The LIS: What is best-of-breed?
The use of laboratory data in the clinical setting has been quoted by multiple sources as providing 70% of the information required to make a clinical diagnosis of the patient. Therefore, given the value and importance of the information created in the lab, the underlying information systems that support the lab workflow should also carry high value when considering investment in information systems.
It is acknowledged that a vast majority of LIS / pathology informatics specialists and administrators, as well as designers of LIS solutions, are often ex-medical laboratory scientists. This often occurs as a natural career progression, resulting in experts that truly understand the complexity of pathology informatics and lab workflow. LIS suppliers with years of specialist experience aim to provide a dedicated service and support, so the lab is not lost in the void of an EHR vendor. And today, we see the availability of courses and training in pathology informatics.
Private pathology providers are contracted as a separate service (to the hospital) to provide laboratory services to primary care and in some cases secondary care. Some private labs have developed their own LIS’s, usually on-developed from legacy source code. This can create a high risk situation if the pathology provider does not have the knowledge and resources to support the system for the long term. Best-of-breed LIS fill this niche; where legacy systems become obsolete due to ongoing support issues. Vendors are very much in demand to provide a service to these organisations.
Streamlining Test Referrals
Many laboratories don’t work in isolation, i.e. the entire menu of clinical pathology testing is generally not available in a single lab. Labs refer work out and also receive referred work in for testing. Internationally and nationally approved reference labs process and report on tests that require specialist techniques. In some cases, there are several hundred tests referred each day and managing this workflow needs to be as streamlined as possible. A modern, best-of-breed LIS supports the electronic transfer of test requests within and between laboratories and the electronic receipt of the results back to the original laboratory for reporting. With an enterprise EHR lab system, these processes generally remain paper-based.
Best-of-breed solutions have proven their ability to provide added value and manage extensive complexity and are an integral component of the laboratory service. Emerging disciplines such as molecular and genomics plus digital imaging technologies will increase the complexity and requirements for the LIS.
A best-of-breed LIS built from an in-depth knowledge of pathology workflow and medical laboratory science will continue to be an expert system providing functionality for the lab that is unlikely to be matched by an enterprise EHR with standard off-the-shelf capabilities.