Interoperability of laboratory data in Switzerland - A spotlight on Bern

Abstract

Laboratory data is a treasure chest for personalized medicine: it is - in general - electronically available, highly structured, quality controlled and indicative for many diseases. However, it is also a box with (probably more than) seven locks: laboratories use their own internal coding systems, results are reported in different languages (four official languages plus English with very distinct features in Switzerland), report formats are not uniform, standard nomenclature (e.g. Logical Observation Identifiers Names and Codes [LOINC]) is not routinely used and even these coding systems lack important information, including data, for example, about the specific "kit"used for testing or preanalytical procedures affecting the sample quality and result interpretability. Visualization of complex laboratory and reporting "-omics"data are additional challenges. Currently, there is no "passepartout"key for all these locks available, and also newer concepts such as Fast Health Interoperability Resources (FHIR) might not provide enough plasticity to unconditionally render laboratory data interoperable. In this short overview, we present current approaches in Switzerland with a specific focus on the exemplary Bernese implementations.