Halfpenny Technologies has been marketing its LabHub Web-based connectivity solution since 2010, but the product still may be a little ahead of its time in some sectors of the health care community. So says Todd Thornburg, PhD, who has been visiting South Carolina hospitals and state health organizations with Halfpenny executives touting the benefits of using LabHub as stage two of meaningful use looms large.
South Carolina is one of eight states where Halfpenny is collaborating with state regional extension centers and other health care entities to demonstrate LabHub. A joint effort between Halfpenny and the Center for Information Technology Implementation Assistance (CITIA, South Carolina’s regional extension center) to market LabHub to labs in that state illustrates the opportunities and obstacles that abound as labs, providers, and EHR vendors navigate the complexities of health care information technology.
Funded by a federal grant, CITIA promotes electronic health record system implementation across South Carolina and helps physicians connect to state and national health information exchanges. The collaboration with Halfpenny is not supported by federal funds, but CITIA is slated to receive a small percentage of revenue generated by LabHub in South Carolina.
On a road trip to promote LabHub, Dr. Thornburg, who is CITIA’s executive director, and Halfpenny executives, including Gai Elhanan, MD, chief health care information officer, talked to a group of six hospital lab directors at a meeting arranged by the South Carolina Hospital Association. Some of the hospitals have multiple, disparate lab information systems, says Dr. Thornburg. A LabHub connection would enable those labs to “talk to one another and harmonize and standardize the data and provide bidirectional, discrete data exchange with a variety of EHRs,” he explains. The lab directors embraced the concept and understood the value, Dr. Thornburg continues, “but they need to go next to the CFO, and then the CEO, and the CIO. And what they often hear back is, ‘If I don’t have to have it this year for stage one meaningful use, we’ll talk about it later. We need to get our incentive money.’”
Dr. Elhanan understands their rationale, even though it’s a chicken-and-egg scenario since LabHub provides a neutral platform for data exchange between providers and labs, eliminating the need for multiple and costly point-to-point interfaces. “We developed LabHub in light of HITECH regulation and the meaningful use initiatives,” he says. Although the language hasn’t been finalized, “stage two most likely will require that lab results be sent to the EHR electronically.” (Drs. Thornburg and Elhanan conducted a presentation about the challenges of connectivity and the role of LabHub in the HITECH era at the HIMSS12 annual conference and exhibition in February.)
In the current connectivity environment, it’s not uncommon for labs to have interfaces to several different electronic health record systems. Labs usually bear the cost of providing connectivity, but “some labs are only willing to sponsor connectivity for high-volume providers,” leaving many small and rural practices without a connection, Dr. Elhanan says.
Halfpenny builds and maintains the connections between the hub and the lab, and the lab and providers. Laboratories pay Halfpenny to establish and maintain a connection to LabHub for each provider plus a small fee for each transaction.
Costs associated with maintaining multiple interfaces are substantially greater than the cost of maintaining one connection, so “we are enabling the connectivity for smaller scale providers,” Dr. Elhanan says. LabHub can deliver results to patient portals and health information exchanges, as well as to physicians’ mobile devices, he adds. Results can also be normalized and aggregated and made available to accountable care organizations and government payers.
Although LabHub offers numerous benefits, large reference labs face the challenge of balancing those benefits against competing business interests. Dr. Elhanan says that many of those reference labs, including LabCorp, Quest Diagnostics, and Solstas Lab Partners, are connected to LabHub but are reluctant to tamper with their existing relationships with providers. “They’re much more open to discussing a connection to LabHub for their new providers. However, they still have some reservations that you don’t see with a smaller lab. They don’t like to pay those transaction fees.”
For smaller hospital labs, the biggest obstacle is the interface fee that EHR vendors charge to connect their products to a lab, Dr. Elhanan says. Although the fee can be charged to the provider, when a lab sponsors an interface, it usually takes responsibility for the interface fee, he explains. Small hospital labs “really need to be connected,” he adds. “If they’re not, they get pushed out of the arena because they can’t compete with bigger labs.”
Another complicating factor— the preferred vendor contracts that regional extension centers establish with EHR companies—proves that timing is everything. “In Georgia, it just so happened that our discusions with the extension center took place at the most opportune time—before they signed agreements with preferred vendors,” Dr. Elhanan says. As a result, “the requirement to work with LabHub became part of the agreements. But that wasn’t the case with South Carolina, as those agreements had already been finalized before we became involved.”
LabHub currently connects 96 labs nationwide to more than 4,000 ambulatory practices and has experienced explosive growth in the past year, Dr. Elhanan says. While only a handful of practices in South Carolina are connected, Drs. Elhanan and Thornburg expect participation in that state to increase as connectivity moves higher on the list of informatics priorities for labs and providers. Dr. Thornburg hopes to explore relationships with hospitals or hospital groups that are “reaching out to practices in their region in unique ways informatically, where LabHub might play a role,” he says.
“The pressure is going to be on the labs,” Dr. Elhanan explains, “because if they can’t offer a compliant connectivity [solution] to providers for meaningful use stage two, the provider most likely will not send tests to that lab. The providers are the ones who need to be compliant, but the labs need to provide the solution.”
3M Health Information Systems has announced that it will open access to its 3M Healthcare Data Dictionary software under an agreement with the U.S. Department of Defense and Department of Veterans Affairs. The agreement also makes the software and terminology content open to the public.
The dictionary will provide the core technology to enable semantic interoperability for the joint DoD/VA integrated electronic health record, making it possible for information systems at U.S. military treatment facilities worldwide and VA medical centers to share medical information and secure patient data.
Open access to the dictionary will accelerate implementation of electronic health records and help health care organizations achieve meaningful use, according to a 3M press release.
All major health care standard terminologies are mapped into the dictionary software, including SNOMED CT, LOINC, RxNorm, ICD-9, and ICD-10. Pending approval from international standards development organizations, the aforementioned standards will be included with the open-access software for entities that have proper authorization. Local terminologies are also mapped into the dictionary, allowing health care facilities to continue to collect data with existing information systems and then crosswalk the data to industry standards for semantic interoperability.
3M Health Information Systems,
MikroScan Technologies has released MikroScan Qumulus, a monthly service that allows users to store, manage, view, and instantly share whole slide images via the Internet.
The cloud-based service works with the MikroScan D2 desktop whole slide scanner and Q-Scan image-acquisition software. The latter can automatically upload a scanned image to a Qumulus user’s account as it saves the image, providing near-instant remote access to pathologists anywhere.
“With its immediate remote sharing capability, Qumulus is especially useful for consults, research, tumor boards, and educational applications,” says Victor Casas, MikroScan’s chief technical officer and applications specialist.
MikroScan offers a free 90-day trial for Qumulus.
Lifepoint Informatics has introduced CPOE Connect, laboratory order-entry functionality for electronic health record systems.
CPOE Connect seamlessly integrates with EHR products to deliver clinical order-entry functionality at the point of care, providing medical necessity verification, advanced beneficiary notice generation, and specimen labeling capability.
The solution handles all types of orders, including those for the lab, radiology, and cardiology, and can be integrated via embedding, Web services, or HL7.
As an intuitive user interface, CPOE Connect allows providers to supply pertinent order-related information through advanced ask-at-order-entry question functionality. Users can electronically submit orders directly into laboratory and radiology information systems.
Siemens Healthcare Diagnostics has revamped its CentraLink data-management system with functionality that synchronizes automation workflow and expands connectivity.
CentraLink serves as a single communication link between the laboratory information system, lab instruments, automation systems, and multiple users in the central lab or across multiple locations.
CentraLink version 14 connects to multiple LISs and the Bio-Rad Unity system. It can detect if an instrument connected to an automation track is offline and automatically re-route samples to another available instrument. An automated sample status feature tracks arriving samples in real time. The system also provides proactive quality control alerts and can be customized for the end user.
Siemens Healthcare Diagnostics,
NovoPath is now marketing smartphone apps for Android and Apple users that provide access to full-length anatomic pathology reports.
Using the NovoNotifier Mobile app, a clinician working with a pathology lab that uses NovoPath anatomic pathology software version 8.0 is provided secure, discreet user identification-based access to patients’ anatomic pathology reports. The reports are automatically sent via unattended delivery, with a signal sent to the physician’s smartphone notifying him or her that a new report is awaiting review. After viewing the report, the clinician can preserve or delete the file, which will be maintained on the lab’s Web site.
NovoNotifier Mobile displays AP reports in a pathology lab’s customized format.
Dr. Aller is director of informatics in the Department of Pathology, University of Southern California, Los Angeles. He can be reached at email@example.com. Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at firstname.lastname@example.org.