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Lab Tech Standards, With Benefits

Scott Mace, for HealthLeaders Media, April 16, 2013

There's also a precedent for widespread adoption of LOINC, and that is the Direct Project, an agreed-upon protocol for securely transmitting records from one disparate EHR to another. Created by the same S&I Framework team, it is an absolute requirement for every EHR that plans to be Meaningful Use stage 2 compliant, and in the U.S., that would be every EHR that wants to remain in business.

Direct's rapid adoption curve will begin to prove that EHR technology providers can compete more completely on the virtues of their products' features, and not on customer lock-in to a particular set of data formats. Direct's creators hope to see a similar commoditization of EHR technology, all the more remarkable because a number of Direct's creators were the vendors themselves.

Putting Direct and LOINC in perspective goes a long way to explain the immense pressure on the industry to solve other pressing technology interoperability challenges, such as patient identification matching, the main impetus of the CommonWell Health Alliance announced at HIMSS.

CommonWell has the industry atwitter, dominating a portion of the most recent HIT Policy Committee meeting with both skepticism and perhaps wishful thinking as we all wait for the actionable details.

But while we wait to see what fruit CommonWell produces, the payoffs of Direct and LOINC are within our grasp. I asked Vreeman what some of the benefits of LOINC vocabulary being everywhere would provide.

"From a provider standpoint, this movement towards electronic health records and health information exchanges is all about having the data follow the patient," Vreeman says. "Their results, their medical record information, follow the patient wherever they go throughout the healthcare ecosystem. And so, having LOINC codes allows for that to happen between independent systems, but also for say a primary care provider to sort of take in data that might have been originated from several other different sites."

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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