Sharing Laboratory Reports

Sharing Laboratory Reports (XD-LAB) addresses the sharing of laboratory reports among a community of healthcare settings and care providers.

Summary

This Content Integration Profile describes a clinical laboratory report as an electronic document to be published towards a document sharing resource such as an Electronic Health Record (EHR) or a Personal Health Record (PHR) shared by a community of care providers, using one of the document sharing profiles defined in ITI-TF. Such an electronic document contains the set of releasable results produced by a clinical laboratory in fulfillment of one or more test Orders for a patient. The report is shared in a human-readable format. In addition, this electronic laboratory report SHALL contain test results in a machine-readable format, to facilitate the integration of these observations in the database of a consumer system.
The scope of this profile covers all laboratory specialties except anatomic pathology.
This profile leverages IT Infrastructure profiles [ATNA] and [CT] for security, and [XDS], [XDM], [XDR] for document sharing.
This profile leverages the [Clinical Document Architecture Release 2] (CDAr2) standard from [HL7]

Benefits

Facilitates Patient Care Coordination

Enables the caregiver to obtain at once the laboratory reports produced during previous episodes of care.
Reduce over-ordering and over blood sampling from the patient by sharing the last laboratory reports among the various physicians attending the patient.
Enables the physician to consolidate their patient biological history by importing into their EHR the structured and coded data embedded in the electronic laboratory report.
Allows a public health laboratory to share broadly its reports related to a suspected outbreak

Details

The Sharing Laboratory Reports (XD-LAB) Integration Profile provides an electronic format for the laboratory report, so as to make this report:

human-readable: displayed on screen or printed out, with a proper layout and presentation.
machine-readable: Each observation displayed in the report is also represented in the document as a set of structured and coded data that can be imported in the database of any consumer of the document.

The XD-LAB Integration Profile covers six major use cases:

At discharge time, a hospital physician publishing a summary laboratory report with the most significant results obtained during the patient stay.
The bio-medical scientist of a private laboratory publishes a report for a patient into the regional Patient Health Record.
An ambulatory physician shares a laboratory report obtained from a laboratory.
A private or public laboratory publishes automatically all its reports in a shared document repository.
A healthcare institution produces a cumulative report of all laboratory tests performed for the patient during the encounter.
A public health laboratory shares its reports into a regional repository.

The standard CDAr2 leveraged by XD-LAB enables to share reports embedding images and charts, which are faithfully rendered by a web browser supporting RFC 2397:

Systems Affected

Systems involved in this profile are:

A system owning a laboratory report and willing to publish it into a document sharing infrastructure. Depending upon the use cases, this can be the system of a clinical laboratory (LIS), the EHR of an ambulatory physician, the EMR of a care setting, the system of a public health laboratory. Each of these systems can play the role of Content Creator.
The system operated by a professional caregiver who wants to view a laboratory report, and may want to import its structured and coded results into its own database. This system plays the role of Content Consumer.

Actors & Transactions: