Product V2 IG
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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
Product Name - NCPDP-HL7 V2 Electronic Prescribing Coordination Mapping Document
- HL7-NCPDP Electronic Prescribing Coordination Mapping Document, Release 1
Type
R1 Informative
Releases
V2 EPCMAPPING, R1; January 2007
Summary
This NCPDP-HL7 Electronic Prescribing Coordination Mapping Document is intended to provide mapping requirements for electronic prescribing systems using HL7 Versions 2.4 and above to communicate with systems using NCPDP SCRIPT Standard Implementation Guide Version 4.2 and above, for transactions in electronic prescribing business functions.
Description
The NCPDP SCRIPT Standard Implementation Guide was recommended by the United States (US)National Committee on Vital and Health Statistics (NCVHS) as a standard for Patient Medical Records Information (PMRI) in the US. It is used to facilitate the transfer of prescription data between pharmacies and prescribers. The current standard supports messages regarding new prescriptions, prescription changes, refill requests, prescription fill status notification, and prescription cancellation. In the future, enhancements may be included such as lab values, diagnosis, patient drug profiles, prescription transfers, and formulary inquiries. The NCPDP SCRIPT Standard Implementation Guide can be used in both the inpatient and outpatient settings, but is primarily used to facilitate messages related to ambulatory prescriptions.
Business Case (Intended Use, Customers)
The NCPDP SCRIPT Standard Implementation Guide has been adopted by US community pharmacies as the means by which they will receive and send prescription information with prescribers; long-term care facilities are reviewing SCRIPT usage. The HL7 2.x standards were not specifically designed to manage transactions between prescribers and retail pharmacies, although this functionality is available in HL7 V3. Because inpatient facilities use HL7 2.x as their primary means for managing prescription information, there is a need to map HL7 to SCRIPT for the purposes of communicating with ambulatory pharmacies.
Benefits
The creation of an HL7 to NCPDP mapping document facilitates a number of potential interactions:
- Inpatient facilities using HL7 could write prescriptions for patients being discharged from the hospital using their existing system. The message could then be translated in an automated fashion to a SCRIPT-compliant message, which could be delivered to the pharmacy for dispensing.
- Similarly, outpatient facilities using HL7-based prescription tools could write prescriptions for patients. The message could then be translated in an automated fashion to a SCRIPT-compliant message, which could be delivered to the pharmacy for dispensing. Likewise, pharmacies could communicate refill or renewal requests to prescribers from SCRIPT messages that are then mapped to HL7 messages.
- Inpatient facilities and prescribers could receive SCRIPT fill notification messages from pharmacies, providing patient compliance information of whether the patient picked up the prescription, picked up a partial prescription, or never picked up the prescription.
- Prescription history messages in SCRIPT can be communicated between prescribing entities using SCRIPT or HL7 standards.
Implementations/ Case Studies (Actual Users)
Resources
Work Groups
Education
Presentations
Relationship to/ Dependencies on, other standards
- HL7 2.4
- NCPDP SCRIPT 4.2
Links to current projects in development
- none
