Interoperable Electronic Health Records and Laboratory Information System



The interoperability function (iEHR) and the Laboratory Information System (Labs) are vital components and next steps in continuing the development of Newfoundland and Labrador's EHR. Several EHR components have been developed and implemented in the province to date, including the Client Registry, the Provider Registry, the Picture Archiving and Communications System (PACs) and the Pharmacy Network.

At the present time these individual EHR components have limited interaction with one another. The interoperable or iEHR portion of the iEHR/Labs project will integrate these various systems, along with additional clinical reports and patient data of relevance, and share the EHR data across the continuum of care. The current planning phase will establish what and how the iEHR will share in terms of patient health information for eventual clinician use. Once in place, the iEHR will provide authorized health care professionals in a patient's circle of care with role-based access to that patient's selected comprehensive and accurate medical information.

This integration of patient health information offers benefits for patients, health care professionals and the health care system. It will reduce the need for patients to repeat information and the need for repeating certain tests, as well as reduce duplication of efforts and minimize risk. Overall, the iEHR will enhance the ability to consolidate clinical findings to support clinicians' evidence informed decision making.

The Labs portion of the iEHR/Labs project involves implementing a provincial laboratory information system that allows clinicians to view laboratory results regardless of where providers or patients are located or where the test was conducted. Like the Pharmacy Network or PACs systems, the Laboratory Information System is an individual EHR component that will share information with the overall EHR system. Deployment of the jurisdictional lab information system will complete the primary clinical domains required to support the provincial interoperable EHR.

Implementation of the Laboratory Information System will generate additional benefits for patients, health care providers and the health care system, including:
  • Access - for example, lab results will be available to health care professionals regardless of where the patient presents, potentially reducing duplicate testing and multiple visits of patients to labs.
  • Consistency - for example, some procedures and tests across the province will have the same format enabling accurate interpretation of results across all instances. Consistent naming of tests will also reduce the number of duplicate procedures performed.
  • Correlation - for example, having test results in an electronic format will allow health care professionals to match orders to tests and ensure timely notification of abnormal results.
  • Efficiency - for example, the Labs system may reduce turnaround times for tests, leading to faster reporting of results to health care professionals.
Newfoundland and Labrador was the first Canadian jurisdiction to implement a provincial Client Registry and is among the first to implement a provincial drug information system, known as the Pharmacy Network, using national standards developed by Canada Health Infoway. These national standards and infostructure will eventually allow the Newfoundland and Labrador system to integrate with other provincial systems to create a pan-Canadian, or national, EHR. The iEHR/Labs project will be critical for this eventual integration of our provincial system with other provincial EHRs and the creation of an even more complete patient health record.

Ultimately, each component of the provincial EHR that is implemented realizes additional benefits for the province. Each EHR component builds upon the others moving the province closer to achieving the goal of a fully interoperable EHR. The iEHR/Labs project, including both the interoperability function and the Labs component, is the next step in the journey to reaching that goal.