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.

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.

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.