1. LRI/LOI Pilots May 1, 2012 1

2. Participants Coordination of Effort Validation Suite Vocabulary Group Implementation Guide Analysis Support Team Others 2 Pilot I Project Participants Allscripts Atlas Development CAP Cerner Halfpenny Technologies KHIE LabLynx RML Pilot II Project Participants Conversations Lab System and EHR Vendor (2) Lab System Vendor (1) EHR Vendor (3) Commercial Laboratories (2) Provider Based Commercial Labs (3) Pilot I Project Participants Allscripts Cerner Optimum Insight RML

3. LRI Validation Suite WG Update for LRI Pilot WG May 1, 2012

4. Phase 1 Core Test Messages Profile Type Short DescriptionMessage Type NG Minimally Populated SED Rate message - Final Results Minimum GU Minimally Populated SED Rate message - Final Results Minimum NG Typically Populated SED Rate message - Final Results Typical-Final GU Typically Populated SED Rate message - Final Results Typical-Final NG Typically Populated SED Rate message - Corrected Results Typical-Corrected GU Typically Populated SED Rate message - Corrected Results Typical-Corrected NG Maximally Populated SED Rate message - Final Results Maximum GU Maximally Populated SED Rate message - Final Results Maximum NG Rejected SED Rate Message (No OBX segment; OBR.25 = X) Specimen Reject GU Rejected SED Rate Message (No OBX segment; OBR.25 = X) Specimen Reject NG Typically Populated CBC message - Final Results Typical GU Typically Populated CBC message - Final Results Typical NG Typically Populated Lipid Panel message - Final Results Typical GU Typically Populated Lipid Panel message - Final Results Typical NG Culture-Campylobacter jejuni, Salmonella, Shigella - Parent - Preliminary NG-Parent-Linking GU Culture-Campylobacter jejuni, Salmonella, Shigella - Parent - Preliminary GU-Parent-Linking NG-RU Culture-Campylobacter jejuni, Salmonella, Shigella - Parent/Child Susceptibility - Final NG-RU-Parent-Child-Linking GU-RU Culture-Campylobacter jejuni, Salmonella, Shigella - Parent/Child Susceptibility - Final GU-RU-Parent-Child-Linking NG-RN Culture-Campylobacter jejuni, Salmonella, Shigella - Parent/Child Susceptibility - Final NG-RN-Parent-Child-Linking GU-RN Culture-Campylobacter jejuni, Salmonella, Shigella - Parent/Child Susceptibility - Final GU-RN-Parent-Child-Linking

5. Phase 2 Test Messages* Anatomical Pathology/Surgical Pathology Study –Example of A4 result –Two draft messages completed (Skin biopsy and Inguinal Lymph Node biopsy) HIV 1 Ab [Presence] –Example of Reflex testing –Draft message completed A toxicology test –Example of Screening followed by Reflex testing –Draft Screening message for Amphetamines [Presence] in Urine with negative result completed; Reflex draft message needed –Other test messages could include urine test for Cannabinoids, Cocaine, Opiates, Phencyclidine *Will start including in Validation Tool and Test Plans in June 2012

6. Phase 2 Test Messages (cont’d) Cytology Panel with four components –Example of combination of A2 and A4 results in a panel Specimen source (identifier) in cervical or vaginal smear or scraping by Cyto stain – example of A2 result Cytology report of cervical or vaginal smear or scraping Cyto stain thin prep – example of A4 result Recommended follow-up (identifier) in cervical or vaginal smear or scraping by Cyto stain – example of A2 result Cytology study comment on cervical or vaginal smear or scraping by Cyto stain – example of A4 result –Draft message needed

7. Phase 2 Test Messages (cont’d) Human Genome – CFTR gene mutations found [Identifier] –Example of A3 result –Draft message completed Complete Urinalysis (panel test) – lowest priority test –Example of A2 result Draft message completed - to be modified using “+” or “++ “for bilirubin result value –Example of A4 results Urine sediment comments

8. Needed from Pilots Testers and feedback for current version of Validation Suite tool http://lri.sipilotdevelopment.org/lri-dstu/ Volunteers for 1-on-1 Webex testing –Especially EHR systems –Validation Suite to be ready in June 2012

9. Pilot I Project Updates 9 Allscripts Atlas Development CAP Cerner Halfpenny Technologies KHIE LabLynx RML

10. Value Proposition 1)Create value proposition statements for Ambulatory Providers Laboratories (does this vary by type) Vendors –EHR –LIS –HIE System Integrators 2)Value possibilities Setup cost (each party) Support cost (each party) Reduced errors Reduced TAT Improved care delivery 10

11. Next Steps / Questions Next Steps Continue recruiting Pilot II partipants Work on expanded scenarios for validation suite Schedule Pilot calls for coordination every other week at same time 5/1, 5/15, 5/29, … Continue work with Validation Suite on 5/22 Start participation in LOI and compendium effort based on LOI calendar For questions, please feel free to contact Bob Dieterle: rdieterle@enablecare.usrdieterle@enablecare.us 11