Quest Adds Haystack MRD to OncoEMR for Community Oncology

Community oncology practices will soon be able to order Quest Diagnostics' Haystack minimal residual disease (MRD) test and comprehensive genomic profiling (CGP) panels directly inside the OncoEMR electronic health record (EHR), a workflow change aimed at cutting the administrative friction that has long slowed molecular test ordering at the point of care.¹ The rollout begins as a pilot with American Oncology Network (AON) and other community providers, with a nationwide launch planned for the second half of 2026.

Quest is the largest clinical reference laboratory to integrate oncology testing into OncoEMR through the platform's opt-in Molecular Profiling Integration (MPI) ordering feature, built by Flatiron Health to handle the specialized requirements of comprehensive molecular tests. Once complete, the integration is intended to reach 4700 clinicians across Flatiron's network of roughly 1600 community-based cancer care sites.

"By integrating Quest's advanced oncology services directly into existing workflows, we're making it easier for physicians to access critical testing insights without adding complexity to their day,” Quincy Weatherspoon, chief network officer, US point of care, Flatiron Health, said in a statement. “This collaboration helps reduce administrative burden so clinicians can spend less time navigating processes and more time focused on caring for patients with cancer.”

Why Molecular Test Ordering Slows Community Practices

The move targets a well-documented operational bottleneck. Molecular oncology testing can involve dozens or hundreds of individual biomarkers, complicating order entry and producing dense, hard-to-parse reports. Quest said OncoEMR MPI is designed to let practices set up accounts faster, order with fewer steps, and receive more digestible results inside the daily EHR workflow.

Oncology leaders at a recent Institute for Value-Based Medicine^® event by The American Journal of Managed Care^® (AJMC^®) in Chicago, Illinois, contrasted a system where EHR-integrated molecular testing dropped order time to under 2 minutes against a safety-net setting lacking integration, where the same task stretched to 7 to 10 minutes per patient.² This time, they noted, "adds up and leads to a lot of complications."

Nearly 200 AON Sites Get Access First

AON, an alliance of more than 350 providers practicing across 21 states, is among the first pilot customers, with nearly 200 of its sites now able to order Quest tests through OncoEMR MPI. The pilot opens access to Haystack MRD, a circulating tumor DNA (ctDNA) test for solid tumors, alongside CGP panels that use advanced sequencing to identify up to 530 genes tied to therapy response.

Brian Mulherin, MD, medical director at AON, said the arrangement as consistent with the network's model of supplying community physicians with ancillary services and practice-management support so they can order innovative tests quickly. Asia Chang, vice president and general manager of oncology at Quest, described the offering as a single-source ordering and results solution.

Faster Ordering, Same Coverage Questions

For payers and health system leaders, the news lands amid a broader push to embed testing and specialty services into oncology EHRs. AJMC has reported on parallel efforts, including McKesson's precision oncology consortium, which integrates genomic ordering into the iKnowMed EHR across more than 2750 community providers.³ Yet the same body of reporting underscores that access tools do not resolve the underlying coverage picture. Medicare coverage has expanded in steps: the Palmetto GBA MolDX program's local coverage determination opened a pathway for ctDNA MRD tests such as Signatera across several solid-tumor indications.⁴

What the press materials don't say: how much any of this costs, or whether payers will cover it. That's what will actually decide whether ordering goes up.

This isn't Quest's first EHR play. The company began offering Haystack MRD through Epic Aura in 2025, and the OncoEMR deal extends that same approach to a second platform. The real test comes in the second half of 2026, when Quest takes OncoEMR MPI nationwide and finds out whether faster ordering translates into more tests ordered or just faster paperwork.

References

1. Quest Diagnostics now the largest clinical reference lab to extend oncology test access through OncoEMR MPI. News release. Quest Diagnostics; July 8, 2026.
2. Hohmann E. Oncology leaders address testing, access, equity, and pharmacy in cancer care. AJMC. May 27, 2026. Accessed July 7, 2026. https://www.ajmc.com/view/oncology-leaders-address-testing-access-equity-and-pharmacy-in-cancer-care
3. Caffrey M. Tech updates: McKesson launches precision oncology consortium; financing for RISA Labs PA platform. AJMC. April 28, 2026. Accessed July 7, 2026. https://www.ajmc.com/view/tech-updates-mckesson-launches-precision-oncology-consortium-financing-for-risa-labs-pa-platform
4. Gavidia M, Caffrey M. Palmetto GBA's MolDX announces coverage of MRD testing. AJMC. Accessed July 7, 2026. https://www.ajmc.com/view/palmetto-gba-s-moldx-announces-coverage-of-mrd-testing