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The LIS Functionality Assessment Toolkit; Measuring the Value of an LIS

Posted Aug 23 2013 12:00am

On the front page of the August edition of CAP Today, there's an article about a report that will soon be released by the Association for Pathology Informatics (API) (see: Toolkit lets labs make case for the right LIS ). The API report, a  6,000 word document plus three appendices, will be posted on the API web site  in about a month and will be available for downloading at no cost. The report provides a methodology, using a supplied toolkit, for measuring the functionality of a currently installed LIS or one under consideration for purchase. It emphasizes that total LIS functionality (T-LISF) is critical for the success of a pathology department and its clinical labs. The LIS is the workhorse of the lab, receiving test orders, storing results, generating reports, and firing rules that result in greater work efficiency. Agreeing to a "good enough" LIS can result in major service and financial problems. The definition for a "good enough" LIS is subject to interpretation but it's clear that a larger and more complicated set of labs requires a more robust LIS.

Determining whether a current LIS, or one to be installed, provides the maximum T-LISF is no simple matter. You may not get a straight answer to your questions about functionality from the vendor of the system. One more dependable approach is to query laboratory personnel from other hospitals that are running versions of the same LIS. The API toolkit provides another and perhaps more definitive resource for this purpose. The first appendix in the report consists of 850 functionality statements (FSs) which are short, declarative statements organized by core labs function and more specialized function that describe the various tasks that the LIS will perform. You can use these FSs to assess a current system or ask the vendor of a proposed LIS to respond to them. All of this can be a lot of work but there is no other approach that is quite as instructive and quantitative.

T-LISF is particularly critical these days because of cost-containment pressures in healthcare that are being driven by the Affordable Care Act (ACA). Our goal in pathology and the clinical labs must be to automate any task when possible. Moreover, pathology is facing a major manpower shortage due to the aging of our medical technologist cohort. In the near future, highly trained personnel may not be available at any price. If there are functionality gaps in a current or proposed LIS, they need to be filled with supplemental software supplied by other vendors. There is a cost for this including the need to deploy additional interfaces to the primary LIS. In the final analysis, the best course of action is to install a best-of-breed LIS as the primary system and then fill in the occasional gaps when and if necessary.

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