As the adoption of electronic health records (EHR) continues to increase, so does the need to connect lab systems to EMR software.  Interfaces are usually one-way, or uni-directional, enabling a referring physician system to receive results from the laboratory.  But the next wave to hit involves the use of a bi-directional interface where referring physician’s can not only receive results but can also place orders directly from their system to the laboratory.

Method 1: Paper and Manual Entry

Process 1: “Paper requisition.” The user fills out and submits the paper requisition.  Process 2: User accesses Internet site, and fills out and submits an on-line requisition.  This process substitutes a paper requisition for an on-line version.  The benefit to this process is that the user would not have to maintain an inventory of requisitions.

Method 2: Reverse EMR

User enters distinguishing patient ID(e.g.: Patient ID, EMR ID, SSN, etc.), the on-line requisition system queries and the requisition is submitted.

When a user engages the destination provider’s Internet site, they are prompted for a patient distinguishing ID.  When the information is entered, the destination provider’s system will then perform a query of the user’s EMR to request the patient’s demographics to pre-populate entry items on the requisition.  When the requisition is completed, the user then either prints or submits the requisition to the destination provider.

There are a lot of complexities in performing the query against the user’s EMR because if the EMR vendor does not support a complete HL7 or similar interface (many EMR vendors do not employ the full HL7 message set), the “look-ups” will have to be custom per EMR vendor.

Method 3: Bi-Directional Electronic

User issues order request to EMR. The order is sent electronically to destination, the electronic order is “translated” as necessary for receiving party.

This method is the most efficient, but can be the most complex due to the translations and mappings that must occur between the User’s EMR and the destination provider’s system.

Example 1: User’s EMR would submit a pap test with additional esoteric tests as one procedure, the destination provider is expecting distinct order requests, so we would have to split-up the user’s request into separate orders.

Example 2: User’s EMR submits distinct tests (pap, HPV, herpes, CT/NG) but destination lab expects one request with “additional testing modifiers.”

Example 3: Once requests are submitted, results received from the destination provider would have to match the existing pending request from the user’s EMR.

Pathagility supports all three methods through the implementation of its DataPath and OrderPath offerings.  The newest, OrderPath, focuses on providing clean bi-directional electronic order entry from laboratory (LIS) to physician (EMR). Provisioning for multi-partner integration is another key component of the Pathagility platform architecture.

For inquiries, please contact Pathagility at