Guest Opinion by:
Pat Wolfram
Editor’s Note: For almost 20 years, Pat Wolfram has worked to develop electronic medical record systems at companies like MedicaLogic and GE Healthcare. His firm specializes in developing effective electronic interfaces that allow a physician’s EMR system to handle lab test orders and lab test results with that physician’s clinical laboratory provider.
IN THE NEXT FOUR YEARS, more than 360,000 physicians will take steps to implement and use an electronic medical record (EMR) system in their medical practice. Federal policy and incentive dollars will drive this tidal wave of EMR adoption.
This pace of EMR adoption by the nation’s physicians is unprecedented. It also represents both a serious threat and a great market opportunity for all the clini- cal laboratories and anatomic pathology groups in this nation.
Report Card On EMRs
For that reason, I recommend that the laboratory testing industry in this country take the necessary steps to convene a working group and issue a report card on different EMR products. This report card would provide physicians with an objective, clear assessment of how each EMR system available for purchase in the United States is able to appropriately support the interfaces needed for accurate lab test ordering and lab test results reporting.
Such a report card would be welcomed by physicians. Currently, they have no credible source of information that helps them understand the strengths and weaknesses of the different EMR products currently offered for sale—particularly in regards to seamless lab test orders and lab test reporting. Thus, an objective EMR product report card issued by a representative clinical laboratory task force would give them the information they need to make an informed decision about the fea- tures and benefits of the EMR systems they are ready to purchase.
This same report card can help laboratories better deal with the challenge of widespread EMR adoption and use. As a threat, there are two issues soon to con- front laboratories throughout this country.
First, any clinical lab which is unresponsive to the request of a client physician to build the electronic interfaces necessary to support lab test ordering and lab test results reporting between the physician’s EMR and the lab’s LIS is at risk of losing that account to a competing laboratory willing to spend the necessary money to achieve those goals.
Second, even where a laboratory wants to step up and help that physician with the lab orders/lab results interface, it requires plenty of money, lots of expertise, and a competency in healthcare information technology that will place great stress on the budgets of most clinical labs and pathology groups. Simply put, the demand for EMR–LIS interfaces by many doctors—all at the same time—can over- whelm a laboratory organization.
Market Opportunity For Labs
As a market opportunity, this approaching tidal wave of EMR adoption by physicians is likely to mean that the first laboratory which helps them interface their EMR for lab test orders and lab test results reporting has an advantage in establishing a business relationship for years into the future.
After all, it will be expensive and time-consuming for a physician group to switch laboratories and create the necessary interfaces with the new lab provider needed for the EMR to handle lab test orders and results reporting.
These are the reasons why I encourage the laboratory testing industry to issue a report card on how the laboratory testing profession evaluates the different EMR systems. This report card will be in addition to the EMR meaningful use requirements put out by ONC.
Currently, what usually happens is the physician chooses an EMR based on a wide set of criteria, and lab integration is a “check in the box” not requiring much diligence. Only after the purchase does the physician approach the hospital or the lab with the request that it integrate the ordering and reporting functions to that EMR.
70 Different EMR Interfaces
Even if all 70 of the currently-certified EMR vendors are strong at handling lab integration, that’s still 70 different integration projects which, in theory, the lab would have to tackle. It is the reason why labs and the lab industry need to get in front of this issue by offering an EMR report card and holding local town meet- ings to educate physicians on the strengths and weaknesses of the various EMRs.
There is very little downside to this strategy. For example, even if a physician didn’t choose an EMR that handles laboratory data efficiently, he/she will appreciate the fact that the local laboratories stepped up with an objective EMR report card that was good advice at a time when the physician most needed that advice.
It would not be difficult to empanel a lab industry task force to gear up for this work. It would also not be complicated to define the EMR criteria relating to laboratory test orders and test reporting that physicians should use when evaluating the purchase of an EMR system.
Interfaces To Laboratories
Physicians need to know how easy each EMR product is to interface with laboratories. In working with hospitals, laboratories, and office-based physicians, my company has seen wide differences in how EMRs deal with laboratory tests.
There are some EMR products that are quite easy to automate for lab test ordering. These systems make it simple to deploy the ordering rules for each assay offered by the laboratory. And just as frequently, there are EMR products out there which are less adept in how they handle lab tests orders and accept lab test results. However, physicians have no credible, objective source of information to help them evaluate these capabilities.
Laboratories are the experts in how to interface EMRs with their LISs. It is eminently sensible for the laboratory industry to develop a useful EMR report card to inform and guide physicians as they prepare to purchase and deploy an EMR in their medical practice.
With 360,000 physicians about to act on the need to buy an EMR, there can be no more auspicious time for the lab industry to be proactive on this issue. Best of all, I think physicians would welcome a lab industry-endorsed EMR report card.
