MedCom: laboratory test ordering--fully implemented nationwide in less than 3 years

Lab test result reporting has been fully implemented in Denmark since early 2000. Labtest ordering is much more complicated due to different handling and labeling procedures in more than 70 Danish labs. Until 2004 all orders were based on preprinted paper forms. A new electronic national lab test order solution based on national MedCom standards and codes was introduced in 2005 and it was fully implemented in all 2100 GP clinics and 1000 private specialist clinics in 3 years. It also included 42 biochemistry labs, 14 Microbiology labs and 16 histopathology and cytology labs. Implementation was organized by MedCom and planned in rough details. During the implementation period a set of planed and ad-hoc activities to reach 100 % implementation was successfully launched. Today more than 6.000.000 lab test orders (100%) are now handled electronically each year. The implementation process, the challenges: organizational and technically as well as outcome is described in the paper.