield hemorrhage.
In a separate announcement, BBCS reported that SunCoast Blood Bank has signed a contract to install its ABO Suite blood establishment computer system. As a member of Blood Centers of America, SunCoast is eligible to receive group purchasing discounts for ABO Suite under the BBCS/BCA software standardization partnership announced in March.
SunCoast has multiple locations in Florida.
Blood Bank Computer Systems, 888-738-2227
SCC software secures ONC HIT certification
SCC Soft Computer’s SoftLab version 4.0.8 laboratory information system has received 2014 Edition Health Information Technology certification for supporting meaningful use measures. The lab system was granted certification under the Office of the National Coordinator’s ONC HIT Certification Program.
SCC Soft Computer, 727-789-0100
Dr. Aller is director of informatics and clinical professor in the Department of Pathology, University of Southern California, Los Angeles. He can be reached at raller@usc.edu. Hal Weiner is president of Weiner Consulting Services, LLC, Eugene, Ore. He can be reached at hal@weinerconsulting.com.