Laboratory testing is always changing with new technologies and ever-expanding test menus that have complex requirements around reporting, authorizations, reimbursements, and specimen processing. All of these changes impact your laboratory information system (LIS). To thrive in this dynamic environment, you need an LIS that can keep up with industry changes, throughput requirements, user expectations, and business goals.
According to a 2021 survey by XIFIN, one-third of the respondents stated they were unsatisfied with their current LIS. The survey also found that many respondents were unsure if they were operating on their most current LIS software version. How do you know if your LIS is keeping up with your needs? This Quick LIS Check List should give you a good indication of whether it is or isn’t.
Have your business goals changed? Are you satisfied with lab performance? Do you want or need to launch new services? Do you require new workflows or management dashboards?
Are your profit margins where you want them to be? Do management reporting and analytics give you the information you need to identify cost and time savings, improve workflow, and reveal new revenue opportunities?
Are there gaps in your workflow? Are you missing key functionality? Can your LIS quickly accommodate new technologies? Does it support today’s testing demands? Will it support tomorrow’s requirements?
Are users satisfied with workflow? Do you have interoperability or reliability issues? Are you concerned with security vulnerabilities? Does your LIS have known vulnerabilities?
If your LIS isn’t keeping up, then you’ll need to define your essential LIS requirements as well as a wish list of nice-to-have capabilities. This will help determine if you need a complete replacement of your current LIS, or simply augment your existing system.
Identify Your LIS Champions
You’ll want to involve your team in this process by identifying your LIS Champions. After all, these are the people most familiar with the current system and its frustrations and limitations. They know better than anyone the workflow problems and workarounds that have been put in place. Plus, it’s important that a new system if required will improve their current process. The best way to do this is by listening to your subject matter experts and accounting for their needs in implementing a new system. LIS Champions should be regular users of the system and should be able to define system requirements. They should also be individuals who will speak up in group discussions and be good communicators back to the areas they represent.
Scope Out Your Needs
Task the group of champions to focus on the following preferences and requirements.
• Functional Requirements – What does the LIS need to do? How can it support your business needs? Look at your current workflow; what processes could be optimized? Be very detailed, take time, and list everything.
• Usability Requirements – Does the LIS need to offer voice recognition and hotkey shortcuts? What other features could be added to make users more efficient? Make sure to outline and articulate what you want from your LIS.
• Configurability Requirements – Consider these five pillars:
1. Case Types (i.e., NGS, PCR, MOL) – Identify case types for the testing modality and assign the tests and test codes. Be sure to list them all, including current and planned/near-future case types.
2. Workflow – Look at workflow configuration for each case type, so that it matches the exact lab workflow step-by-step, including TC/PC (technical/professional) split workflows.
3. Screens – Determine screen configuration and functions for each defined workflow step, including instrument batching, technical review, QC, and data layouts for results review.
4. Data Components/Layouts – More sure to define configurations for individual case review and batch result review.
5. Results Interfaces – Configure inbound result files to ingest and display the test results.
• Technology Preferences – Should the new system be cloud-based (SaaS) or deployed on-premises? How much physical space would an on-premises system need? Do you have that real estate, and if so, could it be used for something else? Do you have the business continuity infrastructure for security, backup power, and redundancy? Consider the pros and cons of cloud versus on-premises. For example, a cloud-based LIS allows you to create as many performing labs as you like. A SaaS-based LIS should be able to provide regular automatic updates so you always run the most current, up-to-date software. For more information, review the whitepaper Making Sense of an ASP and SaaS Software Delivery Model.
• Reporting Requirements – Define your reporting needs. The diagnostic report is your laboratory’s primary calling card. It must be very professional and represent your lab well. How does the LIS handle simple test results as well as extremely complex multi-modality comprehensive summary reports? What reporting requirements do you want from the system?
Management reports have complex needs; dashboard reports reflective of the lab’s volumes and other data to assist with reporting for internal and external stakeholders need to be considered.
• Scalability Requirements – What plans does your lab have for future growth and expansion? What happens if another COVID-type public health emergency occurs? Can your LIS quickly adapt to new testing and reporting requirements? Do you have multiple physical lab locations? Do you have anatomic pathology, molecular, genetic, clinical, research, and other testing?
Make sure to define all specialty testing needs. For example, your lab’s research component may need to ensure that you do not commingle with patient testing. XIFIN’s research project management modules are accessioned to specific projects and managed to completion. Patient information is optional for research projects. Results can be aggregated and reported in batches.
• Connectivity Requirements – How many different instruments does your lab have? How many other systems are there? Does your LIS easily integrate with all your instruments, EMR/EHRs, and bio-informatics software? Does it integrate with your billing and revenue cycle management (RCM) software to ensure rapid reimbursement?
• Support and Relationship Requirements – Does your LIS vendor adequately support you? Are they a good fit with your company culture? Do you have a strong relationship with them. Are they there when you need them?
• Budgetary Requirements – What is your current cost? What services are you outsourcing? What gaps does your current system have and how much time does that takeaway from staff? Do workarounds put you at risk or result in redundant efforts? What reports do you manually have to perform and how much time is involved? These all have cost implications that directly impact profitability and performance.
• Expertise Requirements – Does your LIS vendor provide expertise across diagnostic modalities, including clinical pathology, molecular, toxicology, NGS, etc.? Can your LIS vendor provide recommendations garnered from hundreds of labs to improve your operational and financial performance? What might these recommendations mean in terms of operational and care outcome improvements?
In a world where change is the only constant, looking at your LIS to ensure it supports your current and future needs is essential for keeping up with changing industry and throughput requirements, as well as user expectations and business goals.