Although automation is key to achieving greater efficiency and accuracy for medical laboratories, many find that laboratory information management system (LIMS) or electronic health record (EHR) interoperability and data integration are stumbling blocks to implementing electronic processes, according to a Medical Laboratory Observer industry survey earlier this year.1 Labs may encounter integration challenges from acquiring a series of incompatible data processing systems unique to each function or department over the years. The lack of standardization makes electronic data transfer between systems difficult if not impossible.
Switching to an all-in-one LIMS platform that seamlessly connects the lab’s clinical, financial, and administrative functions, plus offers EHR integration with providers’ offices, can eliminate these barriers.
Lack of interoperability and integration causes headaches
For clarification, interoperability is when two systems speak the same language. This differs from integration, which refers to translating data between systems. Since software may not originally be designed to communicate with other systems, integration is used to connect a new module to a legacy installation. If a lab utilizes software specific to each department, there may be disconnects in handing off data due to limited or no integration between systems. Accessioning, test processing, and analysis may be handled by one application, but results reporting may be done by another if laboratorians prefer a different format or to meet billing and insurance requirements.
The lack of interoperability and data integration across laboratory systems leads to more human data manipulation, which can increase the chance of errors. Lab managers must rely on technicians to relay data output from analytical instruments to the next workflow operation. When data is manually copied from one software system to another, there is a higher risk of transferring the data incorrectly, generating the wrong output, and a flawed report. In addition to producing inaccurate reports, manual data input lengthens results turnaround times (TATs). Healthcare providers (HCPs) may experience delays in receiving important patient test results, potentially impacting follow-up care. Also, entering lab data by hand is time consuming and requires more dedicated labor. Given the ongoing industry shortages of qualified personnel, labs may be limited in the number of orders they can process, which constrains revenue and business growth.
Diagnostic labs must collect and submit information such as test requisitions, lab reports, and patient medical notes to receive reimbursement from the Centers for Medicare & Medicaid Service (CMS) or private insurance.2 If the LIMS and revenue management software are not integrated, there can be significant lost revenue if charges are unbilled. Additionally, maintaining regulatory compliance and updating system security can be more difficult if the LIMS is unable to communicate with other laboratory systems.
Advantages of a fully integrated LIMS
So how can an LIMS that offers greater interoperability or data integration benefit clinical laboratories?
A modern LIMS, accessed through a single portal, allows labs to manage all their data in one place. It simplifies data exchange among test processing, report generation, billing, insurance, accounting, and other functions. Data is stored in one central location and is accessible to all departments. The platform automates many laboratory processes and aids in streamlining workflows. In addition, a more open system can easily interface with other types of previously installed software.
Ensuring repeatability and consistency of test data is a major challenge for clinical laboratories.
Mistakes can occur when data files are manually pulled from analyzers and copied into a formatted report, which is uploaded to a database. A fully integrated LIMS automatically takes data readouts from instruments and enters them directly into the lab’s central data system without making any changes. Directly integrating facility instrumentation provides real-time data importing and analysis.
An LIMS with advanced features can also process the data to make it more readable for the technician, clinician, or medical director. Though diagnostic tests generate vast amounts of data, clinicians need to focus on only a few key values. The LIMS can identify and highlight the most important data for targeted review by clinicians. This makes it easier to interpret and build an accurate report quickly. Thus, a fully integrated LIMS platform helps labs achieve process standardization for improved data quality, consistency, and ease of use.
A higher level of integration and connectivity enables more efficient test processing and faster TATs. Labs can deliver results much faster to physicians and their patients as well as increase daily test volumes. Predictable interoperability and integration throughout the lab can also ease staff overwork and significantly boost productivity. Less manual data transfer frees laboratorians to perform higher-value clinical work such as complex tests, data analysis, or results interpretation. Given ongoing industry staff shortages, reduced workloads and stress means less burnout, more job satisfaction, and better employee retention.
Improving revenue is another advantage. A platform that integrates the lab’s clinical and financial operations with client EHRs automates data collection and bill processing to improve insurance reimbursements. With shrinking test fee margins, measures to capture additional revenue take on greater importance. And as the coronavirus pandemic wanes, labs are expanding test menus to diversify beyond COVID-19 testing and attract new customers. They are seeking to repurpose molecular analyzers for other applications.3 More extensive integration of lab systems will be needed to manage a much broader range of diagnostic data.
Integration creates a laboratory–physician partnership
An all-in-one LIMS can help labs resolve their own electronic communication issues, but laboratory integration with HCPs in private medical offices, hospitals, and imaging centers benefits those organizations as well.
The LIMS can be directly integrated with patient EHRs located in HCP offices that utilize the lab’s diagnostic services. Such an interface enables faster exchange of bidirectional data: physicians administer patient tests, submit them to the lab for processing, then receive reports electronically. Faxing back-and-forth is no longer needed, eliminating paper documents, saving administrative time, and speeding results delivery.
An LIMS platform that communicates seamlessly between the lab, doctor’s office, and patients allows better management of patient information. By incorporating telehealth and other digital systems, it fosters closer connections to the point-of-care (POC). LIMS integration creates a partnership between medical laboratories and physicians that offers competitive advantages for both.
Cloud-based systems: A complete solution
Whether upgrading or purchasing new, medical laboratories should consider a cloud-based, SaaS LIMS that offers flexibility, scalability, and ease of integration with other laboratory equipment. These systems can transfer large files at high speed across lab locations or to external collaborators. They can also be installed quickly, do not require an up-front investment, and have low maintenance costs.
Cloud-based models provide automatic updates to ensure the lab maintains compliance with important regulatory, data security, and privacy standards such as HIPAA, HITRUST, and NIST.
Up next: Machine learning and artificial intelligence
Already revolutionizing other industries, machine learning and artificial intelligence (AI) are finding their way into laboratory software. Their use in an LIMS can address interoperability and integration barriers that arise when a lab utilizes a mix of legacy systems or each lab within a health system has a different LIMS. Non-standardization limits interoperability between systems and requires the use of machine learning to function.
Some cloud-based LIMS currently incorporate machine learning. They retain historical data from previous diagnostic tests, analyze the data, highlight trends, and make recommendations on what the data may be indicating. Although, the use of AI in LIMS is still under development.
Conclusion
Adopting an all-inclusive LIMS platform can overcome the significant interoperability and integration challenges faced by diagnostic laboratories. Cloud-based, SaaS systems can help them improve the quality and consistency of test results, boost productivity, expand testing capabilities and volume capacity, increase reimbursements, and reduce costs. And system integration with their medical practice clients helps HCPs provide better patient care at lower cost. As clinical laboratories plan for the future, advancing digital connectivity both internally across operations and externally with HCP clients and business partners will ensure their competitiveness and long-term sustainability in today’s evolving healthcare services market.
REFERENCES
- Nadeau, K. State of the Industry: Lab Data Analytics. Medical Laboratory Observer. February 20, 2023. Accessed August 10, 2023. https://www.mlo-online.com/information-technology/analytics/article/21294669/state-of-the-industry-lab-data-analytics.
- Nadeau, K. Best practices for lab management in 2022. Medical Laboratory Observer. April 20, 2022. Accessed August 10, 2023. https://www.mlo-online.com/management/article/21264293/best-practices-for-lab-management-in-2022.
- Nadeau, K. State of the industry 2022: Molecular diagnostics. Medical Laboratory Observer. October 19, 2022. Accessed August 10, 2023. https://www.mlo-online.com/molecular/mdx/article/21283753/state-of-the-industry-2022-molecular-diagnostics.
