Getting the Hematopathology LIS Capabilities You Need

Hematopathology is a complex science with unique characteristics that require sophisticated laboratory information system (LIS) capabilities. That said, there are ways for laboratories to supplement existing LIS investments to achieve a clinically and financially successful hematopathology practice without having to replace an entire LIS infrastructure. Let’s review some of the unique LIS capability requirements for hematopathology.

Pathologists often don’t have access to effective workflow and reporting capabilities for Flow Cytometry, FISH, Cytogenetics, and Bone Marrow Morphology.

Flow Cytometry

A robust flow cytometry module requires integration with the flow cytometry analysis software for easy review and reporting. This includes antibody tables that reflect the results of the panel ordered, a flow differential table, images of relevant scattergrams, and fields for capturing the diagnosis, interpretation, and comments. It should also include file management for various data files (e.g., FCS files, flow workbooks). The LIS screen should also allow for easy test add-ons, re-gate requests, and for requests for global reads (for technical/professional (TC/PC) programs).

Fluorescence in situ hybridization (FISH)

FISH reporting requires integration with the FISH analysis software and links to launch the FISH image viewer. This includes probe scoring tables, FISH image selection for reporting, fields for capturing the diagnosis/interpretation, ISCN nomenclature, and comments. It should also include file management for data files. The LIS screen should also allow for easy test add-ons and for requests for global reads (for technical/professional (TC/PC) programs).

Cytogenetics

Cytogenetics reporting systems are often an afterthought in laboratories. For labs performing traditional karyotyping, they require a system to capture cytogenetics scoring tables, a karyotype image for reporting, and fields for capturing the diagnosis, interpretation, and comments. The LIS screen should also allow for easy test add-ons and for requests for global reads (for TC/PC programs).

Molecular

Often a pathologist will order additional molecular test add-ons to provide additional information about a disease and how to treat it. The LIS must integrate all kinds of molecular results including polymerase chain reaction (PCR), next-generation sequencing (NGS), and gene-micro array for further assessment by the pathology team.

Bone Marrow Morphology

Bone marrow morphology reporting needs to capture a variety of results including the CBC, immunohistochemistry (IHC)/special stains, and any other relevant information. This module is tied to a complete histology module with grossing and histology workflows.

In addition to these unique LIS capabilities required for specific types of hematopathology, there are also valuable LIS capabilities that provide benefits across hematopathology LIS modules including case summary reporting, TC/PC workflow for revenue sharing, and digital pathology.

Case Summary Reporting

The report is in many ways a laboratory’s calling card, and hematopathologists need customizable reports that enable them to better support physicians by providing informative and clear diagnostic guidance. For example, ordering physicians need to be able to quickly digest time-sensitive information. Reports must be able to include diagnostic images, transcripted narratives, current and previous test results, patient history, and calculated scores to show the probability of an outcome against a given population of patient data.
Comprehensive case summary reports can incorporate results from several modalities into a single report. Drilldown links enable physicians to easily review information in detail and share it with others as needed. 

TC/PC – Revenue Sharing

Hematopathologists also need LIS capabilities designed to separate technical and professional workflow components for revenue sharing business relationships, seamlessly managing complex technical/ professional (TC/PC) revenue splits for any workflow including flow cytometry, FISH, and IHC with integrated digital pathology.

Digital Pathology

Successful integration of digital pathology in laboratories is dependent on workflow, including seamless integration with the laboratory’s LIS. The LIS must be fully integrated with histology automation such as the Leica Cerebro or the Ventana Vantage platform. It must also be able to pass case information to the digital pathology system, as well as prepare barcoded slide labels that can be read by the imaging device. Once slides are scanned and the whole slide images are ready for review, pathologists should be notified of their availability via the LIS. The ideal digital workflow includes access to all case-related whole slide images via an image viewer within the LIS, like the integrated Proscia viewer shown below. Pathologists can then capture regions of interest and include them in the LIS report if desired. If the pathologist is utilizing automated image analysis, those results should be easy to seamlessly incorporate in the LIS and final report.

One LIS for All Performing Labs

Replacing lab information systems is both time-consuming and costly. At XiFin we recommend that if you have an LIS that works well for your lab but has gaps, say in anatomic pathology, hematopathology, or molecular testing, you integrate a new system with your existing system to provide a solution for those deficiencies. Labs are not always in a position to completely change out their LIS, but that does not mean that they should live with systems that do not support their needs.

How can XiFin LIS help you?

Laboratory diagnostics can be complicated and require a pathologist to provide a comprehensive assessment to aid in the treatment planning of the patient. In hematopathology this means reviewing results for flow, FISH, cytogenetics, molecular and other case types and provide a summary report to guide the treating oncologist. Labs needs specific solutions for eachindividual case type and a means to review all the results and create a summary case report. XiFin believes in configurable and interoperable lab systems that allow the lab to define case types and workflows, integrate the data via interface, and create a report that represents those results. XiFin believes in products that support the pathology team and further increase the value they provide to the care team.

Learn more about how XiFin LIS can augment your existing LIS to fill any capability gaps you are currently suffering within your hematopathology practice.