New Laboratory IT Systems Transfer Standard Brings True Interoperability Closer to Reality

The vision of true interoperability of electronic health care information has moved one step closer to reality with the release of a new information technology (IT) standard. Called LIVD, the standard maps in vitro diagnostic (IVD) test results directly to the Logical Observation Identifiers Names and Codes (LOINC) code set for identifying lab procedures and results.

In other words, LIVD enables the automated transfer of test results directly to laboratory information systems and electronic health records without transmitting plain text or non-machine-readable PDF reports. Previously, there was no unique relationship between LOINC codes and individual tests.

The Standard at a Glance
The standard, released by the IVD Industry Connectivity Consortium in collaboration with Integrating the Healthcare Enterprise's (IHE's) Pathology and Laboratory Medicine domain, the Regenstrief Center for Biomedical Informatics, the CDC and the FDA, builds on findings from the NIH's 2016 workshops on Promoting Semantic Interoperability of Laboratory Data. The LIVD specification adopts interoperability, as defined by the Office of the National Coordinator for Health IT's Interoperability Roadmap.

The LIVD specification outlines an IVD industry-defined format to facilitate the publication and exchange of LOINC codes for vendor IVD test results. "This effort will accelerate the inclusion of universal LOINC codes in laboratory reports to clinicians and health care systems because it will eliminate the additional laboratory effort now needed to figure out the right LOINC code for each laboratory test," notes Clem J. McDonald, M.D., director of the NIH's Lister Hill National Center for Biomedical Communications in a statement. "The increasing use of universal LOINC codes in laboratory reports will unleash the same wave of efficiency and quality improvements as bar codes did for grocers and retailers."

LIVD complements IHE's Laboratory Analytical Workflow (LAW) profile, which contains rules for exchanging orders and results between IVD devices and health IT systems. Together, LIVD and LAW offer a "plug-and-play" solution.

A Leap of Progress
While some vendor systems began documenting PDF instructions on associating LOINC codes with laboratory information systems, the process was manual and thus a potential source of errors. The new standard allows automatic sending of lab values to the electronic health records and enables units of measure standardization to normalize lab result values.

"The LIVD specification addresses a major pain point for today's clinical laboratory," said Serge Jonnaert, president of the IVD Industry Connectivity Consortium in a statement. "We finally have a true plug-and-play solution to interface IVD instruments to middleware and LIS systems. Clinical laboratories will no longer be subjected to outrageously high fees for custom connectivity implementations."

Moving Forward
It has been reported that Abbott Laboratories, Roche and BioMérieux are among the companies that committed LIVD will be available on product websites for labs to download. The hope is that in the future there will be a central web-based portal to act as a repository of files. But for now, downloadable versions of the LIVD specifications are available voluntarily by manufacturers.

Takeaway: Adoption of the LIVD standard will improve results standardization, plus transmission efficiency and quality by automatically linking IVD test results with lab IT systems.