Pioneering a new model in lab information exchange

A couple of months ago, we signed an agreement with one of the largest diagnostic vendors in the country to distribute all of their COVID-19 test results across Health Gorilla’s data network. We’ve since aggregated over 600,000 COVID-19 test results and made them queryable in EMR systems for more than 700,000 healthcare providers.

The problem we aimed to solve was that all the providers in a patient’s care circle, other than the ordering provider, are completely unaware of their patient’s COVID-19 test status. Lab test results aren’t easily disseminated to other providers involved in the patient’s care, especially if those providers are employed at another institution or use a different EMR. For a patient suffering from multiple chronic diseases, it’s absolutely essential that their specialists know 1) that a COVID-19 test was ordered and 2) the result of that test in real-time.

Labs have a critical role to play in health information exchange. Lab testing is an objective, quantifiable way to assess the patient’s condition, eliminating most biases that appear during history taking or a physical examination. More importantly, the utility of labs goes far beyond searching for a diagnosis. They serve an essential function by 1) screening patients to catch diseases early, 2) monitoring the effect of a therapy or lifestyle change, and 3) conducting research to build our collective knowledge. This data, when made easily accessible to the right stakeholders, can create immense value.

As the Office of the National Coordinator for Health IT (ONC) and the Department of Health and Human Services (HHS) begin to accelerate their push for more data sharing, the focus is shifting from EMRs and hospitals towards labs.

Through our first partnership to distribute lab results nationally, we’ve discovered that forward-thinking labs want to be aligned with ONC’s Trusted Exchange Framework and Common Agreement (TEFCA), which proposes the policies, procedures, and technical standards that will govern a wide range of interoperability efforts over the next decade. The initial focus of TEFCA is to build a single on-ramp to all health information exchanges and ensure that healthcare organizations are contributing their data to these exchanges. TEFCA will affect all HIPAA-covered entities at some point, and with a wealth of data on COVID-19, innovative labs are embracing the policy changes and becoming proactive adopters of interoperability. The era of expensive peer-to-peer interfaces is dying, while network-driven access is becoming the new standard.

The very first product we launched at Health Gorilla back in 2014 was a marketplace where providers could order labs and get results electronically from all the major labs. We eventually turned this product into an FHIR-based API that has been growing quickly and has been adopted by digital health leaders like Oscar Health, Virta Health, and Heal.

On the other side of our business, we have connections to most major EMRs, like Epic, Cerner, Kareo, eClinicalWorks, Athena Health, and many others. We contribute and share millions of clinical documents every month to these EMRs, so providers can easily retrieve and review this data when relevant.

Our advantage in distributing lab results nationally is that we already have bi-directional interfaces with most major labs, and we have established connectivity to all the major EMRs. Health Gorilla serves as the intermediary that labs can leverage to distribute test results with a national network of providers, become compliant with new interoperability rules, and do so at a fraction of the cost of building direct interfaces.

We believe that interoperability is a major strategic opportunity for labs, and now is the time.