Lessons from the Field on Implementing the ELINCS Standard

Background: In 2008, the California HealthCare Foundation awarded funds to a group of grantees to implement the EHR-Laboratory Interoperability and Connectivity Specification (ELINCS), an implementation guide for the delivery of real-time laboratory results. While the electronic exchange of lab information has been increasing, ambulatory practices and laboratories continue to expend significant time and money in establishing and maintaining electronic connectivity with one other. By streamlining the implementation of interfaces between labs and clinical information systems there is significant potential to improve practice efficiencies, the quality of care delivered and facilitate the ‘meaningful use' of health information technologies in clinical settings.

Objective/Purpose: To evaluate the Program, and 1) identify the technical processes and challenges associated with implementing the standard, 2) evaluate the impact of ELINCS on operational processes, quality of care, and provider satisfaction, 3) identify lessons learned, and 4) identify efficiencies gained for sites with prior experience in implementing ELINCS.

Methods: The National Opinion Research Center is conducting a multi-method evaluation of the program. Methods include review of grantee background materials, surveys, grantee telephone interviews and key informant discussions with EHR/Registry vendors and clinical labs.

Preliminary Findings: Early findings suggest that the process of implementing an ELINCS interface is quicker and significantly less complex than a non-ELINCS interface. While LOINC encoding remains a time consuming process for most grantees the burden is significantly reduced given that only the top 550 lab results are being encoded. Sites that have previously implemented ELINCS report significantly faster implementation times. Other benefits include replicability of the interface across different implementations and decreased costs.

Discussion/Conclusions: The implementation of a constrained implementation allows for more rapid interface development and a reduced level of effort in the implementation process. Furthermore, such an implementation has the potential to address many of the issues with current lab exchange processes.