Meaningful use interoperability requirements increase the HIT professionals’ need to be conversant with a plethora of standards and a variety of versions therein. Consequently, it is essential to find tools that serve the dual purpose of educating the user while providing functionality that accelerates complex implementations.
One example of such a tool has been made available at no cost by the California Health Care Foundation called the ELINCS Data Generation and Evaluation tool, or EDGE. The EHR-Lab Interoperability and Connectivity Standards (ELINCS) are clinical data standards, adopted by the Health Level 7 organization, that are used for electronic result transmissions from labs to EMR systems.
What is ELINCS?
ELINCS standardizes the formatting and coding of messages exchanged between lab and EHR systems. ELINCS constrains the HL7 “standard” and is focused on moving lab results from reference labs to physician offices. It defines a specific set of use cases for this data exchange. Additionally, ELINCS provides business rules for trading partners to follow. This approach facilitates a faster and simpler method to enable lab data flow between two or more providers.
The EDGE tool is designed to “help labs and EHR vendors validate their ELINCS implementations.” When used in conjunction with the provided “ELINCS HL7 EHR Implementation Test Script Document”, the EDGE application was intuitive and simple to use in order to generate ELINCS messages for conformance testing in my integration engine.
The documentation available from the CHCF website includes test scripts that walk the user through an entire ELINCS HL7-R1 test scenario, including:
- Specimen Received
- Test Cancelled
- Final Result
- Final Result (Advanced)
- Final Result (Errors)
- Preliminary + Final Result
- Final Result + Reflex
- Final Result + Add On
- Final Result + Correction
- Final Result + Deletion
- Final Result (Copy To)
- Final Result (Unsolicited Copy)
For each test scenario, a checklist is provided that compares and validates the results of the test against ELINCS specification criteria. There are two modes of use for the EDGE tool: EHR mode, and LAB mode.
In the EHR mode, the EDGE tool uses a combination of free-form text and pre-populated drop-down menus to direct the user through the result message generating process. Once the requisite information is populated, the user can generate a sample ELINCS compliant ORU message that can be modified before saving it to a file. Once the file has been saved to disk, the user can import the ORU into their EHR system using the protocol of their choice.
In the LAB mode, the user completes a template similar to that in the EHR mode. In this case, however, the user has the option to evaluate the result against an identified order message. Additionally, an acknowledgement message can be generated or an acknowledgement message can be evaluated against the original result message.
One limitation of the EDGE tool is that it does not appear to support TCP/MLP transmission of the generated messages, instead relying solely on file based transport. In other words, if you cannot import and export HL7 files from disk to your EHR or LIS, or if you do not have an integration engine capable of easily handling file-based messaging, then this tool may not be the most efficient way to test ELINCS compliance.
In summary, the ELINCS EDGE tool appears to be a valuable asset to anyone wishing to test the validity of their ELINCS compliant interfaces, as it not only educates the users on the validation criteria, but generates compliant messages and evaluates non-compliant messages as well.
For additional information, read the complete white paper entitled Accelerating EMR Interoperability with ELINCS.
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