In today’s healthcare environment, most key medical decisions are based on the results of lab tests. It may be a routine blood test, a complex genetic test, or a biopsy to determine the presence of cancer. The result of a lab test determines the direction of treatment. But how does a lab handle thousands of samples, prevent them from getting mixed up, and provide the results to the doctor on time?
The key to this is the concept of a Laboratory Information System, which is commonly known as an LIS. This is essentially specialized software which is the nerve center of the lab because it is what manages every aspect of the testing cycle right from the time the sample is collected to when the results are finally generated.
The Primary Task of an LIS
First and foremost, an LIS is a data management tool that is intended for tracking and storing information related to lab tests. Nevertheless, saying that an LIS is a database is an understatement of a rather extreme nature. A high-quality LIS is a workflow engine. This tool is intended for managing a series of events that must be accomplished with infinite precision.
The general process that a sample undergoes in an LIS system comprises the following steps:
- Order Entry: The system will receive an order request from a clinician. This request comes from an integration of an Electronic Health Record.
- Accessioning: A tracking number and a barcode are given to the specimen by the lab.
- Processing and Tracking: It follows the sample through the stages of the different sections, such as histology and/or chemistry.
- Resulting: The data findings from either technicians or instruments will be put into the system.
- Validation: The results are validated by pathologists or senior scientists for accuracy.
- Reporting: The system produces a professional and easy-to-read report that can be viewed by the physician.
Various Kinds of Laboratory Information Systems
Given that not all labs conduct the same kind of work, there are several specialized kinds of LIS systems.
Clinical Laboratory Information System
These types of software are for high-volume testing, such as blood chemistry, hematology, and urinalysis. Because these labs handle hundreds or thousands of tubes of blood a day, the software is highly focused on automation and instrument interfaces. Here, the goal is speed and reducing manual data entry.
Anatomic Pathology LIS (AP-LIS)
AP-LIS is needed in pathology labs where solid tissue is handled, such as in biopsies and surgical specimens. This is because anatomic pathology is highly visual and requires human interaction, unlike clinical labs where the instrument does the work. The system should be able to handle complicated tasks like grossing, processing, staining, and microscopic examination. Another area where the system should be very useful is in synoptic reporting, which aids in the documentation of cancer diagnosis.
Molecular and Genetic Systems
With the advent of personalized medicine, molecular LIS platforms have become the norm. These platforms are required to process the huge amount of data that comes from Next Generation Sequencing. They also need to be able to handle genealogical data, reagents, and bioinformatics pipelines for the interpretation of genetic variants.
Toxicology and Public Health Systems
Toxicology labs, for example, need an LIS with the capability to support the documentation of chain of custody and complex mass spectrometry results. Public health labs, conversely, require an LIS with the capability to support the reporting of infectious disease results to governmental agencies, such as the CDC.
The Role of LIS in Pathology Labs for Achieving Excellence
Pathology labs: A laboratory information system in a pathology lab is much more than an electronic file cabinet. A laboratory information system is a quality assurance and efficiency instrument. This is how they are utilized in practical, everyday applications.
Patient Safety
Patient safety is the most important function of an LIS: preventing errors. The LIS prevents the wrong test from being carried out on the wrong patient at every stage through the use of barcode technology. In the event the technologist decides to scan the wrong slide for the patient’s case, the system automatically raises an alert. Such is the importance of an LIS.
Workflow Management and Bottlenecks
The lab managers are able to track through the LIS dashboards exactly where each sample is at all times within the lab. If the histology lab is behind on staining slides, the lab manager will recognize this problem and adjust the staffing to prevent a patient result delay. This could not happen with a paper-based system.
Regulatory Compliance and Audits
The laboratory is also the most regulated environment on the planet. The laboratory has to meet the guidelines of CLIA, CAP, and HIPAA regulations. An LIS will record every action performed on a specimen in the laboratory; therefore, if the inspector wants to know who did a particular test or when a particular piece of equipment was last calibrated, the information can be obtained in seconds.
Financial Management
Financial: Many LIS systems have billing components as part of the system. This helps to ensure that the appropriate CPT coding is associated with all procedures performed so that the lab can be reimbursed as efficiently as possible. This system helps the lab to eliminate “revenue leakage” because it identifies all the procedures performed when the patient is being diagnosed.
Pioneers in LIS Solutions
Software selection is an important step for every lab. The market is quite varied, although some companies have managed to stand out from the rest and are recognized as market leaders.
NovoPath
One of the best laboratory information system providers, especially famous in anatomic pathology, is NovoPath. Their product, NovoPath 360, has been developed to be a comprehensive and cloud-based solution that optimizes the whole lab process. NovoPath 360 has been greatly appreciated not only for their user-friendly interface but also for minimizing the number of mouse clicks needed by a pathologist to sign out a case. By emphasizing automated workflow and flexible reporting, NovoPath assists their clients in enhancing their lab throughput with unwavering standards of diagnostic excellence.
Orchard Software
Orchard is a well-respected brand in the inpatient and outreach laboratory environment. They provide a variety of products, including Orchard Harvest and Orchard Sequoia, which are intended for small physician office laboratories all the way up to large hospital enterprises. These products are well-liked for their flexibility and robust rule engines.
Clinisys
As a result of the merger of various large informatics brands, Clinisys is one of the biggest diagnostic health informatics companies in the world. They have worldwide solutions that range from various fields such as clinical, histology, and molecular. They design solutions that can manage large data volumes of reference labs and health systems.
CompuGroup Medical (CGM)
One such company offering a Laboratory Information System (LIS) is CGM, which provides the popular LabDAQ. This system enjoys a wide following, especially within the USA. It is a versatile system common within community hospitals as well as independent labs. It enjoys a reputation for having good technical support and the capability of interfacing with ‘hundreds of different instruments within a laboratory setting.’
LabVantage
Though sometimes classified under the general category of Laboratory Information Management System (LIMS), LabVantage has comprehensive solutions for the clinical and diagnostic sectors. It has an entirely web-based system and is usually selected by organizations that require the integration of clinical diagnostics, R&D, and biobanking.
The Evolving Role of the LIS
The future of the Laboratory Information System is closely linked to the emerging field of digital pathology and the use of artificial intelligence. The days of pathologists examining slides under the microscope are dwindling. Now, they are increasingly examining high-resolution slides on the screen.
A contemporary LIS needs to be capable of handling such huge image files and be compatible with algorithms from AI that would help point out areas of concern on a slide. This is what is referred to as an “augmented” pathology because of faster screenings and more reliable outcomes. Also, with a cloud-based system for an LIS, a pathologist from another city can instantly give a second opinion from another time zone. Ultimately, although the technology used within a Laboratory Information System is complex, its purpose is not. It is there and serves one purpose: every patient must receive an accurate diagnosis as quickly as possible. Through its organization of chaos within laboratory data, the LIS allows doctors and other health care providers to save lives daily.
