On Wednesday the California Healthcare Foundation published Request for Proposals: Using Electronic Data Standards to Communicate Laboratory Orders.
CHCF actually lives up to an important but seldom-followed precept of standards: producing a spec is only the start of getting a working standard. Someone has to nurse it through initial implementations, reflect on the lessons learned and amend the standards accordingly. Connectathon-like testing is moderately useful, but doesn’t get to many real-world issues that come up in deployment.
Ambulatory lab orders have a high potential ROI but are especially tricky. The basic informatics issues are straight-forward but the issues of patient identity, getting orders from a different place than the specimen is collected and dealing with unsynchronized order catalogs are baffling. ELINCS put together a consensus group that included reference labs, integrated delivery networks and vendors. They hashed out the workflows and developed an implementation guide based on HL7 v2. CHCF is now offering $300K in funding assistance to be spread among six or eight sites to test the draft spec. The learning from this effort will go back to a finalized ELINCS ordering spec.
Hopefully, HL7 and the S&I Framework will adopt the final implementation guide virtually as-is since by then there may be dozens of interfaces operating using the spec. It is always hard for a consensus group to accept the consensus of another group, as was demonstrated by the barriers HL7 put up to adopting the ELINCS results specs. Unless a standards organization sets the specific goal of facilitating the use of third-party work the US will never follow what is supposed to be a fundamental principle guiding ONC work: Standards are not created they are adopted.
In the mean time I recommend the CHCF specs to IDNs, EHR vendors and HIEs that are ready now to grapple with lab orders. It won’t be be perfect now, but it is better a better start than a blank sheet of paper. To the credit of CHCF, it stood up to the rough handling it had at the hands of HL7 and came away with a defined path to ease the current orders work. Thanks to that effort HL7 is now talking the talk; CHCF orders will give HL7 be a chance to walk to walk of valuing tested standards and working with outside consensus groups.
(Updated 12/8 to correct link.)
View Free, Relevant Gartner Research
Gartner's research helps you cut through the complexity and deliver the knowledge you need to make the right decisions quickly, and with confidence.Read Free Gartner Research
Comments or opinions expressed on this blog are those of the individual contributors only, and do not necessarily represent the views of Gartner, Inc. or its management. Readers may copy and redistribute blog postings on other blogs, or otherwise for private, non-commercial or journalistic purposes, with attribution to Gartner. This content may not be used for any other purposes in any other formats or media. The content on this blog is provided on an "as-is" basis. Gartner shall not be liable for any damages whatsoever arising out of the content or use of this blog.