The State Health Information Exchange Program of the Office of the National Coordinator for Health Information Technology has issued a Bright Spots briefing on the importance of the exchange of clinical lab data for advancing and improving the healthcare system. The paper is part of the office’s HIE Bright Spots initiative, designed to identify and disseminate successful implementation practices and approaches that are worth spreading.

According to the report, the exchange of clinical laboratory data plays an important role in the functioning and improvement of America’s healthcare system. Studies estimate that US laboratories conduct ten billion clinical and diagnostic tests per year. While lab services account for less than 3% of annual healthcare spending, the results of lab tests affect an estimated 70% of medical decisions, highlighting the potential influence of laboratory medicine on the quality, efficiency, and cost of healthcare.

Accessing lab data in a timely manner and in a format that allows for clinical decision support, trending analyses, and population health management is essential to delivering efficient and effective patient care. For these reasons, the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology targeted the exchange of lab data among providers in meaningful use stage 1 and 2 criteria and in program information notice priorities for State HIE Cooperative Agreement Program grantees. Even with such a level of priority and visibility, achieving these requirements has been a challenging task for third-party HIE entities—those that facilitate the exchange of lab information, but are not clinical laboratories or ordering providers/final users of the laboratory information.

The Bright Spots Lab Exchange Synthesis explores the primary approaches used by successful third-party entities to enable lab exchange and illustrates that there is no one “secret formula” for success. While the final formula for lab exchange may differ among third-party entities, the HIE report identifies several common factors linked to successful exchange:

  • A clear understanding of the local lab market dynamics, economic incentives, and local policy levers to both identify technology and tailor service options to meet the needs of stakeholders, deliver business value, and foster adoption. The maturity and competitive nature of a given market will influence the value that third parties are able to offer for lab exchange and the specific role they may be able to play. This is especially true for entities offering lab result delivery services.
  • Organizational and technical maturity are important for supporting largely automated processes/data flows whether results delivery or translation services are the third party’s focus. Organizational maturity also helps build confidence in services among data trading partners.
  • Application of the Pareto principle helps focus attention and make several aspects of lab exchange more manageable, particularly LOINC and SNOMED coding.
  • Attention to critical operational factors such as:
    • Ensuring staff and management resources are commensurate with the work at hand, whether supported via employees or contractors.
    • Dedicated project management tools and resources across all data trading partners.
    • Strategic executive support across stakeholders.

Proactively addressing these factors during planning and implementation phases and learning from the experience of seasoned third party HIE entities will help ensure a successful approach that is aligned to the specific needs of each local market. To learn more, check out Themes and Lessons from Lab Exchange Bright Spots.