— Bob Gregory, Chief Business Officer
Provider of patient-centric outreach and connectivity solutions including LabWorks, as well as HealthCentric EMPI
Further, with upward of 20 different reporting standards vying for popularity, adding more standards for providers to meet could cause unnecessary stress. A better answer lies in a single software solution that can be used to translate different types of lab data and, like a scaffold, support connectivity and interoperability among laboratory service providers using any number of different technologies and data reporting standards.
Enter today’s emerging enterprise-grade server and application development frameworks. Such solutions provide a real-time, bidirectional data and services platform that permits providers and lab services to cleanly and efficiently exchange data regardless of type, standard, hardware, or laboratory information system characteristics. In addition, such solutions function in real time and provide zero-downtime deployment of bidirectional data packages.
In a field still dominated by legacy systems, these solutions can work with a wide range of programming languages and compliance standards, enabling laboratories of all sizes and types to communicate with each other, as well as outside facilities, easily and efficiently. Moreover, healthcare organizations are able to transmit patient test results and other data directly into electronic health records.
These capabilities not only have immediate application to today’s challenges with respect to laboratory connectivity, but will continue to be required well into the future as labs strive to meet the demands of an increasingly diverse and value-driven clinical environment.
— Ralph Katieb, solutions architect
EISe Enterprise Integration Server
“Cherry-picking” the pieces
Another aspect to this flexible future is that lab software will be hosted in the cloud, which again frees the labs from old-fashioned, huge installations like LIS systems. It gives the lab almost instant and untethered software access, which enables management of the lab from any workstation or laptop at any location. Because cloud-based hosting makes for an easy and quick deployment, the lab can leapfrog over old-fashioned server and network requirements.
To sum up, when it comes to clinical lab quality management and document control software, the features and functionality have reached maturity, and have high rate of uptake. But what’s new is how labs can access them and purchase them, using cloud-based technologies and cherry-picking exactly what they need—giving them maximum flexibility.
— Craig Madison, Senior Partner
Developer of the SoftTech Health LabQMS system
Extending beyond the lab
This, in turn, means that software providers will need to focus their efforts both on meeting the regulatory requirements and providing more innovation within their solutions. With cuts and more oversight being focused on the billing and reimbursement of tests, the labs need to be focused more on the operational aspect of their business in order to be successful. One of the most important areas, and the foundation of that analysis, is within the laboratory solutions. LIS vendors need to provide better connectivity with more reach throughout the lab.
An LIS solution is no longer just a single component; it is a central component that needs to extend beyond the lab. The view needs to extend from the patient in the physician’s office who, it has been determined, needs lab work all the way through to the delivery of the diagnosis and treatment plan—and back to the patient. In the case of molecular and cytogenetic testing, the process may begin even earlier—when a couple starts to think about pregnancy—and continue through generations. The lab, as a business, needs to ensure that each of its areas is functioning to capacity both through the laboratory solutions that are implemented and through the full use of those as a management tool for conducting analysis in every aspect of the business, from the time a test order is initiated until that test is paid for.
— Lisa-Jean Clifford, CEO
Provider of WindoPath LIS and EMR Hub
Promoting rapid diagnostics
Clinical laboratory software, now and in the future, must have the functionality to allow the laboratory to be a part of the clinical decision support system for providers—enabling laboratorians to monitor test utilization and be involved in promoting appropriate test selection, use rules-based support tools to automatically implement testing cascades and algorithms, and provide valuable reports with the desired clinical data to support organizational goals.
In the future, as diagnostics moves toward the use of genomics and personalized medicine and we traverse down new pathways, laboratories will need a strong software partner that is extremely agile and able to adapt as testing patterns shift and diagnostics continues to move to the forefront. The LIS and the EHR will need to work in tandem to monitor population health dynamics, and these software capabilities must be able to continually advance and become more sophisticated to support more standardized, data-driven, best practice models.
— Curt Johnson, Chief Operating Officer
Provider of Orchard Harvest LIS, Orchard Pathology, Orchard Sequoia, Orchard Trellis, Orchard Copia
Monitoring pain management
The results are displayed in an easy-to-read tabular format. Medication dosages should be tracked, and the LIS allows users to enter the dosage for each prescribed medication. For those labs that only provide drugs of abuse screening, an interface with the confirmation lab will electronically send orders to the reference lab and provide a consolidated final report.
Specific pain management features may include:
- Drug Adherence Report for easy identification of consistent and inconsistent test results
- Connectivity to both drug screening and confirmation testing instruments
- Automated rules to alert if a specimen is suspected of adulteration
- Automated ordering of confirmatory tests based on screening test results.
— Jim Kasoff, President, Laboratory Division
Provider of CGM LabDAQ Laboratory Information System, CGM Labnexus Laboratory Outreach Solution
Lab management in a single system
The power to manage the entire clinical laboratory provides the opportunity to have a complete holistic view of the laboratory, driving the development of business intelligence reporting and dashboards. These metrics will enable labs to baseline their performance, identify inefficiencies, and implement improvements. This process will ensure that lab operations are continuously monitored for performance and that improvement is implemented throughout the clinical lab. In addition, as the number of labs with outreach programs increases—accounting for an estimated 25% of hospital testing—software that supports quality metrics for new reimbursement models and physician satisfaction will become a necessity.
In the future, cloud-based computing will certainly play a role as laboratories and IVD vendors explore the benefits and challenges of adopting this technology in a clinical care environment. Of course there will be challenges to overcome—for example, delivering a cloud solution that can ensure that critical software applications continue to have optimal up-time. Also, laboratories will need to become more comfortable with their sensitive data residing outside their premises.
— Jeff Raponi, Senior Informatics Manager
Provider of diagnostic and clinical IT products
Adapting to a changing environment
— Jim Terrano, President & CEO
Providers of point of care data management and revenue cycle management software solutions
Combining best-of-breed and enterprise-wide
Today, the debate centers on considering a best-of-breed approach, where the healthcare provider selects software systems to address each departmental need regardless of the number of vendors involved, or an enterprise-wide approach, where the healthcare provider selects a solitary vendor to meet the needs of all of the departments. The best approach will be a combination of both lines of thinking: reduce the number of vendors to a manageable few while at the same time augmenting the enterprise-wide solution with a best-of-breed approach when the enterprise-wide vendor has an application that falls dramatically short of meeting the business needs. The best-of-breed vendors that will survive in this new environment will be those that seamlessly interface to other software systems while providing departmental functionality that surpasses that of the solution offered by the enterprise-wide vendor.
— Rick Callahan, VP, Sales and Marketing
Provider of NovoPath Anatomic Pathology Software Platform
Implementation of middleware
The key to the successful implementation of middleware is the testing of the middleware in conjunction with the LIS to verify accuracy among all systems. Automated testing and migration tools that help streamline this software implementation process and easily move customers from version to version with all rules, settings, and patient data intact are being sought by clinical laboratories that want to implement their middleware faster, with less effort, and with a greater degree of standardization.
— Anne Tate, Group Manager/IT Automation
Maker of Sysmex WAM Decision Support Software for the Clinical Laboratory
Vertically focused data platforms
These data platforms will serve business applications across the spectrum such as analytics, regulatory reporting, physician reporting, patient reporting, mobile access, etc. Building a data platform such as this will require:
- Laboratory expertise: a deep understanding of the laboratory ecosystem and the challenges our industry is facing today; and
- Versatile technology: Aggregating, cleansing, and managing data that scales across the laboratory’s requirements needs a consolidation of technologies such as data aggregation, big data, and a scaling infrastructure
Limited IT resources continue to be a challenge and cannot scale fast enough to the laboratory’s needs. Data platform technologies will form the basis of data access and delivery at the next generation laboratory.
— Dhiren Bhatia, CEO
Provider of the Viewics Health Insighter and Viewics Pulse Business Intelligence Platforms
The importance of interoperability
— Jamel Giuma, Product Manager, Interoperability & MU,
As the foregoing contributions from an even dozen industry leaders more than demonstrate, the universe of topics and solutions within the broad subject of software for the clinical laboratory is a large one indeed. New products and services available to labs are emerging as the frontiers of IT technology are extended, and as best practices develop in response to increasing outreach opportunities and changing regulatory requirements. MLO thanks the experts who contributed to this “Future Buzz.” We are confident that their important perspectives are valuable and illuminating to readers.