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The laboratory information system, or LIS, is a critical part of the successful clinical laboratory. Driving that importance is the automation, efficiency, and reliability afforded by the software's total connectivity.
Through interfaces and connections to analyzers, electronic health records, practice management systems, reference laboratories, and more, a good LIS—sometimes referred to as a LIMS, or laboratory information management system—promotes efficiency in the lab, streamlines workflows, and ensures speedy, accurate data transmission.
When we think of the lab, the first thing we imagine are the analyzers, or the instruments used to test blood and other samples. Every instrument is different, but all require some kind of data entry before running a test, and all produce some kind of result afterward.
In the most basic case, a uni-directional interface creates a one-way street for results to travel automatically from the instrument to the lab's software and database.
Beyond that, bi-directional and host-query interfaces create a pathway for two-way communication.
Sample preparation and analyzer configuration combine to create a cumbersome manual process. A well-connected LIS streamlines this workflow by transmitting testing data directly from the lab technician's workstation to the analyzer itself. A host-query interface streamlines the process even further by allowing an analyzer to scan the barcode on a sample and automatically request the needed testing information from the LIS. Because it's a two-way street, the results travel back to the lab software, as well.
As pointed out by Medical Laboratory Observer, an electronic health record, or EHR, is designed to store a complete digital patient record including "patient history, physician notes, radiology images, vital signs, and laboratory test results."
While users can enter anything manually, that process is time-consuming and prone to transcription errors. Once again, an interface to the lab's LIS streamlines the process and assures the integrity of the recorded data.
"I worked in a busy physician office lab where we ran tests for 50 to 60 patients a day," said CGM SCHUYLAB Sales Enablement Manager Beth Schmitt, who was formerly a lab manager in Princeton, Indiana.
"We did all orders and results on paper for 20 years," she said.
When her lab purchased its first EMR, it neglected to establish the interface between the electronic medical record and the LIS.
"We did a lot of double work. All orders had to be entered into both the EMR and the LIS," she said. Beth printed results for physicians who later had to accept the results again after she entered them into the EMR. "Needless to say, I was there late some nights trying to get the reports into the EMR and clear the queue for the next day."
Eventually, her lab upgraded its EMR system and finally implemented the connection between the EMR and the LIS.
"Test orders would cross into the LIS right away, and results would flow back as soon as the tests were completed," Beth said. "Providers could make notes for the lab directly within the EMR, and they only had to review reports once. The time saved was tremendous!"
As we've already seen, a laboratory information system's ability to interface with important health software streamlines the entire testing process and ensures that no patient health data goes missing. This is just as true with a connection to a hospital information system or practice management software as it is with the EHR.
Having all of a patient’s data in one location can be critical during an emergency. All data, medications, and demographic information can be accessed quickly and easily thanks to the integration of all the information systems.
With this connectivity, caregivers do not find themselves printing orders and results and sticking them under a patient’s pillow during transport. Caregivers simply log in to see what information is already available.
By sending and receiving data through the industry standard Health Level 7 (HL7) format, lab results link automatically to other important data including billing information, appointments, and patient history.
Of course, it's not possible for every lab to handle every kind of test. For high-volume or specialty testing, we turn to national or regional reference labs for assistance.
A well-connected LIS can send and receive data to and from other laboratory information systems. With a direct interface, a reference lab receives its testing information long before the samples even arrive. Similarly, a reference lab uses its LIS interface to send results quickly to the labs, providers, or patients who need them.
These reference lab interfaces can also be bi- or uni-directional. For example, a physician office could print a paper requisition and receive the results electronically. There are many options to fit the needs of every lab.
A reference lab itself may opt for another type of connection to help streamline the order and results process. Sometimes the volume of testing isn't high enough to justify a direct interface to a provider's EMR, or maybe the lab wants to provide an option for direct patient access to results. When this is the case, labs can employ a web portal such as CGM LABNEXUS or CGM SCHUYNET to facilitate online access to orders and results.
Providers, patients, and labs aren't the only ones connected by a strong LIS. Sometimes a lab is required to report some of its data to a local, state, or national agency.
For example, every US state has a reportable diseases list, and many of those must also be reported to the US Centers for Disease Control and Prevention, or CDC.
To help states meet the requirements for reporting cases of COVID-19 in 2020 and 2021, CompuGroup Medical established interfaces to state health departments for clients across the United States.
The clinical testing process involves an ever-increasing number of variables and touchpoints. Sometimes there's a provider ordering through his or her EMR. There's the variety of instruments and analyzers in the lab or at a reference lab across town. There's a web portal for direct patient access to results. These are just some of the possibilities as orders, results, and billing information travel through disparate systems. Luckily, this web of possibilities has one critical element at its center: the laboratory information system.