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Lab Tech Standards, With Benefits

Scott Mace, for HealthLeaders Media, April 16, 2013

Since 1979, Coli and others have been trying to standardize the format of lab results "as clinically integrated, actionable information, not incomplete, fragmented, almost raw data," Coli says.

When I spoke with Coli, he revealed that LOINC-compliant interfaces are now in pilot testing at nine major sites. S&I Framework participants, including lab giants Quest and LabCorp, have created implementation guides and reference implementations, and these have been balloted with HL7, the nonprofit organization whose standardizing messaging undergirds most of the communications between disparate health IT systems today.

Through these pilots and EHRs that support LOINC, lab results can flow into EHRs in doctors' offices and hospitals and be understood with no recoding necessary.

Why you should care deeply about all this is the opportunity it presents to commoditize the currently (in Coli's words) "exceptionally lucrative business" of writing custom interfaces for every laboratory information system to EHR. We're talking thousands of dollars for each new custom interface developed today. 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.

In that sense, Meaningful Use stage 2 is exceptionally good news for healthcare executives: 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.

But commoditization of these interfaces goes further still. According to Coli, the cost of such interfaces will be "remarkably reduced" by standardization on LOINC.

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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