ONC delays lab standards

Meaningful use still remains a mystery after Tuesday's Health IT Policy Committee meeting and standards for electronic laboratory orders have been pushed off until next month.

David Blumenthal, MD, the national coordinator for health IT, asked the advisory Health IT Policy Committee to defer until January a decision on whether to allow temporary variations in those standards to be used.

The policy committee had recommended providers start using in 2011 a single set of national standards for communicating electronically with labs, one of the tenets of the administration’s meaningful use policy to encourage the use of health IT.

http://www.healthcareitnews.com/news/onc-delays-lab-standards

Quest Diagnostics to Provide ELINCS Lab Results from National Data Exchange Hub

Quest Diagnostics is implementing an ELINCS interface for its national data exchange hub, which will allow Quest to deliver lab results in the ELINCS format to physician EHRs across much of the United States. The ELINCS interface will launch in December 2009.

Quest began the implementation of ELINCS v.HL7-R1 in the Web services hub in April early this year.

Federal panel discovers barriers to exchanging laboratory results

The federal Health IT Policy Committee’s information exchange workgroup learned just how difficult it’s going to be for doctors to exchange electronic lab results to qualify for federal “meaningful use” bonuses.

Physicians can earn a potential $44,000 under the American Recovery and Reinvestment Act (ARRA), beginning Oct. 1, 2011, but they will have to show meaningful use of data, including the use of electronic laboratory results. One of the problems, the workgroup learned at its Oct. 20 meeting, is that state laws regulate the exchange of electronic laboratory results, and standards don’t exist to allow the information to flow easily between labs and physician offices.

http://www.healthcareitnews.com/news/federal-panel-disovers-barriers-exchanging-laboratory-results

HHS faces hurdles on electronic exchange of medical lab results

Federal health authorities will face several problems implementing the electronic exchange of patient lab results as part of an electronic health record (EHR) system, members of a federal advisory workgroup said at a meeting today.

The workgroup is a task force of the Health IT Policy Committee that advises the Health and Human Services Department’s (HHS) Office of the National Coordinator for Health information technology. HHS plans to release regulations later this year on how to distribute $19 billion in economic stimulus funding to doctors and hospitals that buy and "meaningfully use" certified EHR systems.

http://fcw.com/articles/2009/10/20/hhs-faces-hurdles-in-requiring-digital-exchange-of-medical-lab-results.aspx

New ELINCS Web Site Monitors Adoption, Provides Support

While the health IT requirements for federal stimulus funding have not yet been fully defined, "meaningful use" of electronic health records (EHRs) will almost certainly include electronic lab results transmission.

A new Web site sponsored by the California HealthCare Foundation (CHCF) tracks adoption of the EHR-Lab Interoperability and Connectivity Standard (ELINCS) for reporting laboratory results to ambulatory EHRs. Widespread adoption of ELINCS promises to streamline the connection of EHRs to laboratories' information systems, a process that has proven costly and time-consuming.

ELINCS was developed by industry experts from commercial labs, electronic health record vendors, government agencies, professional associations, and nonprofit organizations. ELINCS has been approved and is now maintained by Health Level Seven (HL7). It is also consistent with the 2008 Certification Commission for Health Information Technology (CCHIT) criteria for lab interoperability of ambulatory EHRs.

The new site includes a map that tracks live and pending implementations of the various versions of ELINCS across California. More than 40 organizations across the state, involving over 165 health care provider locations, have implemented ELINCS or are in the process of doing so. ELINCS users are encouraged to submit their implementation sites, which will be added to the map.

The site also includes ELINCS support tools, detailed ELINCS specification manuals, and ELINCS news. To learn more, visit www.elincs.org.

Store patient diagnostic report data today to preload a future EMR

Paper and faxes are the predominant methods of report delivery to physician offices despite the availability of the reports in electronic format (HL7). Smartlink enables physician practices to take advantage of electronic reports delivery without a full EMR solution. Secure electronic interfaces are implemented between the report producers and the Smartlink system to replace or augment the paper delivery mechanism.

Smartlink is a multi-user electronic medical records system designed to retrieve, store and display patient reports from many sources, including reports from medical imaging procedures, laboratory results, dictated reports of surgery, as well as patient demographics and contact information.

Stored reports are accessible using a web browser and can be easily exported to a format supported by the EMR or Document System.

Smartlink complements any physician office workflow environment: EMR, document management system, or paper based and provides a stepping stone modular approach to full EMR adoption.

http://www.smartlinkemr.com

An EMR prepopulated with historical reports and active interfaces at go-live increases successful EMR implementation as well as provides "effective use" to satisfy stimulus requirements.

OpenELIS: Open Source Laboratory Information System (LIS)

OpenELIS is a robust Enterprise Laboratory Information System built around an extensible and scalable framework. OpenELIS is designed and developed through the collaborative efforts of Public Health Laboratories to accommodate business processes that are common to all public health laboratories; encompassing clinical, environmental, newborn screening, and animal testing.

The goal of the OpenELIS team is to develop a state of the art system that is economically sustainable by reducing both initial investment and ongoing maintenance costs. By using an open source approach, we ensure that the project will continue to evolve and meet the changing needs of the community.

The project has potential to become a viable product that can be used in clinical laboratories. It uses cross platform programming language Java and open source database PostgreSQL. One of their goals is to be able to connect to EMRs using connectivity standards.

http://openelis.uhl.uiowa.edu/

HITSP HL7 Lab Standards Webinar

I found this interesting HITSP standards webinar series that is available online.

http://www.hitsp.org/archived_webinars.aspx

The link includes PPT presentations that are discussed in the recorded sessions.

California HIE Releases Open Source ELINCS Documentation

Early this year Alliance Medical Center received a grant from California HealthCare Foundation to demonstrate a simple software tool to receive electronic laboratory results in the new ELINCS format. ELINCS is a messaging system intended to standardize the electronic reporting of test results from clinical laboratories into electronic health record (EHR) systems. A new "HL7-R1" format of ELINCS was adopted by HL7 this past Summer. Today Alliance Medical Center is joined by two partners in releasing a technical specification titled "Using Mirth to transform HL7 v2.x into ELINCS (HL7- R1)".

www.redwoodmednet.org/projects/hie/docs/amc_elincs_20081121.pdf

WebReach Announces Mirth 1.8

Mirth 1.8 has over 200 new features, improvements and bug fixes driven
by your feedback. Some highlights for Mirth 1.8 include:

- Added delimited file support (e.g. CSV files)
- Added DICOM Listener (C-STORE SCU) and DICOM Sender (C-STORE SCP)
- Improved server stability and performance
- Improved UI performance and usability
- Improved inbound and outbound queuing and queue message management
- Added network share authentication support to the File Reader/Writer
- Added SSL and TSL support to SMTP connections
- Added attachment and HTML support to the Email Sender
- Added XSLT transformer support
- Added ability to reprocess and replace stored and errored messages
to only specific destinations
- Added support for transformations using an external JavaScript file
- Added option to check for and install new Mirth updates and updates
to Mirth extensions
- Added auto-creation of the Mirth database schema if it has not been
created yet
- Added ability to import/export entire connectors

You can browse the Mirth 1.8 release notes for the complete list at:

http://www.mirthproject.org/jira/secure/ReleaseNote.jspa?version=10100&styleName=Html&projectId=10000&Create=Create

LOINC version 2.26 and RELMA version 3.25

Regenstrief Institute and the LOINC Committee are pleased to announce that
LOINC version 2.26 and RELMA version 3.25 are now available for download:

http://loinc.org/downloads

This latest version of RELMA includes support for the new context-specific
hierarchies and is also available with multilingual searching via separate
download. RELMA now uses and requires the .NET framework. LOINC version 2.26
features the new Long Common Name.

In addition, we now offer a computable representation of the multi-axial
hierarchy, and selected panels/forms (with hierarchical arrangement and
answer lists) as separate exports available for download.

ELINCS defined

The EHR-Lab Interoperability and Connectivity Specification (ELINCS) specification provides a profile that refines (or constrains) “standard” HL7 messages to moving lab results from reference labs to physician offices. Like IHE, the ELINCS profile constrains the generic HL7 standard to a specific set of use cases. In addition the ELINCS standard provides business rules that must be followed between the trading partners. Such rules are outside the scope of the base HL7 standard.

CHCF Awards $120,000 to Implement New ELINCS Lab Standard

California providers will use the specification to improve delivery and exchange of clinical information

September 22, 2008

The California HealthCare Foundation (CHCF) today announced it has awarded eight grants to implement a new version of the EHR-Lab Interoperability and Connectivity Specification (ELINCS) to deliver lab results to clinical information systems.

ELINCS is a format that enables standardized lab results reporting between laboratories and ambulatory electronic health records (EHRs) systems. It provides a common language for patient data and helps providers deliver the right care by making data consistent, accessible, and accurate.

Grant recipients include independent physician associations, community clinics, private practices, and other ambulatory care providers across the state, which will receive technical assistance and up to $15,000 each over 12 months. The recipients are:

• All for Health, Health for All, Glendale
• Chinese Community Health Care Association, San Francisco
• Clinica Msr. Oscar A. Romero, Los Angeles
• Community Health Alliance of Pasadena, Pasadena
• County of Santa Cruz Health Services Agency, Santa Cruz
• Foundation Laboratory, Pomona
• Redwood MedNet (with CliniPro), Ukiah
• Redwood MedNet (with SpringCharts), Ukiah

"This is a great step to broaden ELINCS adoption to help providers and patients manage chronic diseases such as diabetes and heart disease," said Sophia Chang, M.D., M.P.H., director of the Better Chronic Disease Care Program at CHCF. "Improving access to accurate and timely lab results is also a patient-safety issue."

CHCF supported ELINCS in collaboration with leading national health care organizations, and this year transferred its copyright and management to HL7, a standards development organization that is recognized and accredited by the American National Standards Institute (ANSI).

"Given the specificity of the HL7 ELINCS implementation guide for the electronic reporting of laboratory results to ambulatory EHR systems, such standard transactions should be cheaper and faster to implement, providing immediate value to the health care industry," said Bill Braithwaite, long-time HL7 member and former board member. "We feel that HL7's open, rigorous, and multi-stakeholder standards-development process provides an appropriate home for implementation guides of widespread applicability and national importance, such as ELINCS, and we are happy to take over its development and management."

The new version includes changes to ELINCS that conform to the HL7 v2.5.1 message standard and meet the 2008 Certification Commission for Health Information Technology's EHR certification criteria.

With grants to implement ELINCS, CHCF and HL7 will receive feedback that can be used to improve the specification; expand adoption of ELINCS throughout the state and across the country; demonstrate models for use in diverse settings; and keep California organizations in step with national initiatives.

Electronic lab reporting will be a topic of discussion at the annual meeting of the American Health Information Community tomorrow, September 23 at 8:30 AM Eastern, in Washington, D.C. The public can participate remotely via www.videocast.nih.gov.

For more information on ELINCS, visit www.elincs.org.

Contact Information

Marcy Kates
California HealthCare Foundation
510.587.5162

Related CHCF Pages

ELINCS: Developing a National Lab Data Standard for EHRs