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$5k Per EHR Lab Interface

Posted on February 1, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A provider organization recently reached out to me to discuss the issues they were having trying to get their EHR vendor to do a lab interface with their lab. It was a pretty standard large EHR vendor document where they nickle and dime you for little things like a lab interface. Looking at it always reminds me of when I’ve seen the $5 aspirin charge in the hospital.

The problem with the lab interface charge is that it’s usually $5000 instead of $5. When an organization is choosing to implement an EHR, they often forget about many of the future hidden costs associated with an EHR vendor like the EHR lab interface. Plus, they also forget that the EHR vendor will often charge them $5k for the interface and then the lab will charge them another $5k for that interface. This is often true even when an EHR vendor has created many interfaces with a particular lab vendor before.

In fact, the organization that I mentioned above brought a new light to the cost of lab interface. It turns out that this organization was on its third lab and thus its third lab interface with their EHR. I don’t expect clinics change labs this often, but it is very common for a medical organization to switch from one lab to another. Plus, let’s not even get started on the challenge of getting a hospital lab to integrate with your EHR.

Not all EHR vendors are like those I mention above. In fact, a number of EHR vendors have seen this as a great way to differentiate their EHR from other competing EHR vendors. I know of at least one EHR vendor that’s done a few hundred lab interfaces (all at no cost to the doctor). The large number of labs partially illustrates the challenge associated with lab interfaces. There are just so many of them that need to be done. It’s not like there’s 1 or 2 labs that dominate the market. However, many EHR vendors are offering a free lab interface as part of the EHR purchase. Be sure to ask before you buy.

The sad part of the lab interface story is that because of the items mentioned above, many doctors just end up scrapping a lab interface. They can’t justify a $10k expense to integrate their EHR with the lab. This is unfortunate, because it’s amazing how much benefit can come from a well integrated EHR Lab interface.

Quest EHR Lab Interfaces

Posted on March 7, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at HIMSS I had the pleasure of spending some time talking with Rohit Nayak, VP of Physician Tech Solutions at Quest Diagnostics. Not only is Rohit a very nice gentleman, but he also provides a number of really interesting perspectives on the healthcare industry. Quest is obviously known in the lab world, but as I mentioned last year, Quest is shifting from being a lab company to a technology company. This is clearly seen by their Care360 EHR product.

At one point, Rohit and I started talking about Quest’s approach to interfacing with EHR software. When you consider that Quest has the lab results that many EHR companies want and now Quest is offering their own EHR it makes for an interesting situation. Rohit told me that Quest has 120 EHR interfaces. He told me Quest’s approach was to be open when it comes to sharing data.

Before I talk more about these interfaces, I think it’s worth commenting on the 120 EHR interface number. The number of EHR vendors is often debated and discussed. I personally like to use the 300 EHR companies number. I’ve seen some go as high as 600 EHR companies, but I think those people are counting any software regardless of if it offers a comprehensive EHR product. For example, they might include an ePrescribing app which is part of an EHR, but I wouldn’t count it in my number.

With that as background, I find the 120 EHR interfaces with Quest quite interesting. Outside of some very localized EHR companies, you’d think that most legitimate EHR companies would have been almost forced to build an interface with Quest. Although, someone did recently tell me that Quest and LabCorp only have 7% of the lab market so maybe I’m overstating EHR vendors need to interface with Quest. I’d be interested to hear from EHR vendors who don’t interface with Quest and why they haven’t yet done so.

Heading back to interfacing with Quest, I was interested in how Care360 EHR users that don’t use Quest for their labs would be handled. Say I was a doctor who used LabCorp for my labs, but wanted to use Quest’s Care360 EHR. Would Quest support a lab interface from Care360 to LabCorp? Rohit told me that Quest would have no problem integrating Care360 with Labcorp, but that LabCorp wouldn’t let them do it. Don’t you love competition?

Of course, I only had the chance to talk with Quest about this topic. I don’t remember ever even seeing LabCorp at HIMSS. Considering LabCorp hasn’t taken the EHR route directly that could be why. I’m not sure many LabCorp users would want to use the Care360 EHR, but it is interesting to consider.

Rohit and I also started an interesting discussion about how well EHR software is consuming the Lab data that’s being sent across these lab interfaces. I’ve asked him to do a guest post on the subject, so I hope to bring you that in the future. You can also check out this 5 EHR Questions with Rohit Nayak video I did while at HIMSS as well.

Why Get a Lab Interface and Cost of Implementation

Posted on July 25, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m always sad when I come across an EMR implementation that doesn’t have an interface between their EMR and their lab. I can appreciate someone having just implemented an EMR not having a lab interface. However, it should be one of the first things on your list to implement. It’s such a great compliment to your EMR software.

First thing I must suggest is that you get a bi-directional lab interface if at all possible. One way lab interfaces can work, but do take more management to make it work right.

Why Get a Lab Interface with Your EMR?
Lab interfaces are so seamless. The order is made in the EMR and it’s automatically is sent to the lab. Talk about removing a lot of the possibilities for error. In our case, we have an in house lab and so this saves a ton of time for the lab rat tech as well. No more data entry into the Lab’s LIS system. As a side note, we also use the lab order in our EMR to print out the labels for the specimen. This is an unbelievable time saver and much more accurate. Small things like this are just another hard to calculate benefit to an EMR.

The largest benefit to a lab interface is receiving the results back electronically. Compare this to receiving a paper copy of the lab results. Often this paper copy is sent to a fax machine and then the hunt begins to get that result to the right paper chart/person. The time savings here are apparent. With a lab interface, you no longer have to file the lab results in the paper chart (or scan them into your EMR). The results are automatically available in the EMR and routed to the ordering provider. They can be signed electronically and no one has to then go back and refile the chart.

What’s even more important is that with the lab interface all of those lab results are now stored in discrete values. Storing the lab results this way means that you can graph lab results over time, do studies on lab results across your patient population, and eventually may be needed to satisfy the government and insurance reporting requirements.

Cost of a Lab Interface
Many people are often surprised to find out that there’s sometimes a cost associated with implementing a lab interface. In fact, there could be multiple costs involved.

The costs depend a lot upon your EMR vendor and the lab with which you’d like to interface. Some EMR vendors will offer a lab interface for free (or part of the standard cost of the EMR) while others will charge. The same is true for labs. However, more labs are willing to offer their interface for free. Often that just requires the right negotiating skills. If you’re a large customer of that lab, then if you talk to the right people you can usually get the interface for free. Labs are easier to negotiate with since a lab interface benefits the lab as well. $5,000 seems like the standard charge (from what I’ve seen) for most interfaces. Yes, that’s possibly $5,000 to your EMR vendor and another $5,000 to your lab.

EMR Interfaces Are Like Kids

Posted on June 3, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When implementing an EMR you are very likely to also implement an EMR interface. The most common type of EMR interface is with your lab, but you might also have an interface with radiology, pharmacy, vital machines, ekg machines, spirometry machines, etc. The fact is that you are very likely to run into an interface in the process of implementing an EHR.

Interfaces with your EMR software are your very best friends, but also can be incredibly frustrating. Sounds a lot like my children. Here’s a short list of ways that EMR interfaces are like kids:

  • Some people just know they want one, but others debate getting one all together. In the end, most people end up with one.
  • They often will cost to implement and also cost (time if nothing else) to maintain.
  • A lot of time is spent at the beginning taking care of the interface and making sure that it’s working properly.
  • Most people love them and can’t imagine life without them.
  • When they work your life is wonderful, when they don’t you wonder why you got one in the first place.
  • They cause you serious headaches and usually those headaches happen at the very worst times.

Ok, so it’s not a perfect analogy, but I think this feeling about interfaces is shared by most people involved in them.  All of this said, I think our interface with our lab is one of the best reasons to use an EMR.  It’s so seamless and beautiful to see the orders get sent and the results returned with the lab signed off electronically.

Electronically Signed Lab Results in Your EMR

Posted on May 16, 2008 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My guess is that many of you are using an HL7 interface between your EMR and your lab. How does your EMR handle the signing of lab results?

We worked for an entire year testing, making requests, testing, more requests and more testing before we were able to launch an interface between our lab and EMR, but it’s been one of the best things we’ve done. The reason it took so long is the topic of another post, but it was for good reason.

One of the best advantages to a lab interface with your EMR is that you don’t have to worry about what to do with all those paper labs that you’ve signed. Inevitably all those signed paper labs will have to be scanned and attached to a patient in your EMR.

Really, that’s why a lab interface is so much better. The interface inserts the lab info right into your EMR so you don’t have to worry about:
1. Losing your lab results (before or after you sign it)
2. No need to scan your signed lab results into your EMR
3. You can run really cool reports on the data from those labs in your EMR (ie. blood sugar change over time)
4. Most EMR will notify you that there are lab results to read, so there’s no more waiting for the paper to somehow make it to you

In our EMR, a lab result gets easily signed off with the click of a check mark. Actually our labs our grouped into batches according to labs that were ordered at the same time. This makes it so all our lab results appear on one nice lab report as opposed to one lab report per lab. All doctors have to do is highlight all the labs and click “Mark as Read” and that whole batch of lab results are signed electronically in the EMR.

Of course, many of you will probably ask how we handle abnormal results. Well, I guess you’ll just have to wait to learn about that.