Where do outside labs go in your EMR?

[univlad]

Where do outside labs end up in your EMR?

There are a few insurances in my area that either require patients to go Quest or Labcorp for their lab services or they have have skewed the benefit differential to drive patients there for their outpatient testing. Our laboratory does not use Quest or Labcorp as our main referral lab. For the patients that bypass our system lab and go to Quest or Labcorp, those labs are faxed directly to the physicians who then send them to medical records where they are scanned in placed under the LABS tab in EPIC. If patients come with lab results from outside institutions or hospitals across town, those results are also scanned in.

Some physicians do not like looking at the scanned documents and complaining to me--a pathologist in the health system's laboratory. They would prefer a format similar to how in house labs are displayed in EPIC with discrete date points and ability to trend, etc.

What have other health systems done in this situation? To me it is more of a medical records issue than a pathology/lab issue, but I'm curious what others are doing. Can Quest/Labcorp electronically dump their data into your medical record system? Are you scanning like us? Or do you manually enter all the results? Or have you developed another approach? Please share!

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[Doormat]

This illustrates the brilliance of EPIC and other integrated health system electronic medical records (EMRs). The health system gets to pick and choose what labs they choose to electronically interface with. An electronic interface allows automatic population of lab data fields in EPIC.

The health system I work with offers EPIC at a very cheap price to independent physician groups, but they only allow a single interface with a single lab -- the hospital lab system. The hospital lab has an electronic interface with a commercial megalab (DGX) so labs that are sent out to DGX get electronically transmitted to the hospital lab and then to EPIC.

Manual scanning of lab results into an EMR is just not feasible long term for a practice of any size. An electronic interface is a must. Building an interface is not cheap and most hospital IT departments require >6 months to get one built. If certain patients are required to use Quest or LabCorp for outpatient lab testing, the hospital should really think about building an electronic interface between their own laboratory LIS and at least one of the megalabs. Everything must funnel through the hospital lab.

Where I live, many physician-entrepreneurs use discount labs so they can client bill and get paid $20 for a CBC that they are only charged $3 for. They pocket the $17 as a kickback. Hospital system will not allow an electronic interface to their EMR for these labs.

 

[WEBB PINKERTON]

Managed care contracts are only going to get worse as time goes on.

 

[univlad]

Doormat:
Is DGX your main reference lab? We use DGX for a few send out tests and do have an interface in place so a few sendouts to cross directly into EPIC when they come through our lab. However, I think where the problem lies is that for patients that are required to use Quest, the patients go to a Quest drawstation and nothing is entered in our laboratory system. Do you draw those patients and then treat simple things like a CBC that you would normally do inhouse as a send out and enter them into your lab system so the result has a spot to come back to, or if patients go to a DGX drawstation will the results come back through your lab system and automatically populate in to EPIC without your lab staff ever having to touch the specimen. When you say everything must go through the lab, do you mean physical specimens or just the data coming back? Could Quest labs directly populate into EPIC without coming through the lab?

This illustrates the brilliance of EPIC and other integrated health system electronic medical records (EMRs). The health system gets to pick and choose what labs they choose to electronically interface with. An electronic interface allows automatic population of lab data fields in EPIC.

The health system I work with offers EPIC at a very cheap price to independent physician groups, but they only allow a single interface with a single lab -- the hospital lab system. The hospital lab has an electronic interface with a commercial megalab (DGX) so labs that are sent out to DGX get electronically transmitted to the hospital lab and then to EPIC.

Manual scanning of lab results into an EMR is just not feasible long term for a practice of any size. An electronic interface is a must. Building an interface is not cheap and most hospital IT departments require >6 months to get one built. If certain patients are required to use Quest or LabCorp for outpatient lab testing, the hospital should really think about building an electronic interface between their own laboratory LIS and at least one of the megalabs. Everything must funnel through the hospital lab.

Where I live, many physician-entrepreneurs use discount labs so they can client bill and get paid $20 for a CBC that they are only charged $3 for. They pocket the $17 as a kickback. Hospital system will not allow an electronic interface to their EMR for these labs.

This illustrates the brilliance of EPIC and other integrated health system electronic medical records (EMRs). The health system gets to pick and choose what labs they choose to electronically interface with. An electronic interface allows automatic population of lab data fields in EPIC.

The health system I work with offers EPIC at a very cheap price to independent physician groups, but they only allow a single interface with a single lab -- the hospital lab system. The hospital lab has an electronic interface with a commercial megalab (DGX) so labs that are sent out to DGX get electronically transmitted to the hospital lab and then to EPIC.

Manual scanning of lab results into an EMR is just not feasible long term for a practice of any size. An electronic interface is a must. Building an interface is not cheap and most hospital IT departments require >6 months to get one built. If certain patients are required to use Quest or LabCorp for outpatient lab testing, the hospital should really think about building an electronic interface between their own laboratory LIS and at least one of the megalabs. Everything must funnel through the hospital lab.

Where I live, many physician-entrepreneurs use discount labs so they can client bill and get paid $20 for a CBC that they are only charged $3 for. They pocket the $17 as a kickback. Hospital system will not allow an electronic interface to their EMR for these labs.