Pathology profession’s leading experts in lab informatics predict plenty of disruption as hospitals work to integrate their informatics systems
DATELINE—PITTSBURGH, PENNSYLVANIA: Last Friday, what I will call the All-Stars of pathology informatics and clinical laboratory information systems (LIS) came together for a one-day Strategy Summit. Disruptive forces are loose within the laboratory informatics space and participants were eager to understand these trends and develop effective responses to keep medical laboratory testing at the forefront of clinical care.
Almost 100 pathologists, laboratory informatics vendors, LIS consultants, and hospital CIOs participated. Your Dark Daily editor was here as a careful listener. The Strategy Summit was organized by the Association for Pathology Informatics (API). API President Mark Tuthill, M.D., was chair of the program. Tuthill is also Division Head, Pathology Informatics, at Henry Ford Health System in Detroit, Michigan.
Three Themes in Pathology and Clinical Laboratory Informatics
Presentations centered around three themes. Some speakers discussed unfolding changes in the market for healthcare informatics and how these trends will require an effective and timely response by hospital laboratories and anatomic pathology labs. A second group of speakers, made up of LIS vendors and software developers, shared their perspectives on the state of the LIS market and made predictions as to how it would evolve.
Working laboratorians made up the third group of speakers. They shared case studies on how their respective laboratory organizations were innovating and responding to the changing needs of their parent hospitals and health systems. A common message from these presentations is that integration of healthcare informatics is proceeding at a steady pace and pathologists and laboratory scientists need to act purposefully in response to these developments.
Molecular Diagnostics and Genetic Testing Will Generate Much Data
The list of disruptive forces now exerting pressure on the informatics capabilities of clinical lab is comprehensive. However, three major issues were dominant in the presentations and panel discussions that took place here in Pittsburgh last Friday.
First and foremost is the need for pathologist and clinical laboratory managers to be ready for the coming rapid uptake of molecular diagnostics and genetic testing by physicians as they practice personalized medicine. Speakers at API’s Strategy Summit specifically noted that pathology laboratories will be responsible for handling the specimens that are used in molecular diagnostics and genetic testing. By definition, these specimens will require very different—and quite precise—requirements for handling, processing, and storing.
Several disruptive trends in healthcare informatics got plenty of attention at the LIS Strategy Summit hosted by the Association for Pathology Informatics (API) last Friday in Pittsburgh. Chair for the program was Mark Tuthill, M.D., who is the current President of API and also the Division Head, Pathology Informatics, at Henry Ford Health System.
Further, the lab tests performed on these specimens will generate large quantities of data. Not only will medical laboratories need informatics solutions which help the pathologist interpret this data, but storing this data will require significant resources. Both requirements will require robust solutions by vendors of LIS products and anatomic pathology information systems.
Second is the trend of EMR (electronic medical record) adoption. This is particularly disruptive to clinical labs and anatomic pathology groups based in hospitals and health systems. The reason is simple. Many EMR products struggle to capably handle even the basic functions of ordering laboratory tests and accepting laboratory test data. All speakers warned that the growing complexity of new molecular diagnostics and genetic tests—along with the increased volume of data such tests generate—will put additional stress on EMR vendors to accommodate these needs.
Third, decisions about EMR acquisition and deployment are made in hospital/health system C-suites and typically pathologists and clinical lab administrators have little input in this process. In cases where hospital administration decides to buy an enterprise-wide solution, the laboratory can find itself being told that it must implement an LIS product that lacks the full functionality of an established (or best-of-breed) LIS.
“In an era with the EHR (electronic health record) dominating, it appears now that the LIS [might] be relegated merely to the role of a data feeder system to the EHR, stifling lab innovation,” declared Michael Tarwater, Executive Director, LIS, QM, and Process Improvement, at John Muir Health in Walnut Creek California. Tarwater’s laboratory operates one of most successful hospital laboratory outreach programs in the state of California.
Best-of-Breed LIS Is Recommendation
“In my view, a best-of-breed LIS is still required—and not optional—as your core laboratory production engine when operating a mid- or large-sized hospital-based outreach/reference laboratory program,” he declared. “I have two recommendations on how pathologists and lab administrators can best make this case to their hospital administrators.
“One, leverage business intelligence so your lab team can understand your outreach and inpatient businesses.” noted Tarwater. “Use this business intelligence to demonstrate value of laboratory program to your parent organization.
“Two, engage the hospital CFO and work with him or her to report the performance of your laboratory at the P&L [profit and loss] level,” he emphasized. “We all know how a successful lab outreach program generates substantial revenue to the institution, while at the same time it lowers the average cost of inpatient tests.”
Another aspect of the healthcare informatics marketplace that was mentioned by almost every speaker at API’s Strategy Summit was the rush by hospitals and health systems to acquire and implement an EMR product that would, among other things, allow their institutions to demonstrate meaningful use and qualify for the federal incentives.
Of course, as a hospital implements an EMR, both the clinical laboratory and the pathology department within the institution must adapt their laboratory information systems to support the functions of the EMR. Speakers addressed these issues and also pointed out that one EMR vendor is becoming a major force in this market sector.
That vendor is Epic Corporation. It also has an LIS, named Beaker. Epic encourages its hospital clients to adopt Beaker in tandem with the EMR. It was noted by several speakers that, although Beaker functions well in supporting certain areas of the clinical laboratory, it does not have full functionality yet to support such functions as blood banking and laboratory outreach. Thus, the hospital laboratory may need to run multiple software products in order to use the Beaker LIS and still have all the functionality that is found in one of the first-rank, best-of-breed LIS products.
Interestingly, organizers of the Strategic Summit had invited Epic to come and speak. That invitation was declined and it turned out that no one from Epic was in attendance at the meeting.
On the other hand, the API Strategy Summit had major sponsor support from four companies offering LIS products. They were, in alphabetical order: Cerner Corporation, McKesson Corporation, SCC Soft Computer, and Sunquest Information Systems.
Because the disruptive trends in healthcare informatics and the LIS market have the potential to touch almost every medical laboratory in the United States, Dark Daily will provide additional e-briefings with further insights from specific speakers who were at API’s Strategic Summit last Friday.
Your Dark Daily Editor,
Robert L. Michel
e-mail: firstname.lastname@example.org with your comments.