A lab ordering and results portal is the software through which a doctor orders tests from a laboratory company and receives the results. It sits inside the doctor's electronic health record, or beside it as a website. It is most developed in the United States, where large laboratory companies receive orders from hundreds of thousands of clinics, almost all of them electronically.
Without it, the doctor writes the order on a paper form, and the patient carries the form to the lab. The result comes back by fax or by post. Someone at the clinic then types the numbers into the patient's record. Each of these steps can lose the order or change a number.
With the portal, the order is electronic from start to end. The doctor picks the tests in the ambulatory EHR, the record system of the clinic. The order goes to the reference laboratory in a standard message format. It carries the patient's details, the insurance details and a diagnosis code, a short code for the illness, such as E11.9 for type 2 diabetes without complications. Medical coding explains these codes. The portal checks the order before sending it. American insurers pay for a test only when the diagnosis justifies it. So if the code does not support the test, the portal warns the doctor, and the patient can be told in advance that he may have to pay.
When the result is ready, it returns into the patient's record as data, not as a picture of a page. Each value sits in its own field, with its unit and its normal range. So the record can draw a chart of the patient's results over the years, and flag any value outside the range. This exchange of records in a shared format is called interoperability.
Consider a family clinic in Arizona. A doctor sees a 52-year-old man with type 2 diabetes. She orders an HbA1c test, which shows the average blood sugar over the past three months, and a cholesterol test. The order goes to the laboratory company with the code E11.9, and the portal confirms that his insurer covers both tests. The next morning, he gives blood at the lab company's collection centre near his office. That evening, the results appear in his record. His HbA1c is 8.1%, above his target of 7%, and the record flags it. The doctor sends him a message through the clinic's app and increases the dose of his medicine.
India has no common equivalent yet. Many Indian doctors still write the tests on a prescription, and the patient chooses a lab. Large diagnostic chains run online portals for the hospitals and clinics that send them samples. A report can also be linked to the patient's ABHA number, so that a later doctor can read it with the patient's consent.