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Variation in interoperability across clinical laboratories nationwide.

Vaishali Patel1, Lauren McNamara2, Prashila Dullabh2

  • 1Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, Washington, DC, United States.

International Journal of Medical Informatics
|November 15, 2017
PubMed
Summary

Clinical laboratories show varied electronic health record (EHR) result exchange capabilities, with hospital and larger labs performing better. However, overall electronic data exchange activity remains low nationwide.

Keywords:
Clinical laboratoriesElectronic health recordsHealth information exchangeHealth information technologyInteroperabilityStandards

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Area of Science:

  • Health Informatics
  • Clinical Laboratory Science
  • Health Services Research

Background:

  • Electronic health record (EHR) systems are crucial for modern healthcare delivery.
  • Efficient data exchange between clinical laboratories and ordering practitioners' EHRs is vital for patient care.
  • Understanding nationwide variation in electronic data exchange is essential for improving interoperability.

Purpose of the Study:

  • To assess the national landscape of clinical laboratories' capabilities in sending structured electronic test results to EHR systems.
  • To identify factors influencing the electronic exchange activity of clinical laboratories.
  • To measure the extent to which laboratories engage in high-volume structured electronic data exchange.

Main Methods:

  • A national survey of independent and hospital-based clinical laboratories was conducted in 2013.
  • Logistic regression analyses were used on a weighted sample of 9382 laboratories.
  • Organizational and geographic characteristics were analyzed for association with exchange capability and activity.

Main Results:

  • Hospital-based (71%) and larger (80%) laboratories demonstrated higher electronic result sending capabilities than independent (58%) and smaller (48%) labs.
  • Despite capability differences, only 30% of all labs achieved high electronic exchange activity (≥75% of results).
  • Laboratories in areas with more potential exchange partners showed slightly greater capability and activity.

Conclusions:

  • Clinical laboratory capability for electronic data exchange varies significantly by laboratory size and type.
  • Nationwide electronic health data exchange activity among clinical laboratories remains notably low.
  • The presence of exchange partners appears to modestly influence both capability and activity in electronic data exchange.