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Behind the scenes work is key to CPOE success

Q&A with Monte Gund, Lab/EMR Integration Development

When a clinical lab places a key part of their business operation in another company’s “hands“, they trust that the partner’s entire team understands the importance of tailoring a lab integration solution to meet the specific needs of each lab or imaging client.

As one of the people present at the start of OpenText™ EMR-Link™, Monte Gund, a development owner for EMR and lab integration at OpenText, has seen what is needed to connect diagnostic centers to physicians and clinics – regardless of the EMR. We recently sat down with Monte to learn what goes into setting the stage for a successful implementation.

What was one of the primary goals when EMR-Link was first designed?

We knew that we needed a ubiquitous solution – one that could connect any lab, imaging center, clinic or physician’s office no matter what type of EMR was in place. The development team had a great deal of experience working with EMRs, so we were able to design EMR-Link to fit into the normal workflow in the physician’s office, ensuring the electronic lab order workflow doesn’t add more steps.

What does your team do to make EMR-Link a “plug and play” solution for hospital labs and outreach clients?

Even though the EMR-Link solution is agnostic and can connect disparate EMRs and labs, the key to making those connections work well and simplify the process of ordering tests and receiving results for physicians, we produce a kit for each lab or imaging center. That kit tailors the formatting and communications.

The EMR-Link connection is more than a simple HL7 message to and from the lab. Every lab has codes specific to its operation. When a physician orders a CBC, there is no need to check a list to determine the right code for the lab. Instead, the physician simply orders a CBC, and EMR-Link works behind the scenes to map the request to the right code for the lab.

Although 75% of the process to place orders and receive results is the same for all labs and clinics, each lab has its own compendium – a list of codes identifying the tests – and its own list of questions to ensure that complete information is gathered to support running the test, sharing the results and ensuring that the order will support an accurate claim that will not delay payment.

We start with a base kit, then modify it to reflect the specific format and communication requirements for the lab. From the physician or clinic’s perspective, the workflow for ordering tests is the same regardless of the destination lab.

What are the challenges associated with connecting to the hospital lab or imaging center?

Hospital-based laboratory information systems generally cannot accept an order if the person is not registered as a patient, so the process to register the person associated with the order as a patient, generate a registration ID, and then place the order must be an automated process built into the outreach program integration.

Hospital imaging departments also require additional information and functionality because many of their tests require pre-authorization by insurers. By partially or fully automating the process, based on the imaging department’s requests, EMR-Link can incorporate part of the pre-authorization process into the workflow.

For example, if a test requires a medical necessity check for a Medicare patient, a rules-based module built into the workflow immediately notifies the ordering clinician whether the order passes or fails the medical necessity check. This allows the clinician to make corrections, provide additional information, or notify the patient that the test is not covered by their insurance.

What is the advantage of building the lab kit this way?

We are able to build all of the functionality into the EMR-Link solution for any lab and outreach program clients without affecting the day-to-day operations of the diagnostic center or the clinics. Because we’ve connected several hundred lab and imaging providers with over 60 different EMRs, we’re constantly refining our process and adding features that enable us to create a lab kit in a matter of days rather than weeks, which means implementation and connecting physicians to labs can begin more quickly. This is particularly important when labs don’t have access to IT resources to support integration with each clinic.

Of course, as testing occurs during implementation, we work closely with the implementation team to tweak components to ensure the connection and formatting works as needed. The main goal is to make sure all of our work is done behind the scenes, so we don’t affect the lab or the physician office’s workflow during implementation.

Visit our Clinical Lab Integration website to learn more about OpenText EMR-Link and test out our ROI Calculator to see how you can benefit from a consolidated outreach approach to your physician customers.

Take a look at our first blog in this series, featuring a former lab owner who brings his expertise to introducing EMR-Link to diagnostic centers. Stay tuned for our next interview where you’ll hear from a director of implementation.

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