The shift in healthcare may require more of your LIS
Laboratory Information System
The future of healthcare will be built on data – data to support population health management and analytics to improve patient outcomes and promote cost efficiency. This comes as great news to laboratories, as they handle a vast majority of the clinical data providers use to screen, diagnose and treat patients. Laboratories that intend to thrive in the changing healthcare environment will require nimbleness and high adaptability to ensure longevity. To support this, laboratories need the most powerful, up-to-date and best-fit tools to successfully navigate healthcare reform challenges – and no single tool is more valuable to a laboratory than a well-outfitted LIS.
What a Difference a Decade Makes: Today’s Technology
The majority of LISs in use today are built on older technology, most more than 30 years old. Innumerable technological advances have taken place since most LISs were developed in both IT as well as in laboratory testing methodologies- and our overall healthcare goals have shifted. New, more complex testing and the need to make results available to clinicians faster continues to shape laboratory dynamics and LIS growth. The shift to a value-based system brings to light the need for integration and business analytics. Laboratory professionals and pathologists are finding new opportunities to be involved in best test selection, development of testing cascades and reporting of value-added test interpretations. Your LIS should be capable of supporting these initiatives that allow laboratorians to expand their role and increase their lab’s efficiency and value.
Presently, emergent technologies are becoming available that can offer enterprise-grade server and rich internet platforms. In a field still dominated by legacy systems, newer LIS technology can work with a wide range of programming languages and compliance standards, enabling laboratories of all sizes and types to communicate with each other and their external facilities. These solutions can provide a real-time, bidirectional, structured data framework and the superior connectivity capabilities that leaders in healthcare need to generate and deliver lab data to support patient-centered care and quality outcomes.
Lab Analytics? Healthcare Analytics
Internal laboratory analytics can provide management data that can boost lab productivity, and your LIS should be able to provide detailed laboratory analytics to assess and improve laboratory efficiency. This includes analytics for turnaround time, physician utilization, staffing workload, autovalidation percentages and other quality measures. Being able to recognize patterns in clinical data that can be used to inform decision-making and monitor and promote proper test utilization can boost lab value and improve the care patients receive.
To support the move toward improving our healthcare system, not only will robust internal lab analytics be required, but in addition, the LIS will need to be capable of participating in a system that combines lab data with data sets from other departments to find ways to make a greater positive impact on patient care and cost savings. Advanced lab-focused software is needed to leverage clinical data to make better strategic decisions that support population health management and patient-centered care.
Additionally, going forward, molecular and genetic advances are emerging that require advanced algorithms, interpretations and big data technology that older LIS technology cannot handle. Because these tests produce large quantities of data, new technologies will require a “big data” component that allows for mining and evaluation of large quantities of unstructured data.
Prepare for Patient-centered Care
Our new healthcare paradigm puts the patient at the center of its focus. Laboratory management’s view must extend beyond the lab’s inner circle and encompass the entire patient episode with an awareness of how the timeliness, accuracy and cost of a patient’s lab work impacts their episode of care and final outcome.
Parallel with this, patients are expected to become more involved and diligent about their own personal healthcare decisions. The lab must be forward-thinking and realize how this may influence its testing menu, volumes, testing locations and LIS needs. Consider the role that patient self-monitoring apps will play in the future and whether your LIS technology is advanced and versatile enough for this new paradigm of patient involvement.
Integration of POCT Takes on Renewed Importance
Point-of-care testing (POCT), because of its ready availability and quicker turnaround time, can offer substantial benefits, potentially reducing ER visits and hospital admissions. Because of the increased need for rapid TAT and the continued development of Accountable Care Organizations and other integrated delivery networks, it is anticipated that POCT will continue to increase. Laboratories need an information system (IS) solution that ensures that POCT results are electronically incorporated so that all healthcare workers throughout the network have access to the data to make timely, optimal care decisions. This will also allow data from POCT to be included in analytics needed for risk stratification and population health statistics.
LIS Needs Integrated Outreach Capabilities
Declining inpatient visits are compelling laboratories to expand outreach services, creating the need for more connections to physician EHRs, nursing homes, clinics and pharmacies. This creates a demand for full robust outreach operability that includes courier management, customer relationship management, supply and inventory tracking and services marketing. Look for an LIS solution that includes integrated outreach capabilities.
Your LIS Must be a Cost-effective Integration System
Laboratories can no longer afford inefficiencies or to be unaware of “hidden” costs. All IS solutions require support, upgrades, interfaces and modifications to stay up-to-date and maximize productivity. Consider carefully the amount of money spent on annual support and upgrades. Laboratories cannot continue to spend millions of dollars for support and hundreds of thousands of dollars for each software upgrade. When the cost of an upgrade is nearly as expensive as buying a new system, and that cost will be repeated every upgrade, this creates an opportunity for the laboratory to recommend an LIS that better supports its workflow needs and meets budgetary requirements.
Best-of-Breed vs. All-inclusive
In the journey to determine the best LIS fit for an organization, laboratories are often encouraged by upper management to consider the enterprise-wide LIS component that comes “included” with the EHR package. As EHR adoption continues to expand and healthcare organizations strive for interoperability, implementation of enterprise-wide solutions (EWS) can override consideration of other LIS systems that are considered best-of-breed (BoB).1 A BoB LIS is defined as a stand-alone system that offers optimum functionality as compared to equivalent competing systems.
With a large number of systems that need integration, it is easy to understand the lure of a single-source system. However, with improvements in interoperability standards making it just as easy to connect the better system, why settle for the lesser technology? In our new healthcare model where we must connect systems and share data, it makes no sense to limit your capabilities by using immature lab software that most all-inclusive choices offer.
Functionality Assessment Toolkit
If you are in the market for a new LIS, the Association for Pathology Informatics (API) offers an LIS Functionality Assessment Toolkit (LIS-FAT) to enable laboratories to more succinctly convey to their C-suite the complexity of lab IT needs. The toolkit’s Appendix I is an 850-item list of each LIS function.2 Laboratories in the process of LIS selection can use the list to grade each line item by its weight of importance.
The Lab’s Bigger Role in Patient Care
As healthcare moves toward the use of genomics and personalized medicine, laboratories will need an agile LIS capable of adapting quickly to change. Future focus will be on finding ways to use diagnostic testing to impact the Triple Aim goals of improving patient experience, improving population health and decreasing per capita costs. In addition to performing accurate testing, labs will have to look for improved test methodologies and opportunities to influence the total patient care episode. The lab will be required to expand its reach and will need a robust LIS that meets the intricate and complex needs of the laboratory now and into the future.
Kim Futrell is products marketing manager, Orchard Software Corporation.
1. Healthcare IT Index.” Healthcare IT News. Accessed at: www.healthcareitnews.com/directory/cloud-computing.
2. Association for Pathology Informatics LIS Functionality Assessment Toolkit. Accessed at: www.pathologyinformatics.org/toolkit.