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Chapter 53 : Electronic Health Records and Their Implications and Opportunities for Laboratories

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Abstract:

This chapter describes the basic components of electronic health record (EHR) systems. It discusses recent federal regulations aimed at increasing the use of EHRs, including the criteria for meaningful use of EHR technology and federally directed certification of EHR systems. The chapter explains potential concerns and regulatory impact of increased use of EHRs in physician practices for pathologists and laboratories. It talks about strategies for laboratories to succeed in laboratory information management in the EHR era. EHRs are transforming the delivery of healthcare and the practice of medicine. The proliferation of EHR use presents laboratories with new challenges and opportunities in meeting their core mission: to deliver to healthcare providers information that is pivotal to clinical decisions and patient care. Laboratories will depend on EHRs for preanalytic and postanalytic data management and processes just as they depend on laboratory information systems (LISs) for data management and operations inside the laboratory. Recent landmark federal legislation and regulations have dramatically altered the healthcare information technology (IT) landscape, with the aim of spurring utilization of EHRs. EHR systems and computerized provider order entry (CPOE) have profound implications for the management of laboratory information across the healthcare enterprise. The use of CPOE has significant implications for how laboratories receive and process laboratory test orders. Going forward, EHRs impact the laboratory’s ability to achieve its mission by affecting upstream data sources (orders) and the output stream (result display). Laboratories will be well served to develop organizational and administrative strategies to succeed in the EHR environment.

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53

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Figures

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Figure 53.1

Relationships between the HITECH Act and the CMS and ONC EHR-related programs. ARRA, American Reinvestment and Recovery Act; HITECH, Health Information Technology for Economic and Clinical Health; CMS, Centers for Medicare and Medicaid Services; ONC, Office of the National Coordinator for Health Information Technology. doi:10.1128/9781555817282.ch53.f1

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
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References

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Tables

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Table 53.1

Core functionalities for an electronic health record system

From reference .

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
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Table 53.2

CLIA-required information for test reports

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
Generic image for table
Table 53.3

Types of laboratory reports with unique display considerations in EHRs

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
Generic image for table
Table 53.4

Laboratory report elements subject to variation in EHRs

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
Generic image for table
Table 53.5

CLIA-required information for test requests

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
Generic image for table
Table 53.6

CPOE-based methods to improve test utilization

Modified from reference .

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
Generic image for table
Table 53.7

Concerns for laboratories regarding EHR interfaces

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53
Generic image for table
Table 53.8

Operational considerations in LIS-EHR interfaces

Citation: Henricks W. 2014. Electronic Health Records and Their Implications and Opportunities for Laboratories, p 918-932. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch53

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