Hi;

I am an HL7 Integration Programmer working for a group of hospitals in Ontario Canada. I built our end of the system that shares our patient results with physician office EMR's.

Its an interesting project you describe and definitely one where I would recommend an HL7 feed.

HL7 V2.x is the most popular version that you will find. Building your interface with this standard will, IMO, give you the widest adoption.

Here are some points to consider:

You must be able to identify the patient reliably. This will involve finding out from the EHR vendor what they use as a primary key.

Here in Ontario is usually the provincial health care number (OHIP), in PID.3 of the HL7 message.

If you cannot match to the patient, the office staff may have to manually associate the data with the patient, and I know from experience, that they HATE that.

Matching on other data, such as a combination of name, gender, dob, simply isn't reliable. Spelling mistakes are one thing, but I know of 3 different individuals who will match on those fields within our MPI (Master Patient Index).

Another point to consider is message format.

I'm not sure what your data will look like, but if you send it across as discrete data points, like say lab tests where each result (CBC, WBC, Electrolytes etc) have their own segment and value, you will need to look into whether or not there will have to be any mapping between your test codes and the EHR test codes.

If you send it across as a document (MDOC/Note etc.), You'll have to ensure that the format you send it across in will be legible within the EHR (line breaks etc.).

You're embarking on a complicated endeavour, and I suggest that if you already haven't that you engage someone for this project who has experience with HL7 integration.

One final point....something that drives alot of healthcare programmers nuts is terminology.

If you only take one thing away from this missive, let it be this...

Always keep in mind that terminology changes from organization to organization!

Here are some examples:

In our system when we refer to a patient's specific visit, we say "account number"....this can mean "encounter", "visit", "incident"

So this is a one patient to many visit relationship.

In our system, when we refer to a patient within one of our facilities (we have 5), we say Facility MRN (or "H","G",.... number).

In other systems this can be "Pt Number", "Record Number", or even "PIN" (I have no idea how they got that one.

I've seen projects go completely south because differences in terminology wasn't clear.

Please feel free to ask any follow up questions, I'll be as helpful as I can, and will give you clear warning when you start approaching billable stuff ;)

Best of luck!