Bringing lab interfaces to production at volume

Lab interfaces look like the simplest integrations in healthcare. An order goes out and a result comes back. Then thirty of them are in flight at once, each lab has its own reading of HL7, each EMR has its own expectations, and the simple interface becomes a queue of small, urgent problems.

As project manager and technical lead at an LIS vendor, I brought 250+ lab HL7 interfaces to production for EMR vendors including Epic, Allscripts, eClinicalWorks and Practice Fusion, and ran more than 35 integration projects at the same time. What made that possible was mostly standardization, and a test method that caught problems before a clinician did.

Standardize the interface, not the lab

Every lab and every EMR will ask for something slightly different. The work stays manageable when there is one well-understood baseline and every difference is an explicit, named variation on it.

• Start each project from the same channel template: the same filters, transformers, connectors and monitoring, with the variations layered on top.
• Keep a mapping sheet per client for test codes, specimen sources and result units, so a new order code is a table change and not a code change.
• Settle connectivity early. VPN, SFTP and SOAP each fail in their own way, and a finished interface is no use until the connection underneath it holds.

Test with the results clinicians will actually read

A lab interface is correct when the result a clinician sees in the chart matches what the lab reported. Syntax validation is the start, not the finish.

• Test every result type the lab sends, including the awkward ones: long text reports, several observations under one order, corrected results, and results for tests ordered outside the interface.
• Check abnormal flags and reference ranges on screen in the receiving EMR, not only in the message.
• Test the order side for cancellations and changes, not just new orders.

Run many projects with a simple rhythm

Thirty-five concurrent projects cannot be run from memory. With up to four points of contact on a project, the work stalls whenever it is unclear who owes the next step.

• Hold a short daily call with each lab while its project is active, and keep one tracker of who owes what.
• Move every project through the same stages: connectivity, test orders, test results, validation with the practice, go-live, and a post-go-live watch.
• Treat escalations from support as input to the template. A problem fixed once should not be fixed thirty times.

At volume, the fastest lab interface is the one that starts from a template you already trust.

Investors and consultants can book an hour through Office Hours. Teams with an interface to get right can pick a time directly.