Preparing for a Reference Laboratory Interface

1. Laboratory Package for Small Sites without a Laboratory Professional ResourcePatient Management System Preparing for a Reference Laboratory Interface

2. Session Objectives • Gain insight to the process of reference laboratory implementation and understand the roles of each of the three entities involved in an interface deployment: • Client/Facility/Area IT • Reference Laboratory • OIT Contractor • Understand the process used by the Generic Interface System (GIS).

3. Reference Lab Interface • Generic Interface System (GIS) Menu is required. • GIS is within RPMS • Label printers must be installed in the laboratory prior to going live. • The interface is actually a two-part system. • The GIS accepts the data from the Reference Laboratory and stores it in the UNIVERSAL INTERFACE FILE (^INTHU). • The data is passed to ^LAHM(62.49), the LA7 Message parameter file, where it is held prior to verification. • From that point on, the data is handled just as any other data transmitted by an auto instrument.

4. Reference Lab Interface (cont.) • Reference lab interface set up is Contractual. • Communication must be established between Reference Lab and facility’s RPMS. • Reference Lab interface is dynamic • Reference Lab interface requires constant monitoring and maintenance • Changes are made frequently and these need to be communicated to person maintaining Lab Package.

5. Bidirectional Interface - LEDI Results passed to PCC and available for provider review in EHR Provider Orders Tests Results verified using EA MA/Nurse Accessions Tests Results received in RPMS Testing performed Results released Labels printed Shipping Manifest Built/Shipped Electronic Orders Orders received by Ref Lab Information System LAN to LAN VPN

6. Three Pieces of Interface Deployment What are the roles of each of the three entities involved in an interface Deployment? • Client/Facility/Area IT • Reference Laboratory • OIT Contractor

7. Client/Facility • Contact Client Service Representative to initiate a new project for a bidirectional interface • Client Service Rep will fill out or help Facility to complete a Client Needs Assessment (CNA)* • Review and sign off on any contracts required by the reference laboratory* • Work with the area IT staff and/or NOSC to determine what kind of connection will be made for exchange of data*

8. Client/Facility • Begin working with the Business Office to sequence insurers if the Reference Laboratory will be billing Medicare, Medicaid, and or Private Insurers • Order and install a label printer* • Build EHR Quick Orders and Menus • Participate in training • COMMUNICATE and PARTICIPATE

9. Reference Laboratory • Assign a project manager • Initiate a project kick off call • Provide a Utilization Report and test compendium* • Provide connectivity information • Perform validation testing • Perform high volume testing • Switch settings to production • Provide contact information for post “go-live”

10. OIT Contractor • Review software status • Configure interface • Perform a connectivity test • Build tests and map to order and result codes provided by the reference lab • Perform validation testing • Perform high volume testing • Provide training • Switch interface to production • Support

11. Portland Area • Tulalip • Inchelium (Colville Tribes) • Swinomish • Skokomish • Snoqualmie • Cowlitz • Chehalis – hung up on label printer

12. Phoenix Area • Reno • Washoe (Quest development)

13. Aberdeen Area • Rapid City • In order to move existing sites to NPL • Change prefix on Path accession area • Switch to long form bar code labels • Add ask at order questions • Map NPL order codes • Validation testing

14. California Area • San Diego • Santa Ynez • Santa Barbara • Los Angeles (UAII) • Karuk (Quest Development)

15. Bemidji Area • Mille Lacs • Nimkee

16. Nashville Area • Chitimacha • MicMac (Development project with Affiliated Lab of Bangor) • Naragansett and Mashpee may be eligible • Oneida will be a development project with Quest for Pittsburgh

17. Oklahoma Area • White Cloud

18. Change in process • CMI (OIT Contractor) will not initiate an interface. • If a site desires an interface they will have to initiate the project with their client service representative. • Site will have to install label printers • CMI will add the Client/Facility into the project queue when contacted by the reference laboratory and printers are installed.

19. Monitoring Reference Lab Interface Laboratory staff or those assigned responsibility for monitoring the interface need to check both the GIS processors and the IHS Lab Transaction Processor at the following times: • At the beginning of each day • Any time the RPMS system goes down • Whenever the Referring Facility is notified that the Reference Laboratory interface system has been shut down and restarted • When the courier picks up samples to ensure the orders are with the reference lab

20. Monitoring Reference Lab Interface (cont.) • OUTPUT CONTROLLER: controls data moving from the Universal Interface File to the IHS Lab Transaction Log or the LA7 Message Parameter file. • FORMAT CONTROLLER: formats outbound data from the RPMS and queues it for output to the Reference Laboratory. • HL IHS LAB RECEIVER: accepts data coming in from the reference laboratory. • HL IHS LAB TRANSMITTER: sends orders to the reference laboratory.

21. Challenges • Coordinating pieces • Label printer purchase and installation • Connectivity • Insurance • Training – not just reference laboratory piece but more importantly tieing it together beginning with provider orders in EHR to signing off labs • Training – monitoring and following up on bad orders or no results • COMMUNICATION

22. Questions & Discussion