Connectivity between hospital-based laboratories and the physician community plays a pivotal role in the provision of health care because of the ability to send and receive laboratory orders and results electronically. Establishing connectivity with health care providers can help improve the quality of patient care, workflow, and productivity. This capability can even reduce or eliminate costs associated with paper requisitions and lessen the potential for errors entering the process. Although connectivity offers great benefits, hospital-based laboratories still may face many challenges. As the onsite laboratory IT consultant for a major hospital in the Midwest, I have directly experienced some of these challenges.
- Interfacing: This is the major challenge that the hospital laboratory faces when working with diverse EMR systems used by its physician clients. Proper interfacing of those systems with the laboratory system is crucial for electronic test ordering and result delivery.
- Costs: The hospital laboratory and especially physician clients both want to avoid excessive costs for connectivity. Interfacing, maintenance, laboratory IT resources, and training can be very expensive and cumbersome and labor efforts intensive, depending on the type of process and EMR that the physician client utilizes.
- Physician client’s EMR: The capabilities of EMR systems vary widely and many deficiencies exist, from difficulty distinguishing between test codes from different laboratories to the inability to collect and transmit third-party payer information so the laboratory can collect payment. Also, the inability to accept discrete vs. formatted results and have them correctly filed into the patient’s record in the physician client’s EMR can present difficulties.
- Hospital-based LIS system: Depending on what LIS system the hospital employs, it can be a challenge if the system is outdated, not compatible, and not customizable. Competitors such as the commercial laboratories offer more up-to-date and customizable solutions in order to beat out their hospital laboratory competition.
- Physician clients with no EMR: Physicians with no EMR are ones that want to save money and/or are reluctant to adapt to technology. The challenge is getting these providers on board to obtaining connectivity through a middleware or even purchasing an EMR.
- Billing and Coding: Without connectivity, there is more potential for errors and increases in denials. In the end, it affects the hospital’s revenue cycle.
I have encountered both the benefits and challenges of supporting hospital-based laboratory systems and physician clients. With the proper planning and education, the benefits of connectivity far outweigh the challenges. I have worked on implementation projects with several clients to establish middleware or an interface to achieve optimal flow of laboratory results. These clients are content and working efficiently. In contrast, I have worked with a variety of client EMRs, researching every piece in the workflow to decipher why the client did not successfully receive its laboratory results. Without proper connectivity, the effort is greater and risk increases for clients to become extremely dissatisfied. In order for hospital-based laboratories to survive in such a competitive environment, they must seek a strategic approach to connectivity that will not only enable them to address existing concerns but will position them to meet future challenges.
Tina Nuon, RHIA
Client Laboratory IT Consultant
Chi Solutions, Inc.