Laboratory Pilots/Deployment

June 26, 2012

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Participants

Coordination of Effort• Validation Suite• Vocabulary Group• Implementation Guide Analysis• LRI/LOI/eDOS Workgroups• Support Team

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Pilot I Project Participants• Atlas Development• CAP• Halfpenny Technologies• KHIE• LabLynx

Pilot II Project Participants Conversations• Lab System and EHR Vendor (2)• Lab System Vendor (2)• EHR Vendor (3)• Commercial Laboratories (2)• Provider Based Commercial Labs (3)

Production/Deployment Project Participants• Allscripts (EHR)• Athenahealth (EHR)• Cerner (EHR/LIS/HIE)• OPTUMInsight (HIE/EHR)• RML (LIS)• LabCorp (LIS)• Halfpenny Technologies (Integrator)

Agenda

Updates on Laboratory Activity

1. LRI – DSTU comment review

2. LOI – Status

3. eDOS – Status

4. Validation Suite update

5. Vocabulary Workgroup update

6. Next Steps

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LRI• Finishing response to

DSTU comments• Expected completion

next couple of weeks• Need feedback from

Pilots WG regarding:– length/conformance

length– 1.7.3 re “snapshot”– TQ1/TQ2 RE/O

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LOI / eDOS Status

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LOI• Charter

complete• Use Case

Consensus Review

• Alignment in process

• Vocabulary work in process

eDOS• Charter / Use

Case status

Laboratory PilotsCommunity Options for Piloting

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Option One: Individual Initiative Pilots aka Pilots I• Point of Contact: Bob Dieterle• Details: Participants will pilot LRI

LRI LOI eDOS

LRI LOI eDOSOption Three: eDOS Only Pilots• Point of Contact: Freida Hall• Details: Participants will pilot eDOS

eDOS

Option Two: “Pilots II” • Point of Contact: Bob Dieterle & Freida Hall • Details: Participants will pilot LRI AND LOI

with the option to additionally pilot eDOS

LRI LOI

Validation Suite

• LRI DSTU update to be completed by July 7th.• LRI to be published to Federal Register by July 15th • Validation Suite Incorporation of updated DSTU LRI by end of July• Coordination of effort with Public Health• Initial meeting TBD• Review LRI validation suite and applicable test list• Solicit help from participants

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NIST Validation Suite Considerations

Reporting Scenarios

1) Preliminary Report2) Partial Report3) Final Report4) Cumulative Report (for recurring draws?)5) Corrected Report / Amended Report6) Cancel due to ………….. (e.g. specimen quality)7) Error conditions (e.g. R, RE, C,CE misuse invalid syntax)8) Reflex Testing9) Add-on Tests/results10) Addenda Report (is this a valid HL7 report type/status?

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Test Types

1) Single numeric result with reference range A1

2)Single alpha result from limited response list (e.g. Positive, Negative, …) A2

3) Panel testing with combinations of 1) and 2) A1&A24) Textual Results A45) PDF as payload A46) Textual with tabular data A47) Combinations of 1) and 2) e.g. susceptibility MIC and Interp A3

Errata

1) NTE2) PID text3) Multiple OBR4) Addon5) Multiple OBR6) Additional OBX7) Reflex testing8) Multiple OBR9) Additional OBX10) Add OBX for specific result types from order (e.g. total urine volume)11) Multiple testing locations12) Non-standard abnormal flags

Interaction between Pilots and S&I

• Provide feedback on any implementation, deployment, support issues with IGs

• Provide feedback on any implementation, deployment, support suggestions to improve adoption/use of the IG by other entities.

• Provide feedback on any Validation Suite gaps, issues and additional requirements

• During initial production deployment, participants are strongly encouraged to report scope of use of IG compliant interfaces (e.g. options supported, tests, LOINC codes utilized, SNOMED CT codes used, UCUM used

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Needed from all participants

Testers and feedback for current version of Validation Suite tool

http://lri.sipilotdevelopment.org/lri-dstu/

Volunteers for 1-on-1 WebEx testing– Especially EHR systems– Validation Suite for reconciled DSTU version to be ready end of

July 2012

Ecosystem Each participant will propose a complete ecosystem for reference

implementation purposes

The recommended ecosystem should consist of a laboratory, LIS/interface vendor (may be in-house effort) , provider organization, and EHR vendor

To the extent third parties integrators are required to create and/or support the reference implementation, they will be considered part of the proposed ecosystem

If participants are unable to assemble the entire ecosystem, Laboratory Pilot/Deployment leadership will assist in making introductions where possible

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Laboratory Results Interface (LRI)

Each participant shall develop/implement and test a production or pre-production interface compliant with the Draft Standard for Trial Use (DSTU) version of the LRI IG for the exchange of laboratory results between the LIS and EHR.

Utilize the online validation suite to test all supported use cases applicable to the specific ecosystem.

Each laboratory/LIS and EHR should participate in an S&I Laboratory Pilot coordinated virtual interoperability forum to be established among the Laboratory Pilot II participants.

The resulting pre-productions LRI implementations are expected to be taken to production use by the end of 2012 and where possible rolled out to additional implementations in early 2013.

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Next Steps / Questions

• Next Steps• Continue recruiting Production/Deployment participants• Work with Public Health on expanded scenarios for validation suite • Establish ecosystems for production/deployment • Ask for help if need partner

• Schedule• Calls for coordination every other week at same time next call 7/10• Continue work with Validation Suite • Continue participation in LOI and compendium effort based on LOI calendar

• For questions, please feel free to contact • Bob Dieterle: rdieterle@enablecare.us

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