The future of the lab is not inside the LIS…it is outside. Performing a laboratory test is now a commodity, a place where high quality and efficiency are assumed features, not extra values had at a premium. So, much like a bag of sugar or flour at the grocery store, there is little brand loyalty (or brand awareness for that matter) in lab testing. The cheapest, meets-minimum product will win every time. In this climate, labs have been reduced to a mere black box that exchanges an order for a result. But this reduction is, in reality, a self-imposed prison.
The labs that are succeeding are the ones that have evolved past the traditional confines of the four walls of the laboratory. These labs are using their LIS as something more than just the traditional workflow engine, billing machine, or report typewriter. These labs are using their LIS as a platform to project their value back to the patient and the care team. These labs are becoming active, engaged members of the care team for the patient. Leveraging the new climate of interoperability and employing appropriate tools, the modern LIS can connect, transmit, and proactively engage in the management of the care of the patient. The labs that are thriving in today’s storm of increased demand with decreased reimbursement are using these tools via their LIS to move past the old era of just performing laboratory tests and are proudly claiming the role of “The Diagnostic Expert” in healthcare.
—JD Nolen, MD, PhD, MSPH
Sr. Director, Clinical Strategy
In a healthcare system focused on value, a Best-of-Breed (BoB) LIS is invaluable as an integrated part of a larger Integrated Delivery Network (IDN). Laboratory medicine plays a critical part in a value-based system because lab testing can bend the downstream cost curve and positively impact patient outcomes. The lab of the future will require a BoB system to focus on internal efficiencies, and on the interoperability and analytics throughout the rest of the healthcare organization.
Understanding that labs will no longer be revenue centers, internally, the LIS will help make lab workflow as efficient and cost-effective as possible. Externally, the LIS of the future will support test utilization, population health management, and other advanced analytics that focus on downstream savings and improving patient outcomes. Also, the LIS of the future must be prepared to handle what lab testing means in the future. Testing will continue to grow to include more molecular and genetic testing, point-of-care testing, home health testing, and mHealth. The lab requires a system that is capable of collecting, disseminating, and using its data productively within a value-based system.
—Kim Futrell, BS, MT(ASCP)
Products Marketing Manager
Orchard Software Corporation
An important aspect today, and moving forward, for all LIS vendors to consider, incorporate, and provide their customers is a mentor- or coach-style relationship. With all of the changes in testing regulations and reimbursements as well as test types merging and evolving, such as cross-over molecular, PGx, etc., labs need to be able to focus on the medical side of their business, and their technology providers should be providing them the clear direction on how to best leverage their IT investment. Vendors should provide coaching throughout the setup, implementation, automation, and integration with all aspects of the lab’s IT infrastructure. After all, no one should understand the technology and technical capabilities better than the vendors, regarding how to best gain efficiencies and utilize the applications to support the laboratory objectives.
Another key aspect to consider is that data is each laboratory’s gold. The LIS is the central repository of all of the data coming into, and going out of, the lab. There are many types of data that the LIS has access to—not just the obvious ones of patient data, demographics, test results, and diagnosis—all extremely valuable not only in the testing the lab is doing, but also in the big data picture. All of this discrete data is information that can be processed, analyzed, and used to provide personalized medicine—in many forms, but primarily in the form of treatment plans that have the best outcomes per patient. There is also very valuable data for the lab on its business operations. This data provides insight for each lab to understand where its strengths and weaknesses lie as a business. This provides a significant opportunity for the lab to incorporate new processes and make changes to existing ones or updates in training, interfaces, and automation to become more profitable, have better turnaround times, and focus on areas that have higher and faster reimbursements.
Chief Executive Officer
Psyche Systems Corporation
Value Based Reimbursement and the emergence of Accountable Care Organizations in healthcare are rapidly displacing the traditional model of Fee-For-Service Reimbursement and the “individualized” physician/patient approach to treatments. As labs re-evaluate their roles during this evolution, they need to understand how they could contribute to the most efficient and comprehensive medical team treatment of a patient while maintaining awareness of test mix and volume through this transitional period. During and after the transformation of our healthcare system, information and analytics becomes critical. A lab will need to understand what role it played in the treatment of the patient and how that role impacted patient outcomes and costs. For this, “real time” data is needed in conjunction with the ongoing “present tense” evaluation of this data/information. LISs should have well defined dashboards to monitor current activity in the lab, specimen tracking, and Lean Processing procedures to identify where a specimen is at any time and to evaluate if existing procedures could be modified to improve turnaround time and reduce resources required to generate a result (unnecessary/redundant activity, wasted time and materials, etc.).
As important as managing the transitional reimbursement process, labs need to have an evolving test menu incorporating molecular, genetic, and next gen sequencing methodologies. While these tests may require significant capital and intellectual investments today, within a very short period of time, costs will come down and testing/resulting procedures will be simplified. Expansion of the test menus to incorporate these types of specialty tests will play a significant role in efficient and comprehensive patient care in Accountable Care Organizations as they evolve.
VP Sales and Marketing
The future laboratory information system must go beyond basic order capture and results delivery. Labs must engage more fully with diagnostic communities and provide greater value in a changing healthcare landscape, and therefore its systems must also adapt. However, replacing a LIS is expensive and not always an option.
Therefore, the LIS of tomorrow must work in concert with other complementary technology solutions that enable more complete management of the diagnostic process. This means to expand the capabilities of the LIS to provide a unique breadth of support for clinical testing processes and connectivity to systems, instruments and providers across the world – spanning the pre- to post-analytic stages of care. Together, these solutions can connect community care givers with laboratories equipped with the most advanced clinical capabilities available.
- Tomorrow’s laboratory technology must deliver:
Advanced connectivity between labs and physician customers, as well as other labs
- Efficient clean electronic orders, from any source
- Support for multi-lab networks, including centralized administration of joint test catalogs networks
- Flexible results reporting, including multi-lab report consolidation
- Improved patient outcomes, safety and cost savings
This technology also must help the lab address the shift to fee-for-value, capitated payments, and hospital / lab consolidations that are threatening to commoditize or outsource many current diagnostic services.
Labs that adopt this technology approach will play a central role in the diagnostic community, improve healthcare outcomes, reduce costs, and enhance patient experiences.
—Michelle E. Del Guercio
Vice President, Marketing