Laboratory integration services · United States
Lab orders out and results back, between your EHR or product, your laboratory information system, reference labs such as Quest Diagnostics and Labcorp, and state public health. We build the HL7 v2 and FHIR interfaces, map every test to LOINC and keep corrected results tied to the order that produced them.
ORM or OML with placer order number, LOINC-coded test, ask-at-order-entry answers and billing.
Accession, specimen collected, result verified in the LIS, reportable results copied to public health.
ORU^R01 matched to the order and patient, corrections replacing the original, abnormal flags routed.
The short answer
Nirmitee builds lab interfaces for EHR and health tech companies, laboratories and health systems. We connect ordering systems to laboratory information systems and to reference labs such as Quest Diagnostics and Labcorp with HL7 v2 ORM^O01 or OML^O21 orders and ORU^R01 results, following the HL7 LOI and LRI guides where the partner supports them. We map local test codes to LOINC, specimens and organisms to SNOMED CT and units to UCUM, handle preliminary, final and corrected results, and send reportable results to state public health agencies using the HL7 2.5.1 ELR guide. You get an order-to-result loop that never loses a result or attaches it to the wrong patient.
Lab message flows
These are the transactions a lab interface is made of. Your reference lab's connectivity team will use these exact names.
| Flow | Messages and standards | What it carries | What we design for |
|---|---|---|---|
| Orders to the lab | ORM^O01, or OML^O21 under the HL7 2.5.1 LOI guide; FHIR ServiceRequest where the lab offers it | Placer order number (ORC-2), ordering provider NPI, LOINC or lab test code in OBR-4, diagnosis codes, priority, specimen | New, change and cancel control codes in ORC-1, ask-at-order-entry answers and bill-to (client, patient or insurance) |
| Results back | ORU^R01 under the HL7 2.5.1 LRI guide; FHIR DiagnosticReport and Observation | OBX results with LOINC codes, values, UCUM units, reference ranges, abnormal flags and status | Preliminary, final and corrected results (OBX-11 P, F, C), microbiology parent and child results, and PDF reports embedded as ED |
| Order acknowledgements | ACK, ORR^O02 or ORL^O22 | Accepted, rejected or error, with the reason | Rejected orders routed back to the owning team, never silently dropped |
| Test compendium | The lab's test directory, or eDOS where supported | Orderable tests, specimen requirements, ask-at-order-entry questions and result components | Keeping compendium updates in sync so a retired test code cannot be ordered |
| Requisitions and labels | Lab-specific requisition and barcode label formats | Patient, order, specimen and bill-to data printed at collection | Labels that match the order the lab receives electronically |
| Electronic lab reporting (ELR) | ORU^R01 under the HL7 2.5.1 ELR guide to state and local public health, often through the APHL AIMS platform | Reportable results with patient demographics, performing lab and CLIA number, LOINC tests and SNOMED CT results | Each jurisdiction's reportable condition list, onboarding tests and acknowledgement handling |
| Results to patients and products | FHIR R4 with US Core 6.1.0 laboratory result profiles | DiagnosticReport, Observation and Specimen resources | Release rules so results reach patients and apps with the same status and corrections as the chart |
Also in scope when your workflow needs it: pathology and cytology reports, point-of-care testing devices, blood bank messages and lab billing through DFT^P03.
What we build
Pick the workstreams your lab workflow needs. Each ships with a specification, tests and an owner.
Order and result interfaces to national and regional reference labs such as Quest Diagnostics and Labcorp, built to each lab's own specification, compendium and onboarding tests.
ORM^O01 · OML^O21 · ORU^R01 · AOE · ABN
Lab ORM and ORU to FHIR mapping →Bidirectional interfaces between a laboratory information system and hospital or ambulatory EHRs, with order matching on placer and filler numbers and accession tracking.
ORC-2 · ORC-3 · OBR-4 · SPM · OBX
HL7 integration services →Local test codes mapped to LOINC, specimens and organisms to SNOMED CT and units to UCUM, with a named reviewer and a queue for new codes.
LOINC · SNOMED CT · UCUM
LOINC and SNOMED CT mapping in production →Results routed to the ordering provider, copies to other recipients, abnormal and critical flags surfaced, and corrected reports replacing the original with an audit trail.
OBX-8 · OBX-11 · ORC-1 · copy-to
Routing ORU lab results in Mirth Connect →ELR feeds from laboratories to state and local public health agencies, including onboarding, validation against the ELR guide and acknowledgement monitoring.
HL7 2.5.1 ELR · APHL AIMS · CLIA
Public health reporting with Mirth Connect →Results exposed or delivered as FHIR DiagnosticReport, Observation and Specimen resources that validate against US Core 6.1.0 for patient apps and data platforms.
FHIR R4 · US Core 6.1.0 · DiagnosticReport
FHIR integration services →Buyer decisions
Most products use more than one. The right mix depends on how many labs you need and how quickly.
| Option | Best fit | Strengths | What to plan for |
|---|---|---|---|
| Direct interface per lab | Products with a few high-volume labs, and laboratories connecting to their main EHR clients | Full control of the data, no per-transaction fees to a middleman | Each lab's specification, compendium, onboarding queue and test cycle |
| Lab network aggregator | Products that need many labs quickly | One API and contract across many labs | Aggregator fees, their data model and less control over edge cases |
| EHR's built-in lab interfaces | Practices whose EHR already has the lab connected | Nothing to build if the connection exists | Your product still needs the results, usually through the EHR's own API or an outbound feed |
| Interface engine you run | Health systems and labs with an integration team | Mirth Connect, Open Integration Engine, Rhapsody or Cloverleaf handle routing and transformation | Engine licensing, operations and on-call |
| Interoply (our platform) | Products that want lab, HL7, FHIR and X12 behind one API | Connectors, mapping and monitoring in one place | Fit with your hosting and data residency rules |
Most first lab connections are delayed by the lab's onboarding queue, not the code. We request the lab's specification and test slot in week one.
Integration boundaries
Lab interfaces cross the laboratory, the ordering practice and public health. We write the split down first.
The laboratory holds the CLIA certificate and owns test performance, result verification and the content of the test report under 42 CFR 493.1291. The interface carries the report intact, including corrected-report status and the performing lab.
Publishes the order and result specification and compendium, issues account numbers, and runs onboarding and validation tests. We run that correspondence.
Owns ordering workflow, result display and provider acknowledgement. We list every field that needs a home before code is written.
Transport, parsing, validation, mapping, routing, acknowledgements, retry, replay, audit logging and alerts. Defects in this layer are ours to fix.
Each state sets its reportable conditions and onboarding process. We build to the ELR guide and the jurisdiction's rules and handle their test cycle.
Deliverables
Everything below lands in your repository and your runbook.
Order, result and acknowledgement layouts, segment and field mapping, and annotated sample messages per lab.
Versioned engine configuration or services, with per-lab settings kept out of the code.
LOINC, SNOMED CT and UCUM maps with reviewer sign-off and a process for compendium updates.
Normal, abnormal, critical, corrected, cancelled, microbiology and unmatched-result cases, with results.
Unacknowledged orders, results without orders, queue depth and silence alerts routed to your on-call.
Cutover plan, replay procedure, lab contacts and a checklist for onboarding the next lab.
Delivery phases
A first reference lab order and result interface typically takes 8 to 12 weeks. The lab's onboarding queue sets most of that date, so we file the request in week one.
Weeks 1 to 2
Lab specification and compendium received, account and test slot requested, interface specification drafted
Weeks 2 to 6
Order and result interfaces built, compendium and LOINC mapping done, labels and requisitions matched
Weeks 5 to 10
Connectivity proven, the lab's test scripts run, corrected and cancelled cases verified
Weeks 8 to 12
Cutover, two weeks of hypercare, monitoring live and runbook handed over
Cost drivers
You get a fixed scope and price after one scoping call. These are the factors that move it.
Results-only interfaces are smaller than bidirectional order and result interfaces.
Each lab has its own specification and validation. Configuration-driven design keeps the second lab cheaper than the first.
A reference lab compendium with thousands of orderable tests is its own mapping workstream.
Printing lab-specific requisitions and specimen labels adds format work and testing.
ELR adds each jurisdiction's onboarding and validation.
FHIR mapping adds profile validation. Monitoring and on-call are priced per connection.
Proof
Client names are withheld. The code and write-ups linked here are public.
Our integration team has built more than 350 interfaces on Mirth Connect, including lab orders, results and result routing.
Public channels and transformers, including ORU^R01 to FHIR DiagnosticReport and Observation, and an importable MLLP listener channel.
View the cookbook on GitHub →Our headless EHR models lab orders and results as FHIR R4 resources and passed all 47 ONC (g)(10) SMART App Launch tests in Inferno on 11 June 2026.
View the headless EHR on GitHub →Our platform runs lab, HL7 v2, FHIR and X12 connectors behind one API, with monitoring and replay built in.
See Interoply →We are ISO 27001:2022 certified and sign Business Associate Agreements for work that touches patient data.
FAQ
Lab integration connects the systems that order lab tests with the systems that perform and report them: EHRs and health tech products, laboratory information systems, reference labs and public health agencies. It covers orders, acknowledgements, results, corrections, compendium and terminology mapping, and monitoring of the feeds.
Orders use ORM^O01 or OML^O21, results use ORU^R01 and acknowledgements use ACK, ORR^O02 or ORL^O22. In the US the HL7 2.5.1 Laboratory Orders Interface (LOI) and Laboratory Results Interface (LRI) guides define the constraints, and many labs publish their own specification on top.
Yes. Both provide HL7 v2 order and result interfaces with their own specifications, compendiums, ask-at-order-entry questions and requisition and label rules. We handle the onboarding with each lab's connectivity team, build to its specification and run its validation tests.
We map each local or lab-specific test and result component to LOINC using the lab's compendium, specimen and method, with a named reviewer confirming each mapping. Specimens and organisms map to SNOMED CT and units to UCUM. New codes go to a review queue instead of passing through unmapped.
A corrected result arrives as ORU^R01 with OBX-11 status C against the same order. The interface replaces the earlier value, keeps the history, flags the correction to the ordering provider and makes sure downstream apps and patient portals show the corrected value, as 42 CFR 493.1291 expects for corrected reports.
ELR is the automated reporting of results for reportable conditions from laboratories to state and local public health agencies. It uses ORU^R01 messages under the HL7 2.5.1 ELR implementation guide, often routed through the APHL AIMS platform, with each jurisdiction setting its own reportable conditions and onboarding process.
CLIA certification belongs to the laboratory, which owns test performance and the test report. The interface has to carry the report intact: patient identifiers, test, result, units, reference range, performing lab and corrected-report status, so what the provider sees matches what the lab released under 42 CFR 493.1291.
Most lab orders and results in the US still move over HL7 v2 because that is what labs and EHRs support. FHIR R4 DiagnosticReport and Observation, validated against US Core 6.1.0, is the right format for patient apps, data platforms and newer APIs. We often receive v2 and publish FHIR.
Yes. Lab network aggregators give one API across many labs, and a direct interface gives full control for your highest-volume labs. We build either, and many products use an aggregator to launch and direct interfaces where volume justifies them.
A first reference lab order and result interface typically takes 8 to 12 weeks, and most of that is the lab's onboarding and validation queue. Results-only interfaces are faster. Each additional lab is quicker when lab differences live in configuration.
Cost depends on direction, the number of labs, compendium size, requisition and label printing, public health reporting, FHIR delivery and the support level. We give a fixed scope and price after one scoping call.
Yes. We sign Business Associate Agreements, run interfaces over encrypted transport, use de-identified or synthetic messages until production and work inside our ISO 27001:2022 certified management system.
Next step
Tell us the lab, the direction and your date. An integration engineer replies with what the lab will ask for, what could move the date and a fixed scope.
Start with your workflow
Share the labs, systems and direction you need, plus your target date. Use de-identified examples only. Read by an engineer, answered within one business day.
