1. Applying the Lab-EMR Interoperability Profile Jan Flowers Technical Program Manager International Training and Education Center on Health University of Washington, Seattle, WA, USA jflow2@uw.edu

2. Applying the Lab-EMR Interoperability Profile National HIV EMR (iSante) since 2006 (65 sites, ~60k patients in EMR) OpenELIS as national lab system in 2010 (15 sites) Partners In Health OpenMRS

4. Lab Profile – Simplified Use Cases (in 3 implementation phases) Order Transmission on Paper Results Transmission Order Transmission on Paper Identification of Patient in EMR Result Transmission Order Transmission Identification of Patient in EMR Identification of transmitted order Result Transmission Electronic Medical Record Lab Information System Order (Paper) Demographic Query Demographic Response Test Result

5. Facility Level Patient Identification PIX – Patient Identifier Cross-reference PDQ – Patient Demographics Query Patient search from LIS to EMR Current Work – Results Interface from LIS to EMR – Lab Order Entry from EMR to LIS

6. What Else Can We Do With Patient Identification? Back to demographics – Useful for other HIS systems within the current facility! SCMS EDT pharmacy tool Now we have one patient record used in multiple places: – EMRLIS Pharmacy

7. More Patient Identification Biometrics and Fingerprinting Now = verification of patient, enrollment of patient, and identity management – Facility level “Master Patient Index” (MPI/FPI) – All different processes Noticed patterns in the process  same as other domains – Vital Registration – National health insurance (verify, enroll, status changes)

8. We Have An Architecture! These functions are useful across multiple systems and across different levels We have the start of an eHealth architecture: 1.Well defined components 2.Well defined business rules 3.Standards based interoparability that implements the business rules with the components

9. What does this all mean? We have the start of an eHealth architecture: 1.Well defined components 2.Well defined business rules 3.Standards based interoparability that implements the business rules with the components One approach to interoperability!

10. Now what? Organized collection of information at facility- level to make an architecture? Next – talk about what to do with that data: reporting from the facility-level.