INDUSTRY STANDARD HL7 SUPPORT

Medicare and Medicaid have developed incentive programs to provide financial incentive to eligible professionals (EP), eligible hospitals (EH) and critical access hospitals (CAH) for use of an EHR (Electronic Health Record). The overall objective is improvement of patient care. Providers must demonstrate, through required reporting, that they meaningfully use their EHR. Eligible professionals (EP) can receive $44,000 under Medicare and $63,750 under Medicaid; eligible professionals must choose to participate in either Medicare or Medicaid. An eligible hospital (EH) may annually receive $2 million to $6 million overall for each program.

Shadowbox helps Eligible Professionals to demonstratively qualify for meaningfully using their EMRs, by providing fully complaint, all around, HL7 integration between EMR and Lab LIS applications.

To achieve that, Shadowbox has to do relatively little amount of customization work.

Once a Lab, becomes a customer of Shadowbox, they get a standard Shadowbox Inc. Services Agreement that includes up to a 2 month of development toward connecting the Labs LIS to the EMRs supported by Shadowbox. This estimated 2 month provision includes all necessary (and possible) steps toward an Alpha Release and Beta Testing, with all necessary project management and support from Shadowbox Services team. It assumes very little help from Labs own IT Team(s).

 

Explained when looked from user/customer/lab perspective, the features list for that initial integration looks this way:
 1. E-Req order through portal (for practices using an EMR Shadowbox haven’t mapped)
   - Basically, some users should be able to fill-in the Req form without any EMR.
   - Imagine a Shadowbox that has only one Pod - Req Form pod and if the Req Form is filled in, it functions the same way
   - This should be manageable from Portal (i.e. no EMR selected) and if thats the case than Req Form will function without uploading it to EMR.
   - Lab Results should function the same, way. If no EMR is selected that all this practices Lab Results just show-up on Act and the Button above the Pod will just open the PDF for printing or saving.
   - This is actually a new task that I forgot to mention, but its actually a byproduct of the main tasks and not really a new development.
 2. Move all orders off the FTP to portal
   - This is the main purpose of this integration steps, described from User/Business perspective.
 3. HL7 Ordering
   - This is the main task, described from User/Business perspective.
   - Qualifies the Doctors using it for a Meaningful Use incentives.
 4. HL7 Results
   - This is the main task, described from User/Business perspective.
   - Qualifies the Doctors using it for a Meaningful Use incentives.

 

These all main Steps of the integration described above from users perspective, when described in details from development/integration standpoint, the same thing  looks bit different. If we're listing how Shadowbox needs to implement in order to completely qualify to the Meaningful Use program, the HL7 integration should be per what we believe that we need to develop:

1. When user fills-in the Req Forms and Shadowbox sends the dataset to our API to generate PDF, we need to save that dataset in Shadowbox
 - We basically need another module that uses all of the Patients data from EMR and Lab Ordering data from the Req forms, and stores all that data separately
 - This data should include what Checkboxes are checked on the PDF too
2. We have to create the dataset in a form of an HL7 formatted XML, or we need a way to convert it to HL7
 - The idea here is that, if we send any ePHI data, ever, it should be transmitted in HL7 format
 - HL7 is a type of a standard syntax that can also be applied to XML. There are converters for Python language for Falcon framework that can convert regular XML to HL7 XML and back.
* Here is some detailed information about HL7 syntax: http://www.hl7.org/implement/standards
3. That dataset should also include additional information and conversions (data mapping)
 - There are Codes for each and every checkbox under the “PLEASE SELECT GROUP(S) OR SINGLE DRUG(S)” of the Req form
 - If user checks ON for example 3 checkboxes or a group of checkboxes, corresponding code should be included in the HL7 dataset
4. Using that dataset we should populate a form in Labs LIS system UI
 - Labs LIS URLS should be provided.
5. We should fill-in all sections of that form and the Hl7 dataset should include enough information enabling us to do that
 - We will need to do some data mapping, for that we will need help from the Lab
6. We should generate and attach the Req PDF file to the form as well
 - This actually should replace our process of uploading to the FTP
 - Also, if we cannot fill out some of the forms fields, or cannot attached documents, we can find some alternative solutions (we need help from Labs for these)



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