I read that my lab results must be in a discrete structured format. How can I confirm the format if I do not have access to the interface messages? With this requirement, do you anticipate any changes in the way reference labs deliver results? For example we receive a lot of results as HL7 "comments" or “blurbs of text” – is there set criteria to determine how structured "structured data" really is?

The term “structured data” is somewhat ambiguous but the criteria included in the Laboratory Results Interface (LRI) and Electronic Laboratory Reporting (ELR) implementation guidelines from ONC define use of HL7 v2.5.1 with incorporation of universal code sets per value reported.

If the comments are received as structured data per the implementation guidelines in the Thrive System, there is no need for changes to the reference lab result delivery. If the comments are not received as structured data, the reference lab result format could impede the facility’s ability to achieve Meaningful Use.

Any results entered into Thrive manually via the Thrive Laboratory Information System (LIS) application are stored and transmitted out in a discrete format. All results that are received from external entities will require additional examination. Evident has performed a general review of current interface configurations and identified that many vendors are not transmitting all results in a structured format. To ensure your laboratory interfaces meet the requirements, please contact your Reference Lab (or LIS if you do not use the Thrive LIS application) vendor and ask the following:

• Do you have the ability to transmit results to Evident in the discrete/structured format for ALL laboratory results – including micro/culture results – as outlined in the ELR objective inclusive of the LOINC and SNOMED-CT data sets?
• Do you require a product upgrade to transmit all results in a structured format?
• What is the timeline for implementation and subsequently validation testing?

Please note that vendor modifications will necessitate changes in the Thrive System as well and validation testing is crucial to ensuring accurate reporting of the results. Evident will require a lead time of 90 days to modify an existing interface so it’s important to contact us as soon as you determine a need to change an inbound lab results interface.