Interoperability and Your EMR: Integrating Lab Results

Patients today are visiting multiple healthcare providers across multiple healthcare settings; gone are the days when patients saw mostly their primary care doctors. Gone, too, are the days when they carried their healthcare data with them; more and more, patients are expecting this data to be available wherever they go, whenever they need it.

The reality behind this expectation is a network of providers throughout and across the healthcare continuum that use electronic medical records systems (EMRs) designed to interconnect—interoperate—with each other. This behind-the-scenes interoperability can help ensure every provider has access to accurate, comprehensive, up-to-date health data, enabling a patient’s electronic medical record to become part of their comprehensive electronic health record (EHR). This in turn can help ensure that patients receive the best of care, wherever they are.

What does interoperability really mean?

HIMSS (Healthcare Information and Management Systems Society) defines interoperability as the ability of different information systems, devices and applications “to access, exchange, integrate and cooperatively use data in a coordinated manner within and across organizational, regional and national boundaries.” The twofold goal of interoperability: “to provide timely and seamless portability of information and optimize the health of individuals and populations globally.”

Part of the certification process for any EMR vendor is proving their interoperability by demonstrating they can produce and consume (export and import) clinical data and summaries. This is where Thornberry Ltd and NDoc® stand out. Most EMR systems tout their interoperability capabilities, but in reality, seamless interoperability among EMR vendor systems is rare. NDoc is built natively on the HealthShare™ interoperability platform, the market-leading engine for health information exchange, and is fully CCHIT Certified® 2011. The NDoc EMR system has proven itself in the secure, seamless, and reliable transfer of clinical health data.

Why is interoperability important for my agency?

Interoperability implies provider-to-provider communication among many simultaneous data partners: physicians and specialists; laboratories and pharmacies; hospitals and LTPAC (long-term and post-acute care) facilities. As healthcare options continue to expand and the number of providers a patient interacts with continues to grow, the focus is increasingly on interconnectedness, communication, and convenience. An EMR system with limited and/or ineffective interoperability is not an EMR solution, because it does not enable a patient’s electronic medical record to become part of their broader EHR.

Interoperability is geared typically to data exchange that supports care transitions, which in turn can translate into better medical care and better patient outcomes. Interoperability is of paramount importance in the home healthcare arena, since LTPAC patients are more likely to have chronic conditions and comorbidities that necessitate frequent transition between multiple care providers. Smooth transitions of care between LTPAC providers require access to the right patient information at the right time. This is best accomplished by an EMR system that incorporates a strategic, standards-based approach to interoperability and information exchange, enabling the secure and timely capture, sharing, interpretation, and utilization of patient data among authorized healthcare providers across the care continuum.

CMS (the Centers for Medicare and Medicaid Services) is steadily shifting its reimbursement model from quantity-based to quality-based, and corresponding initiatives like accountable care organizations (ACOs) are gaining solid ground. As a home health provider today, you may see your major source of referrals shifting from hospitals and physicians with whom you’re loosely connected to an organization or health system charged with the wellbeing of a defined patient population—an organization or health system to which you must be tightly connected at multiple levels, including data exchange.

You will improve your odds of ACO participation by demonstrating that you can improve patient outcomes; that you can keep the ACO’s patients out of the hospital; and that you can connect – interoperate – with providers throughout the continuum of care. EHRs today must conform to nationally recognized interoperability standards and include vital health and medical data such as demographics and medical history; admission, discharge and transfer notes; medications and immunizations; allergies and advance directives; diagnoses, care plans, and cognitive functioning; lab results and prescriptions; and much more.

Integrating your clinical laboratory results

The time-consuming manual process of reviewing, inputting, and tracking lab results can be a thing of the past for hospital-based home health agencies (HHAs). Thornberry currently offers an inbound Clinical Lab Results interface, enabling laboratory data to go directly from the hospital EHR system or vendor of choice into the NDoc EMR system. As lab results are electronically received, the NDoc patient record is updated automatically. Additionally, NDoc transmits demographic data to the lab system as it is updated in NDoc, to ensure a match between the systems.

Clinicians and case managers can review results in the field and take appropriate action as needed. Lab results will be received but not posted if a patient is “referred not seen” (RNS) or has been discharged by the agency. When abnormal results are reported, NDoc sends out email alerts to clinicians, case managers, etc. (as determined by the HHA). Patients with abnormal results receive the benefit of prompt action, as clinicians are notified immediately and can contact physicians from the field.

Unsure whether integrating lab results with your EMR is right for your agency?  Consider the possibilities, and reach out to a Thornberry team member today.