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Balancing the 4 C’s of Laboratory Information Systems – Cost, Complexity, Control, and Change
September 2, 2020
Deciding which LIS is best suited to meet the needs of your laboratory today and in the future is an important decision with several factors to be considered. No LIS is fully “plug-and-play”; some configuration is always required. The question is how much, and whether it is implemented with the tools and templates provided by the software vendor, in order to avoid becoming a one-off implementation without a supported upgrade path.
A well-defined LIS implementation plan focuses on bringing software and services together to bridge the gap between an off-the-shelf solution and site-specific requirements. The challenge is to find the ideal balance between business needs, such as budget, risk, and product lifecycle and technology needs, such as core functionality, flexibility, and extensibility.
Done well, a successful LIS implementation can streamline laboratory workflow, provide better visibility into operations, automate data exchange across systems and promote good laboratory practices. However, the lab industry has a checkered history of LIS implementations gone wrong, in many cases because business drivers were not well understood, quantified or documented up front.
Balancing the four C’s are a key factor in choosing the right LIS for the long-term:
Control
Laboratories that desire significant control over the design of the solution, the product roadmap and the ownership of the resulting intellectual property will likely need a fully-customized LIS. This can be a much more expensive (you own all the development costs), lengthy and complex undertaking than configuring a commercial LIS. Choosing the amount of control needed in acquiring and implementing software systems will indicate which path is most appropriate whether off-the-shelf, configurable, or custom.
Change
Customization and configuration are two options for changing the application to more closely fit the specific needs of the laboratory. The more modification required typically brings more control of the software, adapting it to the organization’s needs rather than the other way around. Configuration enables laboratories to tailor many important elements of the LIS, while retaining a core vendor-supplied software solution.
Complexity
The more customization required, the more complexity there is to deploying and maintaining the system. More complexity drives higher costs. It also drives the need for a more knowledgeable laboratory IT team.
Cost
If the implemented solution strays too far from the off-the-shelf product, further customization, and therefore a higher cost is incurred in order to keep pace with technology, innovation, and competition.
This conceptual illustration identifies the three general categories of LIS in the market:
1. Purpose-Built, Off-The-Shelf Systems
These systems are generally less expensive to acquire and manage and are relatively simple. They provide little ability to modify the application or workflows and work best for straight-forward, low complexity operations providing test-specific functions with limited configurability.
2. Configurable Off-The-Shelf Systems With APIs
These solutions provide more flexibility and control but do so within the parameters of the administrative toolset provided by the vendor. Customizations are limited to system elements such as reports that do not prevent the lab from easily adopting new releases and upgrades. A documented application programming interface (API) provides open connectivity from the LIS to other software systems.
3. Custom Solutions
Custom-built LIS provide full control and access to the software application code in order to build a system that meets every site-specific requirement. These systems work best in laboratory environments that are extremely unique and require a heavy, ongoing IT expertise and investment in order to maintain and update.
Ultimately, each lab should select the system that best fits its circumstances and aligns to its business requirements while balancing the Four C’s. Most laboratories will find themselves best suited for a configurable off-the-shelf solution, however, some smaller labs with a narrower test menu may be able to save money with a purpose-built off-the-shelf solution. Specialty labs with highly unique requirements will find that it is often worth the extra cost, time and complexity to build and maintain a custom solution.
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