Office EMRs and Lab Portals; Discussion in Laboratory Economics

In previous notes, I have made a distinction between hospital EMRs and physician office EMRs, the differences being apparent from their names. The December issue of Laboratory Economics contained an article entitled LABS WORKING TO MAKE EMR CONNECTIONS which addressed the very important issue of hospital lab connectivity to office EMRs. This newsletter requires a paid subscription but a sample issue can be downloaded from the home page for review. Take a look at it -- the publication is always topical and provides valuable information for lab professionals. Here is an excerpt from the article cited above:

More and more physician offices want to receive test results and make orders through their electronic medical records (EMRs)—and they expect labs to pick up the tab for these difficult and costly connections. Seventeen percent of independent labs and hospital outreach programs with Web-connectivity systems say they have established “many” EMR interfaces— up sharply from 10% a year ago, according to preliminary results from Laboratory Economics 3rd Annual Web-Connectivity & EMR Survey completed by 294 labs in early December....Today, between 17% and 30% of office-based physicians are using an EMR.... But this figure is likely to jump to roughly 50% in the next few years. Physicians are moving to the EMR because it offers a single point for ordering and viewing all patient data....Over the past five years, most labs have put a Web-connectivity system in place to send test results to their physician clients. Seventy-four percent of labs now have a Web-connectivity system versus 37% in 2004, according to [Laboratory Economics'] 3rd Annual Web-Connectivity & EMR Survey. Among those labs that have established a Web-based connection with their physician clients, 15% say they are using Atlas LabWorks. Eleven percent of surveyed labs use Cerner, while 8% use4Medica. LifePoint/LabTest has a 7% share, and another 7% reported using an internally developed system....[I]t looks like most labs are using Web vendors as a gateway between the EMR and LIS, so that orders can be cleaned up and checked for proper ICD-9 codes before being transmitted to the lab. Web vendors are also providing expert IT support staff to help labs establish interfaces with EMRs. The most frequently cited benefit surveyed labs said they received from Web connectivity was “Cleaner lab test orders” at 62%, up from 53% from our survey in 2007, and 42% from our survey in 2006. Next was “Fewer phone calls from physician offices seeking test results” (58%), followed by “Better client retention/need it to compete with Quest and LabCorp” (46%). Another 28% cited “Better tracking of specimens.”

I think that it can be said with certainty, firstly, that the majority of physician offices or clinics will soon have an EMR and, secondly, that hospital labs will need to deploy what Jondavid Klipp, the publisher of Laboratory Economics, refers to in the article as a "web connectivity" system linked to these physician office-based systems. In previous notes, I have  referred to these systems as lab or web portals. There are three major current categories of necessary clinical lab software: LIS, middleware, and lab portal. I include an anatomic pathology LIS (AP-LIS) as a component of the LIS but it can also be obtained as a standalone system. A fourth functionality category that is rapidly emerging as necessary is a digital imaging system comprised of both software and hardware.

In the Lab Economics survey cited above, it's interesting that "cleaner orders" and "fewer phone calls" ranked higher than the competitive advantage over the large commercial labs in terms of the benefits of lab portal software. I suspect that the competitive advantage was the initial driver for the purchase and then the other key benefits of the software became more obvious to lab personnel.

The following four vendors of lab portal systems will be represented at the 27th annual Lab Infotech Summit to be held on 16-18 March, 2009, at the Venetian Hotel in Las Vegas, two of which are cited above:  Atlas Medical, Blue Iris, CareEvolve, and Cerner. Online registration for the conference is now available at the conference web site. The first 100 registrants for the conference will qualify for a complimentary copy of "The Inovator's Prescription: A Disruptive Solution for Health Care." Dr. Jason Hwang, one of the authors of the book, will be a keynote speaker at the event.