Custom-hl7-Interoperability Integration

Custom (HL7) Interoperability Integration

Written by Pawan Sharma, Director of Operations for Healthcare at Chetu, and David Zelmanovic, President of LabThruPut Posted June 1, 2017 by Carolina
Pawan Sharma

Pawan Sharma

Increasing the interoperability between disparate software systems is still a primary focus in the healthcare IT landscape. As software providers intentionally limit the interoperability of their software systems, favoring profits over coordination of patient data through the continuum of care, a void is created. This leaves middleware providers poised to reap tremendous market opportunities where major players fall short.

David Zelmanovic

David Zelmanovic

One such entity, LabThruPut, provides decision support software solutions that improves the accuracy and efficiency of reporting clinical laboratory results in the veterinary space. Extending beyond traditional "middleware," the company offers an end-to-end lab results automation and management software product that streamlines the overall testing process. It achieved success due to the ease of installation, training, and use of its products' features for sample tracking, status monitoring, productivity statistics, plus results review and follow up. It provided a more efficient solution than conventional methods, which led it to work with many veterinary clients throughout the U.S.

To expand into the human healthcare space, it was recognized that although their software was fully functional for veterinary use, it needed to meet the necessary interoperability standards to communicate with EHRs. Within the veterinary industry there are no regulations on the communication protocols used for software applications that interact with each other. Hence, a secure data exchange interface to receive orders from and return results to major hospital EHR platforms is vital. With their technology sitting between labs and Hospital Information Systems (HIS), it needed an update to allow EHRs to seamlessly communicate with lab instruments through a proprietary interface.

To accommodate the need to meet HL7 standards, Chetu, a custom software development company, provided custom development within a communications platform to create secure messaging channels for bi-directional communication between laboratory information systems and hospital EHRs. The platform is used to transform messages from HL7 to XML, and vice versa. Since the proprietary system needs to interface with various lab instruments using a XML protocol, HL7 order message (ORM) and observation result (ORU) functions and segments needed to be converted for interoperability between the two systems.

The following channels were developed to simulate real-life scenarios based on project requirements to pull HL7 ORMs from host EMRs such as EPIC and Athena, transform them to XML, and push them into lab instruments from manufacturers such as Siemens, Beckman and Horiba in order to obtain results and send back HL7 ORUs to the hosts:

  • Orders From Host – LTP receives orders from host (EHRs)
  • Orders From LTP – LTP adds information to the orders received from EHR
  • Orders To Instruments – LTP sends orders to instruments
  • Results From Instrument – LTP Receives results from instruments
  • Results To LTP – Insert lab results into LTP DBs
  • Results To Host – Prepare the lab results to send to host.
  • Results From LTP – Send the results to host (HL7)

Host Specific Implementation of channels:

  • Host Orders – Athena
  • Host Orders – EPIC
  • Orders From Host – Athena
  • Orders From Host – EPIC

To emulate the SQL job functionality, the following channels were created to generate the XML schema, which is used to communicate with instrument systems:

  • Orders For Instruments – Athena
  • Orders For Instruments – EPIC

The results showed that the simulation was a success. With the implementation of the communications platform and HL7, the client was able to enhance their products to meet current healthcare industry standards. This allowed them to gain opportunities it sought in order to assure future company growth without abandoning the veterinary space.

"HL7 technology standards are important for any healthcare software looking to facilitate patient care," says Pawan Sharma, Director of Operations for Healthcare at Chetu. "Using an open source platform, we were able to implement a custom solution that allowed LabThruPut to operate in this highly regulated industry and improve patient outcomes by optimizing lab processes."

"Chetu has provided skilled and useful programming services to our company with very little learning curve," States David Zelmanovic, President of LabThruPut. "The delivered code is clean and on-time. The daily reports and weekly team meeting keep the projects on track. The developers are accessible and responsive."


Chetu, Inc. does not affect the opinion of this article. Any mention of specific names for software, companies or individuals does not constitute an endorsement from either party unless otherwise specified. All case studies and blogs are written with the full cooperation, knowledge and participation of the individuals mentioned. This blog should not be construed as legal advice.

Chetu was incorporated in 2000 and is headquartered in Florida. We deliver World-Class Software Development Solutions serving entrepreneurs to Fortune 500 clients. Our services include process and systems design, package implementation, custom development, business intelligence and reporting, systems integration, as well as testing, maintenance and support. Chetu's expertise spans across the entire IT spectrum.

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