By: Gary Tufel
Although the subject matter of laboratory information systems (LIS) is relatively broad, says Dan R. Angress, chief commercial officer, PathCentral, Irvine, Calif, “When we use the term LIS, it can refer to everything from large hospital lab systems focusing on throughput and clinical results to our specific space which is anatomic pathology LIS where our target buyers are pathologists who have much different needs.”
Without getting into too much detail, Angress offers his take on the overlying trends for the lab industry in general, which includes clinical and anatomical.
• Cloud computing. People want the option to outsource data to the cloud for several reasons. The cloud should not be considered just an all-or-none solution. There are pieces and parts that can be stored while local production is hosted.
o It makes access easier for others including, in the near future, the patient
o It saves money
o It provides for much more flexibility for scaling—think of hospital mergers where each hospital has a different LIS
• Connectivity. All labs wants cheaper and efficient means to interface to their clients for several reasons
o Meaningful use act encourages physician offices to get an EMR and use it by connecting to others
o An interfaced client tends to be a sticky client
o The ease of interfacing has gotten faster and cheaper for many LIS companies
• Managing comprehensive and unique data files. This includes digital images, complex reports generally confined to the pathology side and converted to PDF, combining other parts of the patient’s record outside of the lab including radiology.
o As background, a traditional hospital LIS handles discrete data such as numerical cholesterol results. It does not handle images. If a path report with images and a lot of text needs to be stored in the hospital LIS, many do not have the capability via an HL7 standard interface to handle. The workaround is transferring this data via a PDF, which only some systems can handle. The trend is toward a more open, robust platform that uses tools compatible with many systems.
• Networking. This has multiple meanings, but Angress is referring to the ability to use social networking technology to link groups of health care employees together to share data of many types. In his area, PathCentral is launching a pathology-specific tool where images can be shared and consultations can happen online anywhere in the world.
“These are the four big ones in my mind. I’m sure there are a dozen more trends others may pose, but I see these as driving our business model,” Angress says.
“When we use the term LIS, it can refer to everything from large hospital lab systems focusing on throughput and clinical results to our specific space which is anatomic pathology LIS where our target buyers are pathologists who have much different needs.”
~Dan R. Angress, chief commercial officer, PathCentral, Irvine, Calif.
DATA MINING AND DASHBOARD: NEW SOLUTIONS WORK WITH IT AND BUDGET CONSTRAINTS
When it comes to challenges in data mining, Justin M. Clark, founder, Millennial Consulting, Austin, Tex, says that organizations fear the involvement of the IT department in any new purchases.
That’s because IT teams are typically overwhelmed, and some think they can develop a similar in-house product. “The challenge for any BI [business intelligence] or data mining company is to have a solution that requires little to no internal IT involvement while being able to connect with data points that have been hard to connect with in the past,” Clark says.
He says there are two types of BI solutions: ones that serve only one specialty, and the scalable BI tools such as Viewics that are designed to scale throughout a wide range of specialties.
Another challenge: the connectivity of these BI tools with LIS, payroll, and consumables’ purchasing systems. “Finally, you want your BI tool to offer the ability to drill down into the data the tool is referencing to generate its reports,” Clark says.
Tim Kuruvilla, vice president, sales and marketing, Viewics, Sunnyvale, Calif, notes that with Electronic Health Records (EHR), Health Information Exchange (HIE), ICD-10, and the myriad of other initiatives in the health IT world, IT teams are severely resource-constrained. However, they are still relied on heavily to extract data from cumbersome information systems and create reports for the functional users. In addition, maintenance of these legacy business intelligence solutions and their associated databases is also very time-consuming. Business intelligence may be a priority for the operations team, but IT teams just don’t have time for it among all of their other mandates, he says.
Viewics creates and manages a database that is optimized for quick and efficient data analysis. “There is no risk of latency to the underlying information system and sophisticated analyses can be created within minutes."
More often than not, Kuruvilla adds, business intelligence solutions require that users have knowledge of SQL or other technical expertise to extract, share, and drill down into information. Thus, the operations team is constantly requesting reports from IT departments to manage their daily needs. Due to the separation between the creation and the consumption of reports, there is tremendous inefficiency. IT may not be well-versed with the exact functional context of a report request. Thus, even after the onerous process of having a report created, it is often sent back for additional edits. Once the operations user sees the data, it is also often the case that he or she discovers they really want something else or will require additional detail. This leads to a back-and-forth exchange between the operational and IT departments, which is not only time-consuming for both parties, but there are significant delays in accessing the information required and action may be taken too late.
Running, managing, and editing these reports requires a significant amount of time, Kuruvilla notes. For example, reporting tools such as Crystal, which are often packaged with health information systems, often query the transactional database. Since the transactional database is not structured for analytics, these reports take hours, if not days, to run. Often, a runaway query or error is only identified after several hours; if there is a runaway query, there can be tremendous impact to performance of the information system itself, which IT also has to follow up on. Kuruvilla notes that Viewics creates and manages a database that is optimized for quick and efficient data analysis. “There is no risk of latency to the underlying information system and sophisticated analyses can be created within minutes,” he says.
Limited budgets and IT time/resources are often key challenges to adopting business intelligence solutions, says Kuruvilla. These are challenges not only faced by health care organizations, but also other industries. In light of these challenges, hosted or Software-as-a-Service (SaaS)-based software is growing rapidly. SaaS solutions minimize upfront costs incurred by the IT organization for software licenses, as well as infrastructure costs required to support the product. SaaS solutions are not only deployed with minimal involvement from IT departments, they also take away the support, hosting, maintenance, upgrades, and training demands of the product on the IT department. Sensitive to the budget and resource constraints within IT departments today, Viewics SaaS solutions enable organizations to adopt the product with minimal time and resources, Kuruvilla says.
"Business challenges continue to intensify within hospitals, and data is not only critical to managing these complex organizations, but the government is also demanding more sophisticated reporting and management," Kuruvilla says. "With Viewics Health Insighter, IT teams have found a
solution which empowers their operational teams with the right analytics
tools while letting IT focus on what is most important to them."
Viewics, adds Kuruvilla, provides easy-to-use, intuitive business intelligence tools that can be used by every member of the team, computer-savvy or not. The solution puts analytics where it belongs by enabling the users of information and drivers of business decisions to access, drill down and take action on the information that matters most to them.
When the Health Information Technology for Economic and Clinical Health (HITECH) Act was implemented in 2009, there was much speculation in the clinical lab community about how it would affect the industry.
Now, with the hindsight of 4 years, how has HITECH impacted clinical labs?
Tim Kuruvilla, vice president, sales and marketing, Viewics, Sunnyvale, Calif, notes that the HITECH Act “caused a flood of digitized data into the health care system that has to be useable in a meaningful way. Labs were among the first to automate their systems/processes and thus have incredibly structured and valuable data—they have an opportunity to pave the path for business intelligence.”
Today, he says, with so much connectivity, there’s a significantly greater emphasis on business intelligence (BI), which he likens to a treasure chest that users want to plunge into. “And HITECH has played into this, because it’s helping lift the limits on the amount and speed of data provision,” he says.
But despite predictions of integration among anatomic pathology, clinical pathology, and molecular testing lab systems, Kuruvilla isn’t seeing much of that; he says systems such as the CoPath anatomic pathology laboratory system are still pretty distinct. “There’s no convergence toward one program.”
There may be platforms working across CP and AP that bring data together to find correlations between patients with clinical results. However, “this is facilitated by analytical tools on top of the systems, not convergence of the systems themselves,” Kuruvilla says.
Predictions of more competition are being proven true. “You have to be more thoughtful in how you relate to customers, deliver good service, and meet turnaround times, etc,” he says.
Advancing medicine requires next-generation informatics solutions
She notes that the field of laboratory informatics has advanced to meet these needs by delivering the best of both worlds—a convergence of functionality between a traditional LIS [laboratory information system] that manages secure patient information, and a LIMS [laboratory information management system] that facilitates the comprehensive management of laboratory information, sample tracking, dynamic workflows, and instrument integration. Unifying the distinct functionality required of physicians in hospital settings, as well as researchers in clinical labs, Thermo Scientific Clinical LIMS delivers lab-centric solutions for patient-centric results, Meek says.
CLICK HERE to read CLP's roundtable discussion with industry experts about preparing for the ICD-10 transition.
Gary Tufel is a contributing writer for CLP. For more information, contact Editor Judy O’Rourke, jorourke@allied360