In the Lab, ATLAS Enables Technology Teamwork

For better patient outcomes, disparate systems need to work together.  But that can be a tall order.

So, when lab leaders seek better integration and enhanced functions to work with their laboratory information systems (LIS), what should they look for, really?

Look for an adjunct solution that connects and augments different systems – such as the electronic health record (EHR) and LIS, which each have their own workflow requirements and business rules. Furthermore, new adjunct technology must also recognize that electronic medical records (EMRs) have still other intentions. And that functionality has little to do with the lab’s workflow, which could be disrupted if information from EMRs is not complete in advance of order and specimen arrival.

Lab leaders need an adjunct solution that enables technology teamwork: sharing and interpreting data toward the goal of enhancing patient care.

Interoperability a Challenge, But “Reliable Interpreters” Can Help

In fact, interoperability—the extent to which systems and devices can exchange data and interpret shared data–is the subject of a study released in October 2016 by KLAS®, a research and insights firm.

The study suggests considerable work needs to be done to achieve meaningful record exchange.

Only 6% of healthcare providers report information accessed from exchange partners on a different EMR is delivered in an effective way that facilitates improvement to patient care, the study showed.

“We learned that challenges related to effective sharing—especially with a different EMR vendor than your own—are experienced across all facility types and across all vendors,“ said Bob Cash, KLAS vice president of provider relations, in a statement.

Also, on a related subject, Vindell Washington, MD, national coordinator for health information technology (IT), says drivers for success in health IT include adopting common use standards.

“Ultimately, health technologies have to speak the same language or at least have reliable interpreters in the form of interfaces, to truly unleash the potential of all electronic healthcare data,” he said in an October presentation to healthcare journalists,“You Never Want to Go Back:  The Promise of Health IT,” also posted on Health IT Buzz.

In the lab, leaders must ask if they have such a “reliable interpreter.”  Can the LIS acknowledge nuances and updates of vast EMRs on the market?  Does the lab need adjunct technology to enable these business imperatives:  connectivity, clean orders, flexible results reporting and support for multi-lab networks?

The ATLAS Coordinated Diagnostics® Platform makes it possible for labs to achieve those objectives and others as it complements an organization’s LIS and enterprise strategy.

Diverse Systems Don’t Have to Lead to Dirty Orders

When labs have data coming from multiple sources who are also using diverse systems, dirty orders may emerge. And they can be worse than the paper kind. Dirty orders are incomplete orders. They lack information—demographics, insurance and medical necessity data. As a result, the lab may be denied payment by insurers and increase its bad debt.

OSF System Laboratory had high expectations for test orders when it engaged ATLAS: electronic orders complete with clinical information, orders meeting medical necessity, use of appropriate test codes and assurance of accurate patient identification. The ATLAS Platform enabled:  clean orders, completed answers to order-entry questions, orders meeting medical necessity, alerts and ability to print forms for pre-authorization and advanced beneficiary notices.

The achievements are possible regardless of the order source.  So, even for orders placed in an EMR, the Platform is able to alert the lab of the missing or incorrect data.  And this means lab staff can address each issue before the order is processed in the LIS or the specimen is received in the lab.

Clean Orders & Flexible Results Reporting Possible

Even when OSF System Laboratory changed its LIS to Epic Beaker, ATLAS enabled a smooth interface and continued clean orders. The ATLAS test catalog synchronized to Epic Beaker’s test menu, meeting container requirements and specimen optimization.  So, the physician office, tapping ATLAS technology, used containers appropriate to Epic Beaker.

If test catalogs are not synchronized, recollection of specimens may be required (for proper specimen requirements or test order), specimens may not be of the highest quality or blood volume can be unnecessarily excessive. Patients may need to return to the lab for more testing, which can be stressful, costly and inconvenient. (More is detailed in the Success Story OSF System Finds All it Needs with the ATLAS Platform).

Also, often orders are placed in an EMR but need to go to multiple performing labs.  ATLAS technology splits the order so tests go where they need to: reference lab, clinical lab, anatomic pathology lab. When results come back, ATLAS technology enables a single report, saving doctors from searching several information loads in an e-mail box.

Diverse EMRs, used by physician offices and other outreach clients, also pose challenges to results reporting by labs.  And labs also find that different outreach customers want results in different ways.  Some choose Web-based interfaced results or bi-directional interface.  In working with clients and diverse LIS systems and EMRs, ATLAS experts have customized the company’s Platform to enable test results to be consolidated into one report for the patient–regardless of ordering source or performing lab.

Finding Common Goals in Multiple Lab Networks

Differences among labs, as well as their systems, also pose challenges for alliances and management services organizations that are forming and expanding in healthcare today.  Each lab usually has an LIS, enterprise system and workflow different from the other labs in the alliance.

When labs, part of the new Trivergent Health Alliance, were called together, their leaders discussed challenges as well as opportunities to share tests, send specimens between labs with instrument-ready barcode (IRBC) labels and reduce reference lab costs. Ultimately, a partnership among three companies—ATLAS (multi-lab networking solution), MEDITECH (each lab had a different MEDITECH LIS version), and Data Innovations® (Instrument Manager™ technology)—made it possible for the labs to share and insource tests, create a batch list and safely and accurately route specimens affixed with IRBC labels.

“What we did here, with Atlas Medical, was integrate the equipment (while acknowledging the LIS).  Data Innovations® played a key part,” said Bruce Williams, corporate director of Laboratory Services, Trivergent Health. (Learn more by requesting the Success Story Hospital Labs Share & Insource Tests, Reduce Costs & Increase Efficiencies After Turning to ATLAS & Its Partnership with Data Innovations®).

Look for a Lab Team Player

It sounds as though Dr. Washington would like to see more of that kind of teamwork. In his presentation, the government’s chief of health IT said that providers and suppliers need to aim for a culture that eliminates what he called “data blocking.”

“Too often we are seeing health systems and vendors focusing and competing on having access to data and not delivering better care or applications, and it is holding back progress,” he said. “We need to change the culture around access to information.”

Lab leaders can help to advance access to diagnostics and aim to improve care by choosing specialized solutions that enable technology teamwork. As the customer stories described above point out, ATLAS is making success possible for many labs and their diverse systems.

Questions for Discussion:  

In your lab, what challenges are too much for the LIS?

What are your expectations for LIS adjunct technology?