ELINCS Standard: Laboratory Results to EMRs

The EHR-Lab Interoperability and Connectivity Standards (ELINCS) is a national data standard for transmitting results from a Laboratory Information System (LIS) to an Electronic Medical Record (EMR) or Electronic Health Record (EHR) system.

The ELINCS messaging specifications seems to be a practical, real-world approach to solving the application level problem of electronic lab results. ELINCS simplifies and normalizes only the lab results, which are the most valuable piece of data to the physicians. Furthermore, it supports the information required by CLIA (Clinical Laboratory Improvement Amendments) for lab reporting to clinicians.

The ELINCS standard was originally based on the HL7 v2.4 messaging standard, specifically, the result message, ORU. It greatly reduces the complexity of the generic HL7 result message by restricting it. The ELINCS specification clearly outlines in detail the structure of the ORU message including supported message elements (segments, fields, etc.) and their associated cardinality, plus code set usage. For ELINCS, the LOINC, Logical Observation Identifiers Names and Codes, coding standard is used to identify the top 100 tests based on frequency of use and value for HEDIS (Health Plan Employer Data and Information Set) reporting. (Please note: The ELINCS implementation guide was updated in March 2010, and ELINCS is now based on HL7 v2.5.1. Read more on the ELINCS HL7-R1 specification.)

The only aspect of the interfacing that is not addressed by ELINCS is the communications layer. The lower layer protocols used for data exchange will need to be negotiated by the lab and ambulatory care center. The standard methodology for near real-time HL7 messaging is TCP/IP with MLP (minimum lower layer protocol).

ELINCS adoption is well underway. In December 2006, it was announced that Health Level Seven (HL7) will begin a process to adopt and maintain the ELINCS specification from the developers, California HealthCare Foundation (CHCF). Also, ELINCS is included on the 2007 interoperability certification criteria for EHRs as proposed by Certification Commission for Health Information Technology (CCHIT).

As noted earlier, in March 2010, an updated ELINCS implementation guide was released; read more on updated version – ELINCS HL7-R1 specification.

If you are an independent laboratory or EMR/EHR site looking to implement a results interface today, ELINCS is the recommended version. Laboratory results interfacing may be a challenge today, but as LIS and EMR vendors begin to comply with ELINCS, the future may be more simplified.

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Sonal N. Patel, MBA, BS, MT(ASCP) has extensive experience working in healthcare from both the provider and vendor perspective. Prior to Corepoint Health, she served as a Medical Technologist and Laboratory Supervisor at Roche Diagnostic/Golden Triangle Regional Medical Center/Baptist Memorial Hospital and also operated in several client services, support and training roles at Antrim/Sunquest/Misys Healthcare Systems.

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