Four Things to Remember when Acquiring a Lab Interface

The following are important considerations when acquiring a lab interface for your EHR:

  1. In many cases the major lab companies will pick up the initial cost of the lab interface with your practice.  However they generally do not pick up the costs of a bi-directional interface(s) and/or the ongoing maintenance cost of the interface.  Most EHR vendor’s annual maintenance fee is based upon the total cost of the EHR system, which typically includes the lab interface cost (even if this cost was initially picked up by the lab company).  Depending on the initial cost of the interface, the annual support fee may be upwards of $4,000 per year.  While this is a substantial expense, the resulting workflow efficiencies will likely outweigh the ongoing investment.
  2. Upgrading your EHR system may temporarily break your lab interface(s). Just to be clear, I am not recommending that you do not upgrade your EHR system. The caution is that when upgrading, you should be prepared for the possibility. While these problems are usually corrected after the upgrade has taken place, it is a best practice have either a fax server or an old-fashioned fax machine ready to receive results in case your interface goes down.
  3. While you currently do not need a lab interface to achieve Meaningful Use, the incorporation of discrete lab data for 40% of all labs (which is an optional criteria) will make Meaningful Use substantially easier to achieve. It is also likely that lab interfaces will be required in Stage 2 Meaningful Use. Additionally, computerized order entry (CPOE) requirements in Meaningful Use will likely be expanded to include laboratory orders in Stage 2. If this occurs, you will need to implement bi-directional interface(s).
  4. Not all lab interfaces are the same.  While this may seem obvious it is more complicated than you may think. One little known fact is that lab interfaces within the major lab companies may not be identical. For illustrative purposes consider that LabXZ is one of the largest lab companies in the country with multiple regions across the country.  Different regions may use different technical standards, thus an interface that works for LabXZ Region 1 will not necessarily work in LabXZ Region 2.  For most practices this just means that if you are looking at an EHR product, make sure the vendor has interfaces with the labs in your area and not just nationally.  For practices that manage patients in multiple regions, it may dictate a need to have multiple lab interfaces from the same lab company. In addition, that practice may not be able to obtain bi-directional interface(s) for all labs.

Click here to read more about the Basics of Lab Interfaces

    This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.


    One response to "Four Things to Remember when Acquiring a Lab Interface"
    • November 19, 2010
      Glen Moy

      Labs and EHR vendors will typically say that they use a communication standard called HL7 to exchange data. But this is a bit misleading. Although HL7 is a standard developed to facilitate exchange of health information, it must support a wide range of communication scenarios, e.g., hospital information system to pharmacy, admission system to radiology, etc. In order to do so, the HL7 standard allows for a lot of flexibility in how interfaces are implemented, such that most times no two interfaces are alike. This is unlike other communication standards we’ve come to rely on, such as Wi-Fi or BlueTooth.
      This variability in how interfaces are implemented results in longer EHR implementation timelines and greater costs. Imagine what it would be like if each time you wanted to connect wirelessly to the Internet you had to re-define what the Wi-Fi standard is. To try and address this variability at least for lab results, the California HealthCare Foundation developed the EHR-Lab Interoperability and Connectivity Specification (ELINCS). While it does not eliminate all of the variability, ELINCS does reduce it significantly, so much so that EHR vendors who have implemented ELINCS have reported implementation timelines reduced by 30% or more. Major commercial labs such as Quest and LabCorp now support ELINCS, as well as major EHR vendors.
      Additional information regarding ELINCS can be found at .

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