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Product Brief - V2 Implementation Guides

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Product Name - V2 IG Lab Result Report

  • HL7 Version 2.5.1 Implementation Guide: Orders and Observations; Interoperable Laboratory Result Reporting to EHR, Release 1

Type

R1 Informative, ANSI Technical Report, HL7 Technical Report

Releases

V2.5.1 LABRSLTRPT

Summary

This guide contains the necessary specifications for clinical laboratory results reporting to EHRs for use in the U.S. Realm. It is one component of an overall project for HITSP to establish implementation guides for aspects of the American Health Information Community (AHIC) use cases that can be recognized by the Secretary of the Department of Health and Human Services (HHS). In particular, this guide addresses messaging content and dynamics related to the AHIC Harmonized Use Case for Electronic Health Records (Laboratory Result Reporting), an AHIC EHR-Lab Result use case.

Description

The U.S. Realm – Interoperability Specification: Lab Result Message to EHR is the Health Level Seven (HL7) response to a request from the U.S. Health Information Technology Standards Panel (HITSP) for a standard laboratory message to meet the requirements of its use case. In March, 2006, the HHS Office of the National Coordinator For Health IT published the Harmonized Use Case for Electronic Health Records (Laboratory Result Reporting) in response to a request and specifications from the American Health Information Community (AHIC). The use case focuses on widely-available, well-standardized methods that will support the secure access to electronic laboratory results and interpretations for clinical care by authorized parties and is driven by the need for timely electronic access to ordered, referred and historical lab results. Ordering clinicians receive lab test results as a response to an order by having the test results sent either directly to the clinician’s EHR system (local or remote) or to another clinical data system in support of the provisioning of historical results.

HITSP received the harmonized use case and developed Interoperability Specification 1 (IS01) for Electronic Health Records Laboratory Reporting. HITSP has requested this implementation guide to serve as guidance for implementers and those certifying electronic health record systems. This document is intended to meet the needs and requirements of implementation guidance in relevant HITSP Interoperability Specifications.

This specification provides an applicable ambulatory care lab-reporting specification that can be adopted as a US industry standard, thereby obviating the need for clinical laboratories and EHR systems to define anew the specifications of each laboratory-to-EHR interface that is implemented. This standard covers the exchange of laboratory results from the testing source between providers and other authorized parties, such as Public Health. Be aware, this guide does not address laboratory orders.

One of the primary features of this implementation guide is its focus on key points of broad interoperability. These key points include the following:

  • Use of strong identifiers for key information objects – These information objects include patients, orders, providers and organizations. A strong identifier is one that uniquely identifies the object in question in a global fashion. This means the identifier includes enough information to remain unique when taken out of the context within which the identifier was created. This is accomplished through the use of assigning authorities for the identifier. In this guide, an assigning authority is normally handled as an ISO Object Identifier (OID). The combination of the identifier and the OID should always be unique. Assigners of identifiers need to create and register OIDs such that each identifier associated with an assigning authority is globally unique (i.e., it does not collide with another identifier assigned by the same or another assigning authority). This uniqueness ensures that each identifier can be broadly shared among independent healthcare organizations and still point to its originally associated object.
  • Use of Vocabulary Standards This guide calls for specific vocabulary standards for the exchange of laboratory information. Use of standard vocabularies is important for a number of reasons. Use of standard vocabularies allows broad distribution of healthcare information without the need for individual institutions to exchange master files for data such as test codes, result codes, etc. Each institution maps its own local vocabularies to the standard code, allowing information to be shared broadly, rather than remaining isolated as a single island of information. Standard vocabularies, particularly coded laboratory results, enable more automated decision support for patient healthcare, as well as more automated public health surveillance of populations.

Business Case (Intended Use, Customers)

  • Provider:Laboratory Services,
  • Vendor: Lab,
  • Stakeholder: US Clinical and Public Health Laboratories, Local and State Departments of Health

Benefits

Consistent implementation across disparate systems.

Implementations/ Case Studies (Actual Users)

Public Health

Resources

Work Groups

Education

Presentations

Relationship to/ Dependencies on, other standards

  • HL7 2.5.1,
  • SNOMED,
  • LOINC,
  • UCUM

Links to current projects in development

  • none


Product Name - V2.5.2 Orders and Observations - Lab ELINCS

  • V 2.5.1 Implementation Guide: Orders & Observations; Ambulatory Care Lab Result (ELINCS),

Type

R1 Informative, ANSI Technical Report, HL7 Technical Report

Releases

HL7 TR V2.5.1 OO ELINCS R1-2008

Summary

The HL7 Ambulatory Care Laboratory Result Implementation Guide (US Realm) is a messaging specification intended to standardize the electronic reporting of test results from clinical laboratories to electronic health record (EHR) systems found in ambulatory care practices. It is specific to the US Realm.

This specification provides an applicable ambulatory care lab-reporting specification that can be adopted as a US industry standard, thereby obviating the need for clinical laboratories and EHR systems to define anew the specifications of each laboratory-to-EHR interface that is implemented.

This specification focuses exclusively on the electronic reporting of ambulatory care lab results in the US Realm. Electronic messaging for other tasks and other contexts is outside the scope of the specification at this time, including messaging for ordering ambulatory lab tests, for reporting inpatient lab results, for reporting lab results outside of the US Realm, and for special-purpose reporting such as public health or biosurveillance.

Business Case (Intended Use, Customers)

Provider:Laboratory Services, Vendor: Lab

Benefits

Consistent implementation across disparate systems.

Implementations/ Case Studies (Actual Users)

Quest Diagnostics Incorporated, LabCorp, see more at http://elincs.chcf.org/Implementations.aspx

Resources

Work Groups

Education

Relationship to/ Dependencies on, other standards

  • HL7 2.5.1,
  • SNOMED,
  • LOINC,

Links to current projects in development

  • none