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Hi everyone,

I'm an office manager and a newbie at tech (though not too green). I had some questions about AC's lab interface. I'm having trouble figuring out the electronic lab delivery process. I've read the description on the AC website, but because I'd like to have multiple lab interfaces, I guess I need a little more detail than that.

To summarize what the AC website says: To completely interface AC with a lab company's system, two steps must be taken. The lab company must install a software on the user's computer. This software delivers the files in an HL7 format to a folder where AC can access it. The second step is that a feature (i.e. 'import ability') of AC must be enabled.

Okay. So here come the questions.

1. What is the software that the lab company installs? Is its only purpose the secure transmission of data?

2. If I'm not mistaken, AC keeps its data in the xml format. Is the feature that must be activated in AC an HL7 interface engine? i.e. something that has the ability to convert HL7 formatted data into the different formats and vice versa?

3. I'd like to interface with the State of Texas Lab Services Section. It is not on the list of AC lab partners. Is an interface with them in the future unlikely?

I've got more questions, but I won't know how good they are until I learn a bit more.

Thanks,
Mario.


P.S.
A word about HL7. Health Level 7 - non-profit organization that was started advance the standardization of electronic medical data interchange. But from what I can tell, it also refers to a file format.

Hi Mario,

My name is Jeff Mathes, and I am the Interface Development Group Manager here at Amazing Charts. I wanted to take this opportunity to introduce myself to you and the rest of the user board, as well as answer your questions.

The software that our laboratory and radiology partners install at the practice is indeed to secure transmission of the data. Typically, they tend to install and setup either an SFTP server (which stands for Secure File Transfer Protocol) or a VPN (Virtual Private Network) connection. Both allow for the secure transmission of the HL7 result files between the practice and the lab/rad office.

Establishing these connections between the practice and the lab/rad are the one part of the interface process that we don?t get directly involved with. We have found that the process is much more efficient that way. The vast majority of our lab/rad partners have experienced IT staff that have prior experience setting up just these types of connections.

You were also spot on in assuming the piece that needs to be activated in Amazing Charts is an HL7 interface engine. We store and transmit lab/rad results using standard HL7 text files ? we do not currently use XML. Our specifications are currently based on HL7 Version 2.3, which is what we endeavor to base all of our interfaces on. However, as is true everywhere in the world of HL7, everyone always seems to have their own ?flavor? of HL7. That is why you see such a vast list of interfaces in the program ? we tailor all of our interfaces to each partner to ensure the best possible accuracy and ease of connectivity. You can turn on as many of the interfaces as you want or need ? you are not forced into using only one specific interface to communicate with one specific lab/rad partner.

We are always looking to expand our interface library, and would be happy to build an interface between Amazing Charts and the State of Texas Lab Services Section. If you could let me know a little more about what kind of information you are looking to receive from them, as well as provide me with any contact information you may have for someone there, we will reach out to them to get the process started. We currently have several other interfaces underway in our development queue, but the sooner we get it started and placed into the queue, the sooner we can get it completed and available to you and the rest of our practices!

While we are on the topic of interfaces, I?d also like to share some exciting news with the user board. We have begun development on what we are calling our Interface Hub. As the name implies, we are building a powerful service that will serve as a "Hub" - a central clearinghouse between all of our practices and lab, rad, and other third party partners. We are very excited about the Hub for a number of reasons, some of which include:

- The Hub will streamline the process of establishing connectivity. Future versions of the Amazing Charts software will automatically know how to connect with the Hub, and connectivity with our partners will only have to be established one time. Once we have that connection in place, they will be able to transmit messages to the Hub ? which your version of Amazing Charts will retrieve automatically for you to process at your convenience ? for any and all of the practices that we have in common.

- The platform we are building the Hub on will provide us not only with the ability to more rapidly develop new interfaces; we will also be able to offer much more flexibility in the versions of HL7 we will be able to ingest. We will be able to transform any flavor of HL7 into a flavor that the Amazing Charts program will be able to work with ? all done instantly on the Hub and transparently to the end users. This capability will allow us to interface with just about any partner, as well as give us the tools to more easily update our existing interfaces as new standards emerge.

We anticipate initial development of the Hub to be finished in January 2012, at which point we will be able to begin developing and rolling out interfaces that will take advantage of all it has to offer. To say we are excited to start doing so would be a gross understatement!

I hope this answered your questions sufficiently. If you or anyone else here on the user board have any further questions or comments at any time, please feel free to contact me.

- Jeff

Excellent plans, Jeff. Glad to have your update.

Looks like someone is getting a copy of Biztalk server for Xmas.

JamesNT

Wow! That sounds fantastic!

Jeff,

Thank you so much for answering my questions! With regards to the State of Texas Lab Services Section, as far as I know, they have three remote data systems. 1) Newborn Screening 2)Clinical Chemistry 3)Public Health (Microbiology). However, the Newborn Screening system is the only one with HL7 file transfer capability. That's the one we'd like to interface with. I'll send you that contact information.

The hub sounds great!

Once again, Thanks,
Mario.

Great! Maybe I can finally get more interfaces going. I'm way down on the priority list of the local labs since I am such a small player.

Jeff,

How about something simple, like an EKG interface? Does AC have the ability to get the data in directly?

EKG interface is already in place for Midmark Digital ECG.

I see that it is. How about some other manufacturers? We have a Schiller (WelchAllyn) AT-2. I don't see any interface for that. There are also other manufacturers.

I really don't want to spend $4,000 for a new machine. I'd rather a serial to USB cable and support built into AC.

Hoping for some good news from AC.

Mario,
There is a wonderful but modest sized Private Rad Group in Syracuse, "CNY Diagnostic Imaging". Being that they too are attempting to Buck the HUGE trend and they take execptional care of us and our patients, Nancy (My Doc Wife) tries like heck to send most of referals for their kind of work to them first choice.

Not sure if it is worth for either of us, Not sure how many users you have in our greater Syracuse CNY Region, but it sure would be nice to be able to access and download their stuff like others are doing.

I know someone has to "eat the development costs" of something like this, so in such local regional cases who eats this? The other place that wants to send us their stuff? Us who wants it? AC as a customer curtiousy? (I gather not, but it doesn't hurt to ask) I do know of at least 2 or 3 other AC users in our area but not sure what their take on any of this would be.... If they even use or want a connection to this great modest sized group with a few offices around town. They are perhaps the only well known private, Non-Hospital Rad Group pretty much.

Thanks Much and Thanks for Working on all of this for all of us,
Paul

Kevin,

Can you tell me what interfaces you would like to see developed? Also, as a general rule, we don't prioritize if/when we develop an interface based on the size of the lab/rad.

- Jeff

ANSHarda,

We already have an existing interface with Midmark's IQecg device. We anticipate beginning development on an interface with various Welch-Allyn devices at the beginning of the new year. We are likely going to start with Vitals, with their EKG offerings coming second.

Are there other device manufacturers out there that you folks would like us to investigate creating an interface with?

Jeff,

Thanks for the update. I'm thrilled that you will be interfacing W-A Vitals. I just bought one for the office--hoping that some day there would be an interface.

I am VERY excited to hear that wa ekg integration is coming. I wish that midmark spirometry had one less screen to interpret.

Paul(aka hockeyref),

I'm from Houston... Houston, Texas. Texas, you know, like cowboys and cattle and the like. But thanks for the sentiments.

Mario.

Jeff,
So, will this help those of us who cannot get on the interfaces (such as Quest) because our volume is too low?
That would make me happy.
Sharon

Jeff, maybe I'm missing it, but an interface to vital signs just doesn't seem all that useful in an office setting. The probable clumsiness of operating, say, a thermometer to interface with a laptop or pc just doesn't seem practicle.

What may be more appreciated by users might be interfaces to EKGs other than Midmark. The Midmark is so so expensive. I'd think interfaces to Welch Allen, and maybe Schiller EKG machines might be more appreciated. This would give users some choice other the the Midmark and may be more practicle.

If we are requesting interfaces I would like to request two Health Systems to add:

Spectrum Health (Large in West Michigan) - http://www.spectrumhealth.org/body.cfm?id=886
and
Trinity Health (12th largest health system in US) - http://www.trinity-health.org

We have alot of patients that get their labs done at one of these health systems. We also may be willing to contribute a small amount to the production of these.

Thanks!

Ben

Jeff,

Thanks for the update. Anyway to make the labs that come in more user friendly?

1) Less work to sign off ie, moving from one to the next without leaving each lab, less mouse movement to get to the clicks, less clicks,


2) Better spacing of the labs...they are double spaced often making multiple clicks down to visualize them all

3) Labs print in many pages....quest will be 2 pages, AC will be 5...

4) Easier access to flow sheets......one should be able to see old labs right away for comparison without multiple clicks to visualize them all.

Thanks

Just to throw my 2 cents in on the EKG interface requests. We have a Burdick Atria 3100 (Cardiac Science). We were told when we bought it 3 or 4 years ago it would have the ability to interface in the future. Hoping the future is near.

Thanks.

Would like to say our office would love to see a more user friendly lab viewing interface and printing. Agree with you that when you print out the reports they are 5 pages long. Would love to have something condensed and 1 or 2 pages.

Who said it would be "interfacable" (if that's a word) AC or Burdick?

Even if it is capable, are they working on an interface on the AC side? It may be worth sending the question to AC to find it's status. There aren't that many EKG machines that interface.

Folks, this is NOT the best place to put requests for interfaces, updates, ect. Only intermittently is is monitored by tech support. My suspicion is that they are looking for problems, not new projects and thus may not move something they see upline anyway. There is a recommend improvements under the "help" menu for this.

I must admit it was the Sales Person for Burdick. So it may have been smoke & mirrors at the time in order to make the product look more appealing.

I am in no hurry so thought it was worth mentioning what EKG we use if it is even a possibility. I have had good response from AC and others on many different threads. And I am very well aware of the help, and suggested improvements in AC which I use as well. I do tend to make sure when I post a comment it is related to the topic/thread. But thanks for the advice.

We have the same EKG machine. It is able to be networked, and an EKG saved in the machine can be transferred to a computer over the network as a PDF file. However, there is no interface with AC. So to put the EKG into AC, you need to move into Imported Items in the usual way.

I was also hoping that I could record the EKG only electronically without using any expensive EKG paper, but that's not possible with this machine.

I realize that everyone here wants to save money and have all their systems talk to one another, but let us please be realistic.

* Interfaces take time and real work to implement. Have any of you even read the HL7 documentation? It takes computer science majors like me to build these things and we expect to get PAID.

* AC will make interfaces for the things/services the most people are using first. The onesie twosie stuff may never get done. Sorry.

* Interfaces, in many cases, also depend on the entity you are trying to interface with. If that entity does not cooperate, that means no interface. And in the world of EMR/PM vendors, few of them ever want to cooperate.

Guys, these interfaces are NOT simple. I'm not trying to be all doom-and-gloom, truly I'm not, but some of you don't need to hold your breath.

JamesNT

Practice Fusion reminds its customers that lab integration is available at no cost and that connections are currently available with 16 regional and national reference labs.

Yep. 16. And that's awesome, until you aren't one of the 16.

See my second bullet point above.

JamesNT

So, Jeff_AC,

In December you stated you would be working on a Schiller (WelchAllyn) EKG interface beginning 2012. Can we get it?

One of the local hospital's lab that requested interface with AC, informed me that Amazing Charts id demanding $5500.00 for lab and $5500.00 for radiology interface.

That is the normal amount for developing an interface - our hospital paid it and got an interface from their EMR to AC. Unfortunately it is not cost effective for a non-national lab company to develop the interface. My hope is that eventually as things such as HIE get developed we can find ways to piggyback some of this as I have 2 labs, 1 pathology, 1 x-ray, 1 state immunization interface as well as Phreesia and practicom on my computer.....

As far as cost, I have mentioned that we would be willing to help pay for those interfaces, but i have not heard back from AC yet.

I was planning to set up an interface with quest lab.
Is there any news about this hub that was mentioned last December.
should I wait to set up this interface with quest until the hub is established

It's not a matter of cost, but also a matter of finding the time to do it. Look around on the forum and you'll see hints at other projects they are working on such as the new PM module, meaningful use stage 2, AC in the cloud, etc.

I don't think you guys are aware of just how hard writing an interface can be.

JamesNT

The point for me isn't whether it's easy or hard. I'm just asking for the status of an interface that the AC rep claimed they would be working on. As Jeff stated, "We anticipate beginning development on an interface with various Welch-Allyn devices at the beginning of the new year."

The present Quest interface is unidirectional only, just to download reports. It is useful, but I wish it would work both ways.

ANSharda,

We have indeed begun working on interfaces with various Welch Allyn devices. At this point, I cannot guarantee an exact release date for them, but it is still our intent to have the Welch Allyn interfaces available this year.

- Jeff

rsag,

For now, I would recommend moving forward with the point-to-point Quest interface that exists today. When we move Quest over to the Hub, we will be able to make the transition transparent to your practice, so that we can minimize any interruptions on your end.

To give everyone an update on the Hub, we are progressing on schedule, and are very excited with what we have seen so far. We are currently beta testing the Hub with a few select lab interfaces. This beta test has been timed to coincide with the beta test of our next imminent software release (which is needed in order to access the Hub to receive lab/rad results.)

For all intensive purposes, it looks as if we will be able to start rolling out lab/rad interfaces on the Hub very shortly.

- Jeff

Jeff,
Thanks for the good news on the Hub. Is that still set to be part of V6.3? Would you be willing to tell us more about the specific functionality that will be available with that release?

Jeff, thank you for the info on the HUB. When the HUB is activated, will AC be able to implement bi-directional interfaces? That would be really nice.