Vol. 14 •Issue 13 • Page 14
LIS Selection Guide
Research your unique requirements before purchasing or upgrading your LIS.
If you are looking to acquire your first laboratory information system(LIS) or looking to upgrade your current DOS-based data manager to a full LIS, there are critical areas you should review to make sure you get the system that meets your needs. The requirement of the LIS will vary depending on the lab environment, but since all labs perform the same core functions each will have common needs. Of course, the buyer should closely examine requirements that are unique to his testing environment.
Here, the definitions of many of these areas of interest will be reviewed. Table 1 provides a shopping list of capabilities and features that you can use to select your new systems.
It’s a Windows™ world and this is not a bad thing. There are other operating systems that are just as robust (i.e., Unix and Linux), but Microsoft has made choosing the Windows architecture the obvious choice for both capabilities and cost of acquisition. Please be aware that there are remaining in the market a few older DOS products still using the Windows format as a shell. Your key question to all vendors is to make sure that the core program code is a 32-bit architecture. With the launch of Windows XP™, Microsoft officially put DOS to sleep forever. If the system you are exploring can’t use Windows XP, then it may still be using DOS-based coding.
Ease of networking is again why the choice of a Windows-based architecture is the logical choice. Consolidating data is great, but communicating data is the real goal. Even the smallest physician office lab (POL) now or in the near future will base its business operations on a series of networked computers. These “local area networks” (LANs) will probably also be using Microsoft’s networking software (NT or 2000) to facilitate network communications. This software is equally adept at supporting “wide area networks” (WANs). A WAN connects multi-site facilities into a single network using phone systems to facilitate the connections.
We do not mean this to be a commercial endorsement for Microsoft, but a simple statement of a pragmatic view that in health care, like the business world, this architecture will present the shopper with the most buying options. Of course, with the options comes competition and with that the shopper can expect to receive a better value.
Getting the lab’s data out to the people who need it is the primary productivity goal that any LIS system should achieve. Most systems are capable of network printing to multiple locations or producing a Fax transmission of patient results. New systems should also employ Internet capabilities to achieve productivity for the physicians who are the ultimate end users of patient data. The Internet is here to stay and its use will continue to grow in popularity for both health care providers and their patients.
In most health care venues, multiple software products are employed between various departments. Practice management systems dominate the business functions of the practice. Electronic medical record systems, though not nearly as common as practice management or LIS systems, are more directly used by the physicians. All of these systems capture and store patient demographics and specific patient data pertaining to their function. The ultimate productivity of any practice using multiple software systems can only be achieved when these systems become interfaced. In employing an interface, data from one or more systems is automatically captured by the other systems. Implementing an interface can be a time-consuming and expensive effort but, once completed, the productivity gains continue to pay dividends for the practice for years. The initial investment may seem costly, but again this investment will pay off.1
With the passage by Congress of the Health Insurance Portability and Accountability Act (HIPAA) in 1996, LIS security has taken on new emphasis. Although a practice’s internal policies have much more to do with HIPAA compliance than a software product, the software products used by the practice should support these policies.
Communications from your LIS should meet HIPAA compliance for encryption and methodology. Users should be prompted to log on and off the software to ensure that unauthorized access is prevented. The LIS should have full transaction capture, indicating any manipulation of patient result data. Advanced systems will also log access to data and record the individuals that requested the data.
Ready to Shop
It is important to note that LIS systems tend to last a very long time within a facility, so your system decision will impact the practice for many years. Shopping for a new system should involve a process. Make sure that everyone at the practice becomes involved. So that the process doesn’t get bogged down in committee, it’s also important that a leader, usually the lab manager, be designated. It is this individual’s task to become the final arbitrator of any system requirements.
There needs to be a design document to be used as a roadmap in selecting the new system. We suggest that you utilize the areas we have discussed, the table provided and a list of your practice’s specific needs to develop this specification.
Armed with these tools and, of course, your budget, you should be able to find systems that will meet your goals. Once identified, you can validate your choice by obtaining demonstrations and references to support your decision.
1. Ostrander, C. A guide to system integration. ADVANCE for Administrators of the Laboratory 1997; 6(1):58-60.
Richard Jefferson is a freelance writer and speaker on health care issues. He also is director of sales and marketing at Antek Inc./LabDAQ, Westminster, MD.