BACKGROUND

The Laboratory Orders Interface (LOI) Initiative is focused on the creation of an Implementation Guide (IG) for the ambulatory setting that builds on the architecture and design of the California HealthCare Foundation’s (CHCF) EHR-Lab Interoperability and Connectivity Specification (ELINCS) Laboratory Orders and the Health Level Seven (HL7) Version 2.5.1 Implementation Guide: S&I Framework Lab Results Interface.

Further, the Initiative seeks to design an IG that can serve as a foundation for eventual use in acute care and public health and incorporate vocabulary consistent with the above mentioned guides as well as support for the HL7 Electronic Directory of Service (eDOS) IG. Additionally, tools will be developed to aid evaluation and adoption of messages compliant with the LOI IG generated by Electronic Health Records (EHR) Systems and Laboratory Information Systems (LIS).

The lack of a single, comprehensive implementation guide for laboratory orders interfaces is a major gap in the healthcare standards portfolio. The lack of clear and interoperable implementation guidance for laboratory orders that is aligned with other laboratory data exchange implementation guidance drives up the cost, effort, and time to implement an interface and consequently hampers broad adoption of such interfaces.

Laboratory orders interfaces automate the electronic communication of test order information between EHR Systems and LISs. To date, there is no consistent implementation guidance available for electronic laboratory order interfaces across the ambulatory setting. Implementation guidance that defines the communication (i.e. message structure, data elements, vocabularies) of test orders from an EHR System to an LIS, based on accepted industry standards, can:

• Improve care delivery and clinical outcomes through the tight coupling of order and result messages;
• Reduce implementation efforts and costs;
• Reduce on-going support and maintenance-related activities and costs;
• Provide an extensible foundation for use in acute care and in-patient settings.

The Lab US Realm suite of Implementation Guides are available for download and comment at HL7 using the links below.

HL7 Version 2.5.1 Implementation Guide: S&I Framework Laboratory Test Compendium Framework, Release 2 - US Realm (eDOS)
Product Brief: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=151
DSTU Comments: http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=172

HL7 Version 2.5.1 Implementation Guide: S&I Framework Lab Results Interface, Release 1, DSTU R2 – US Realm (LRI)
Product Brief: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=279
DSTU Comments: http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=171

HL7 Version 2.5.1 Implementation Guide: S&I Framework Laboratory Orders from EHR, Release 1, DSTU Release 2 - US Realm (LOI)
Product Brief: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=152
DSTU Comments: http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=180

HL7 Version 2 Implementation Guide: Laboratory Value Set Companion Guide, Release 1- US Realm
Product Brief: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=413
DSTU Comments: Please use the LRI DSTU Comments link