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Health Information Exchange Among Clinical Laboratories

Safety rules. Smart young woman wearing special protective glasses while working in the lab
A landscape assessment of how the electronic exchange of laboratory data has evolved since 2012
  • Client
    Office of the National Coordinator for Health Information Technology (ONC)
  • Dates
    February 2020 - June 2020


Multiple technical and policy developments have shifted the interoperability landscape of health information exchange.

In 2012, the Office of the National Coordinator for Health Information Technology (ONC) conducted a first-of-its-kind National Survey on Health Information Exchange (HIE) Among Clinical Laboratories. The survey was conducted in collaboration with NORC as part of the evaluation of the State HIE Cooperative Agreement Program. The goal of the survey was to assess exchange capability and volume of electronic exchange of test results among clinicians and hospitals participating in the Centers for Medicare & Medicaid Services Electronic Health Records Incentive Programs.

Since that survey, new terminology and data exchange standards for interoperability have emerged and gained acceptance, and challenges with the use of specific standards and interoperability remain. New information was needed to better understand the current state of affairs.


NORC evaluated how the electronic exchange of laboratory data has evolved since 2012.

In 2020, ONC tasked NORC with conducting a landscape assessment to explore how lab information exchange had changed over the years and to explore the need for conducting a follow-on national survey of clinical laboratories.

The landscape assessment consisted of a targeted literature review and interviews with a multi-disciplinary group of key informants. The assessment focused on:

  • Adoption of standard terminologies, vocabulary, and messaging standards; and implementation guides
  • Exchange capabilities of clinical laboratories
  • Sharing data with patients
  • Public health departments and electronic laboratory reporting


Our assessment identified current issues in laboratory interoperability that warrant measurement.

Since the 2012 survey, the landscape for electronic health information exchange has evolved considerably. Federal efforts to advance interoperable exchange of data have focused on the increased use of standards, including LOINC and SNOMED. Our assessment identified several measurement topics for a potential repeat survey to assess clinical laboratory interoperability. Specifically:

  • The current use of terminology standards
  • Public health reporting for hospital and commercial laboratories
  • Health Information Exchange Organization participation in lab exchange
  • Genetic testing
  • Patient access to laboratory reports

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