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I am trying to develop and job description for LIS coordinator. What do you suggest and what are the national requirements for education and salary?

This is a good question and one that should be answered based on the goals and objectives that your facility has developed for this position. I would suggest that you meet with some key players (lab manager and IT contact at a minimum) to discuss the role that you’d like the LIS coordinator to fill. Are you looking to have a liaison between your technical staff and the clinical personnel or is this person strictly in a clinical or technical position? What responsibilities will the individual filling this position have and who will he or she report to?
You should also check with peers, and network to determine what other facilities have included as key functions in the job description. While each facility will be different, you can pull relevant information to use for your facility.
I don’t believe that there are national requirements or standards for this position. While CLIA does have personnel standards for laboratory director, technical and clinical consultant, technical supervisor, and testing personnel , there is not a personnel standard for LIS coordinator. When calculating salary, you will need to take into account your geographic market salary range, the applicant’s job experience and level of education required into consideration, as well as your facilities current salary/compensation grades and or ranges.
Keep in mind that a job description should clearly outline the role and responsibilities of the position in order to attract the proper applicants. You can also utilize the job description as a basis for creating goals and standards of performance for the individual who fills the position.

We have developed our own home grown LMS system which is quite suitable to our derm lab. However, we are now interested in HL7 and we are not sure where to start. What do we need to know and where do we need to 'get' HL7?

For those who are not aware, Health Level Seven (HL7) is an not-for-profit organization involved in the development of international healthcare standards. The term HL7 usually references a specific set of standards that provide a framework for the exchange, integration, sharing and retrieval of electronic information in the healthcare community.



Based on your question below, I assume you have the need to share data with another patient information system within your facility. If so, I recommend starting at the source for HL7 information, the Health Level Seven website www.hl7.org. You may want to consider joining as an organization member. Organizational membership includes benefits such as the ability to distribute current HL7 standards (specifications).



When implementing an interface to a 3rd party vendor, the process usually begins with sharing specifications and sample messages. You may also want to consider whether to purchase an interface engine (to format outbound messages and import inbound messages) or to build your own. Whether you build your own or purchase an engine, creating an HL7 interface is no small undertaking. You may want to consider purchasing a seasoned LMS with this capability.



A word of caution, while the HL7 specification does a great job of identifying fields and placement of laboratory data, it is subject to interpretation. Therefore interfacing to a 3rd party vendor will have to be fine tuned. This means carefully following your established validation plan once the interface is technically completed. The entire validation process must be completed before the interface is placed into the production environment.

I have been just put in charge of getting an LIS system in out student health center laboratory. We will be using Pyramid EHR in the near future. I need some help to get me started in this process.

The first step is to select an LIS that has experience interfacing with the PYRAMED EHR. Since the EHR is uniquely designed specifically for university student healthcare centers, it is important that the vendor have proven success with the specific interface. I would imagine this step would significantly limit your choices. While selecting the analyzers for your center is an important step early in the process, the analyzer selection will have very little bearing on the interface between your EHR and LIS. Most LISs should be able to interface to the analyzers you choose.

Most LIS vendors will tell you if they have interfaced to your specific EMR/HER, and can provide references as well. As healthcare moves toward becoming more interoperable, your vendors’ experience with developing and implementing interfaces will have a significant impact on your overall investment in your LIS. If you can find an affordable product with superior product support and a vendor with experience, you will be on the right path for a smooth implementation process.

In the near future I am hoping to implement a LIS system in our SHC Laboratory. Is there a LIS that would be easy to use for manually entering lab testing. The only automation we have is a CliniTek100 and an Excell 16 Hematology Analyzer. The majority of our testing is non-automated, eg. wet mounts, mono tests, rapid strep, KOH preps, urinalysis + microscopic, urin hCG, flu test, etc. How would a system hook up for all the manual testing procedures?

It would be difficult for me to objectively recommend a system as I am currently the President of a Laboratory Information System company. There are a variety of systems on the market that will serve your needs. The fact that most of your testing is manual, simplifies the process since there will be limited need to establish complex interfaces to the analyzers. Since your staff will be primarily entering the results manually, I suggest a system that has built in rules to help minimize transcription errors. For example, results should be able to be locked down for certain tests (e.g. Pregnancy results should be limited to Positive or Negative) or if you are entering a numeric test result, the system should support flagging/warning out-of range, critical and invalid results for each test. The rules criteria should be based on patient information such as age, gender, etc… I don’t know if your laboratory is decentralized, but if so you will need a system that allows for manual testing that occurs in different locations. If this is the case, you should consider an LIS that can easily connect over the internet or a wide area network.



As far as how the system would support manual testing procedures, the system should be able to sort/display pending tests for manual entry in a variety of formats to simplify result entry as much as possible. In other words, if you have a tech who exclusively runs UA, security privileges allow the tech to only access UA tests to be resulted. Or if the lab manager only wants to enter tests that have been run at location X, on a particular date, and is only interested in resulting certain tests, they should be able to pull up a list that filters only the desired tests.



Based on your description, my last piece of advice is that your LIS requirements support the purchase of a medium to smaller system. With the advances in technology, the smaller systems should have the functions that I described. When shopping around for your system, it’s important to consider the product support that comes with your LIS purchase. Do not focus too much on the least expensive package, as you will want to be sure to go with a reputable vendor that has experience in your market segment and is a company that has shown sustainable growth.

What LIS companies serve labs in resource-poor countries?

I would presume there are several LIS companies that would be willing to serve these types of labs but I am not aware of a definitive list of these companies. My company recently placed a system in Malawi, Africa in a pediatric AIDS clinic. In this particular scenario, the laboratory was funded by the University of North Carolina. The University collaborated with the Kamuzu Central Hospital of the Malawi Ministry of Health in Lilongwe, Malawi Africa to provide laboratory services for HIV testing. The UNC project mission was to identify innovative, culturally acceptable, and relatively inexpensive methods of reducing the risk of HIV and STD transmission through research; strengthen the local research through training and technology transfers; and to improve patient care for people living with HIV and AIDS.



Unfortunately, most of the labs that are run in resource-poor countries are not well funded. They are typically small office laboratories and these smaller labs typically purchase manual or semi-automated analyzers that are not capable of interfacing. This means they are relying on the tapes and paper printed from the analyzer to get the results out. While these labs are still primarily manual, with limited automation (LIS as a lower priority), there are usually a limited number of larger labs that are funded by the government that do require an LIS for quality assurance compliance and data interoperability.