Analysis of laboratory data transmission between two healthcare institutions using a widely used point-to-point health information exchange platform: a case report.

Objective: The objective was to identify information loss that could affect clinical care in laboratory data transmission between 2 health care institutions via a Health Information Exchange platform. Materials and Methods: Data transmission results of 9 laboratory tests, including LOINC codes, were compared in the following: between sending and receiving electronic health record (EHR) systems, the individual Health Level Seven International (HL7) Version 2 messages across the instrument, laboratory information system, and sending EHR. Results: Loss of information for similar tests indicated the following potential patient safety issues: (1) consistently missing specimen source; (2) lack of reporting of analytical technique or instrument platform; (3) inconsistent units and reference ranges; (4) discordant LOINC code use; and (5) increased complexity with multiple HL7 versions. Discussion and Conclusions: Using an HIE with standard messaging, SHIELD (Systemic Harmonization and Interoperability Enhancement for Laboratory Data) recommendations, and enhanced EHR functionality to support necessary data elements would yield consistent test identification and result value transmission.

Telehealth: a policy analysis for quality, impact on patient outcomes, and political feasibility.

Telehealth is seen as a venue for improving healthcare access in vulnerable populations through use of electronic devices in the patient's home that monitor and assess for early complications. Major technological advances have improved telehealth services, prompting introduction of federal legislation for reimbursement of telehealth care. Yet, policymakers have stalled passage based on several concerns. This article conducted a policy analysis of HR1601, one of the most recent Congressional proposals for telehealth. The policy analysis was based on 3 criteria: quality of telehealth services, impact of telehealth on patient outcomes, and political feasibility. Overall, the concerns regarding quality, impact on patient outcomes, and feasibility are outweighed by the benefits of using telehealth to extend care. Federal funding of telehealth through passage of legislation, such as HR1601, is a good first step to establishing further evidence for its capabilities, and it could lead to a more comprehensive approach to quality care.