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Lab Tech Standards, With Benefits

Scott Mace, for HealthLeaders Media, April 16, 2013

Meaningful Use stage 1 didn't do very much to move toward standardization. According to Regenstrief Institute Investigator Daniel Vreeman, if a laboratory sent an electronic health record system digital lab test results encoded with LOINC, that EHR had to retain those LOINC codes.

Backing up for a moment, LOINC stands for Logical Observation Identifiers Names and Codes. It is a universal code system for identifying laboratory and clinical observations. In Meaningful Use stage 2, LOINC has become a full-fledged menu item. It's still not a core requirement for an EHR, though if the past is any indication, it will be required in the core when we get to Meaningful Use stage 3 in 2017.

But as with many technologies, moving to a standard early can position your organization for productivity gains that could give you an edge over a competitor that lags behind on LOINC.

To understand why, I recently spoke with Robert Coli, MD, a retired gastroenterologist who seems to know everything and everybody connected to laboratory information systems. He is a committed member of the Standards and Interoperability Framework, a public/private group that spearheads the standards embraced in Meaningful Use.

"If you're reporting the test as fragmented data, using infinitely variable reporting formats that change every time a new test is added, the ability to follow the trends over time becomes impossible for the human brain," Coli says.

Fair enough, but now realize that this has bothered Coli since he was interning from 1963 to 1965, and you get an idea of how long forward thinkers in laboratory information sciences have been waiting for a solution.

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1 comments on "Lab Tech Standards, With Benefits"


flpoggio (4/16/2013 at 9:50 PM)
Many good points in this piece, and as you say LOINC codes will be a big help. Yet I have two issues with it: "And the EHR vendor is not required to sell the interface any more cheaply to the second, third or later customers of that same interface." – True but we don't seem to have a problem with Microsoft or Apple charging for each version of their op system, or apps, etc. As a former software developer I have always found this argument unsupportable. Why do you pay $10 for a music CD when it really only costs $1 to copy a disk and package it? Why do you pay $1.00 for an app that costs almost nothing to reproduce? Fact is there is much more that goes into reproducing it than just making or electronically transmitting a copy. Anyone that thinks there are no costs involved after you wrote the initial version has never developed a line of code, or worked in a systems development environment. Secondly, "For the first time, EHR vendors will be required by regulation to disclose the costs of these custom interfaces before you, the customer are required to purchase them.ยด- this is not true at all. Under Stage 2 the vendor must only list the resources needed to complete the install. Dollars do not need to be listed with the resources. The original Stage 2 draft proposal did ask for a price, but in the final version that requirement was dropped. In my opinion it is a meaningless and useless requirement in so much as any CIO that can't list from memory what the typical cost/resource component of installing an EHR are shouldn't be a CIO. Frank Poggio The Kelzon Group