Lab info systems (LIS) ease workflow

Laboratories, more than ever before, are depending on
information systems to combat the critical staff shortage, the increased
demand for faster turnaround times, and the ever-growing burden of
security and regulatory compliance. Connectivity, scalability,
automation of processes that streamline laboratory workflow and
integration of laboratory data into enterprise-wide information are key
issues addressed by the software systems summarized below.

Real-time interface software

WindoPath is a sophisticated anatomic pathology and cytology information system, which is client server-based for complete case processing, with CLIA compliance and HIPAA-related security/privacy provisions. In addition to case development and reporting, the system incorporates many advanced and custom-designed features as standard, such as voice capabilities, image management, and tumor staging. This scalable LIS delivers extensibility, allowing for continuous development and customization to meet individual needs. Two new applications have been introduced: PocketPath, a mobile application that gives physicians point-of-care access to patient diagnoses via a PDA, and Vox Pap conversational computing software, designed to allow technicians to simultaneously focus on specimens while creating reports.

WindoPath/PocketPath/Vox Pap

Psyche Systems Corp.

www.rsleads.com/403ml-171

Integrated lab network

Designed to work with most existing laboratory information systems, the Orchard Copia is a browser-based system, which electronically links laboratories and manages lab order logistics and result delivery. From any Web-based PC, users place orders in a single order-entry screen. Copia reviews each order, identifies potential reimbursement issues, and automatically handles patient insurance and lab routing preferences. Phlebotomists can generate draw lists, produce barcode labels, view clinical questions/container types/personalized comments, and complete shipping manifests. Results are consolidated into a single report, and providers may review current and past results. Copia provides integrated delivery networks with the advantage of multisite communications.

Orchard Copia

Orchard Software Corp.

www.rsleads.com/403ml-172

Web-based LIS system

Building on the technology, adaptability, and speed of the MODU-LIS I, the new Web-based MODU-LIS II offers easier access to laboratory information for healthcare professionals. Key to its design is the report and ordering system, which can be used as part of a total LIS system, or as a stand-alone accessory to any other LIS system. The server communicates with any LIS or HIS via HL7 interface protocol, which can bring real-time clinical results to physicians in almost any environment. The capabilities addressed by the MODU-LIS II provide access to laboratory information from any desktop computer by way of the Internet or through wireless communications and use of PDA within hospital facilities.

MODU-LIS II

Modulus Data Systems Inc.

www.rsleads.com/403ml-173

Genetic/DNA LIMS

Incorporating both software and configurable database, the Starfruit GeneTell, a laboratory information management system, meets the specific needs of genetic-testing and molecular-diagnostic laboratories for the electronic storage and retrieval of data relating to: design/performance of molecular, diagnostic assays from fresh and paraffin-embedded tissue;

detection of infectious organisms, genetic
rearrangements associated with malignant disease and hereditary,
genetic abnormalities;

information analysis to identify, diagnose, and
prescribe medical procedures;

patient records (including demographics, test
history, personal gene databank, and family tree); and

billing.

Starfruit GeneTell LIMS

Data Unlimited International Inc.

www.rsleads.com/403ml-175

Anatomic pathology software package

PacePath, a comprehensive anatomic pathology software system, streamlines lab workflow, as well as data entry and report delivery. The package features modules for cytopathology, FNA biopsy, and surgical and autopsy pathology, all with full imaging capabilities. PacePath allows users to quickly retrieve information, generate reports, and analyze data. The easy-to-use windows provide complete patient and case histories, all on one patient look-up screen. Coded diagnoses maximize information retrieval, and unique comparison methods allow automated correlation of all results.

PacePath

Labsoft Inc.

www.rsleads.com/403ml-174

Global lab solution

MediLab, a third-generation product, offers a comprehensive management solution for the central laboratory. While providing a wide range of capability for the management of information, organization and workflow, the system enhances communications for all in-house and global system users. The MediLab software manages all laboratory activities and is scalable to meet the needs of small, single-discipline laboratories to large, multidisciplinary/multisite institutions. Features include patient file management, Web-enabled accessioning, positive ID for specimen collection and identification, sample/request dispatching, instrument interfaces, QC, result consolidation/distribution, technical/clinical validation, billing, and statistics.

MediLab

MediSolution Ltd.

www.rsleads.com/403ml-176

Streamlining lab processes

The NOVIUS Lab System streamlines lab processes with management reports and tools that help administrators monitor quality indicators and improve outcomes. An automated “turnaround time monitor” helps technologists prioritize and manage their workload, and a patient-report designer provides physicians with results in the format most useful to them. Operational and clinical rules are built into the system, so that it can be tailored to the needs of single or multisite facilities. The system integrates with reference laboratories, point-of-care data managers, instruments, lab automation systems, clinical repositories, and financial systems, providing information at the point of need.

NOVIUS Lab

Siemens Medical Solutions

www.rsleads.com/403ml-177

New blood-bank donor solution

Recently FDA cleared, the Millennium
PathNet Blood Bank Donor solution automates the management of the blood-donation process and assists users in determining donor eligibility and blood-product suitability. Features include streamlined workflow with barcoding; online donor recruitment lists; donor management to track eligibility/demographics; and blood-drive scheduling. The product supports blood-inventory management, delivering review warnings or exceptions for changed products ABO/Rh, promoting safety measures, and guarding against risk. ISBT-28 is fully supported from printing labels to reading all barcoded fields, making it compliant with global labeling standards for world-wide distribution, tracking, and handling of blood bags and blood components.

Millennium PathNet Blood Bank Donor

Cerner Corp.

www.rsleads.com/403ml-178

Graphical lab system

Suited to either network or single PC environments, the SchuyLab Windows-based LIS provides an easy-to-use icon-based program that interfaces with instruments, tracks specimens, monitors QC, compiles worksheets/daily logs, and provides cumulative/consolidated patient reports. The system is capable of communicating with office or hospital information systems using HL7 protocol, and offers additional modules that include autofaxing, barcoding, dial-in results, medical necessity, and direct Medicare/Medicaid billing. The Internet-results module, SchuyNet, allows doctors to securely access patient reports on any PC and review the most recent lab data.

SchuyLab/SchuyNet

Schuyler House

www.rsleads.com/403ml-179

“Case-centric” model

Specifically designed software for laboratories providing surgical pathology, cytology, and autopsy services, the
Tamtron PowerPath Anatomic Pathology System, is a comprehensive LIS that enables the integration and streamlining of diagnostic, management, and business needs. PowerPaths case-centric model provides a solution that can scale from multisite, multientity healthcare enterprise to a single departmental laboratory. The systems key benefits include simplistic data entry, enhanced research, and service functions, customized report formats, improved quality assurance, and increased capture of professional and technical charges. Tamtron PowerPath Anatomic Pathology System
Impac Medical Systems
www.rsleads.com/403ml-180

The 10 Commandments of LIS Troubleshooting

By Roy Motley

Problems involving new technology are
best solved with an old-world approach. Whether you are faced with an
isolated instrument glitch or searching out answers to deeper and more
technical dilemmas, these 10 Commandments offer a disciplined,
systematic, rock-solid route to customer-service solutions stone
tablets not included.

I. Thou shalt know thy symptom
before intervening. This first step is the most important. Poorly
defined symptoms trigger most of the misery involved in troubleshooting.
The instinct to “ready, fire, aim” is a primary sin that leads
to ineffective troubleshooting. Accurately and concisely define the
symptoms, as well as verify that they exist. Define the system area
responsible for the problem. As a hypothetical symptom, let us say an
instrument is failing to read the barcode on a sample tube. This symptom
is contained in the barcode system area.

II. Know thy processes. A system
area can involve many individual processes. For example, creating,
attaching, and reading the barcode labels are three different processes.
Define and investigate the individual processes in the system. A
properly defined problem is a joy to fix. A good troubleshooter is like
a detective. To properly define a problem, thoroughly examine the
instrument and interview the operator. Explore the logbooks for clues,
and ask the operators open-ended questions. Take good notes.

III. Thou shalt not do needless work.
Once you identify a problem and the proper process, use maintenance and
observation to attempt to fix it before moving on to more difficult
steps:

Watch and listen to the operation of the instrument. Look for abnormalities. It helps if you have experience with a properly operating instrument. In the barcode example, look for the red scan beam on the barcode reader. See if the lens is dirty.

Review the customer maintenance
log for entries pertaining to the area you are examining. Perform all
maintenance listed, even if it was recently completed. Routine steps
have quickly resolved many issues.

Look for simple, inexpensive
solutions that pose no threat to the system. Maybe the suspicious area
has an easy alignment procedure. Replace the ink cartridge and paper
on the printer.

IV. Thou shalt gain insight from
looking into the past. Investigate change! It worked yesterday; it does
not work today. What changed? Isolate the differences that may cause
this failure. Are the labels created in the ER the only ones that fail?
Did the failures start after scanner maintenance?

V. Thou shalt not exceed thy
capabilities or transgress into deep thought. Modern technology needs an
empirical approach to avoid “paralysis by over analysis.” Test
and experiment to help eliminate suspected problems in the process. Any
test that can eliminate a specific component is useful, but tests that
divide the failure into a specific area are invaluable. This is called
“divide and conquer.” If you had a thousand suspect components
in a system and could devise tests that split the system in half each
time, it would take only 10 tests to discover the cause.

Examine the diagnostic manuals to learn
more about divisional tests already built into many systems. The
manufacturer may have already developed an elimination process coupled
with automated tests. In the case of the barcode reader, using a
barcoded item that you know had worked within the past few days would
provide a valuable division. The most valuable division tool involves
Commandments I and II. Most of the likely causes can be eliminated by
properly performing these steps.

VI. Thou shalt not rush to conclusions.

Do not fixate on trying to resolve the problem. Instead, try using the
process of elimination to determine what is not the problem. Eliminate
each section until the cause is all that remains.

VII. Thou shalt not be led astray by
false prophecies. Be sure that what you find is truly the root cause.
Recurring problems are often due to this oversight. For example,
excessive debris in the read area could have dirtied the barcode lens.
The dirty lens is just a byproduct of the real root cause excessive
debris. Once a cause is isolated, verify that it is the root of the
problem. Always try to analyze why the component failed. During
root-cause analysis, have an alternate goal of making sure the problem
never happens again. For instance, if the root cause is poor
maintenance, new training in this area is needed.

VIII. Thou shalt not make matters
worse. Once the root cause is identified, formulate an action plan to
resolve the issue. Consider the safety of all personnel involved, as
well as possible harm to the system under repair. Take this step before
invasive procedures are performed.

IX. Thou shalt confirm all repairs.
Once you perform the repair, verify that the entire system is operating
properly. This step is often overlooked in the joy of success. Problems
introduced during the troubleshooting process can induce other unwanted
effects throughout the system.

X. Thou shalt approach this process
with joy in thy heart. Anger and panic have no place in troubleshooting.
A solution can be found. People made it thus; people can fix it. If
negative emotions emerge, take a five-minute walk. When you return,
concentrate on one thought: What experimental tests can be performed
that will narrow the focus of your search even further? By employing
this systematic approach, take pride in the fact that you are making
progress toward the solution by pinpointing the problem. Do not just
think of success as fixing the problem; narrowing the focus of the
search is success in and of itself and paves the way for the next step
in remedying the problem. That remedy, may involve you, another
technologist, a manufacturers help desk representative or even a
visit from a service engineer.

Success is within your grasp when you
use these problem-solving strategies and you shall even help add
long life to thine instruments.

Roy Motley is manager of automated
service processes for Beckman Coulter Inc. in Fullerton, CA.

March 2004: Vol. 36, No. 3