Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, Washington, DC, United States.
NORC at the University of Chicago, United States.
Int J Med Inform. 2017 Dec;108:175-184. doi: 10.1016/j.ijmedinf.2017.09.007. Epub 2017 Sep 20.
To characterize nationwide variation and factors associated with clinical laboratories': (1) capabilities to send structured test results electronically to ordering practitioners' EHR systems; and (2) their levels of exchange activity, as measured by whether they sent more than three-quarters of their test results as structured data to ordering practitioners' EHR systems.
A national survey of all independent and hospital laboratories was conducted in 2013. Using an analytic weighted sample of 9382 clinical laboratories, a series of logistic regression analyses were conducted to identify organizational and area characteristics associated with clinical laboratories' exchange capability and activity.
Hospital-based clinical laboratories (71%) and larger clinical laboratories (80%) had significantly higher levels of capability compared to independent (58%) and smaller laboratories (48%), respectively; though all had similar levels of exchange activity, with 30% of clinical laboratories sending 75% or more of their test results electronically. In multivariate analyses, hospital and the largest laboratories had 1.87 and 4.40 higher odds, respectively, of possessing the capability to send results electronically compared to independent laboratories (p<0.001). Laboratories located in areas with a higher share of potential exchange partners had a small but significantly greater capability to send results electronically and higher levels of exchange activity(p<0.05).
Clinical laboratories' capability to exchange varied by size and type; however, all clinical laboratories had relatively low levels of exchange activity. The role of exchange partners potentially played a small but significant role in driving exchange capability and activity.
描述全国范围内临床实验室的以下特征：（1）向医嘱录入电子病历系统（EHR）的执业医师发送结构化检验结果的能力；（2）其交换活动水平，即通过检验结果中有超过四分之三以上以结构化数据形式发送给医嘱录入 EHR 的实验室数量来衡量。
2013 年对所有独立实验室和医院实验室进行了全国性调查。采用分析加权样本的方法，对 9382 家临床实验室进行了一系列逻辑回归分析，以确定与临床实验室交换能力和活动相关的组织和地区特征。
与独立实验室（58%）相比，医院附属临床实验室（71%）和较大的临床实验室（80%）具有更高的能力水平；尽管所有实验室的交换活动水平相似，有 30%的临床实验室以电子方式发送了 75%或更多的检验结果。多变量分析显示，与独立实验室相比，医院和最大的实验室发送结果电子能力分别高出 1.87 倍和 4.40 倍（p<0.001）。在潜在交换伙伴比例较高的地区，实验室具有发送结果电子能力和更高的交换活动水平的可能性较小，但具有显著意义（p<0.05）。
临床实验室的交换能力因规模和类型而异；然而，所有临床实验室的交换活动水平都相对较低。交换伙伴的作用可能在推动交换能力和活动方面发挥了微小但显著的作用。
