“Disturbing” is how Joseph Rondinelli sums up findings of a survey about pathologists’ involvement in selecting laboratory information systems and hospital-wide electronic health record systems for academic medical centers. Pathologists who don’t play a vital role in their institution’s central information technology group risk being stuck with an LIS or EHR system that doesn’t meet their needs, warns Rondinelli, senior administrator in the Department of Pathology, New Jersey Medical School, a division of the University of Medicine and Dentistry of New Jersey.
In a presentation at the American Pathology Foundation 2012 Spring Conference, Rondinelli discussed the findings of a survey sent to pathology department administrators from the pool of all U.S. medical schools, 21 of whom responded. The survey, co-sponsored and administered by the Association of Pathology Chairs, probed the involvement of lab administrators and pathologists in selecting and implementing LISs and EHR systems in academic settings. The survey also addressed the ongoing role of pathologists in laboratory and hospital-wide informatics.
While the survey involved only 21 respondents, the results are consistent with a workshop discussion among pathologists and laboratory administrators at a July 2011 meeting of the Association of Pathology Chairs. “In the workshop discussion and in the survey of medical schools, a surprising, though not large, number of people said they had little or no part in the RFP [request for proposal] process,” says Rondinelli. “They also indicated that they are not involved in implementation or routine operation of the systems. They were just on the receiving end, with someone else picking and choosing the system.” A few survey respondents said “the hospital senior executives actually chose the LIS—not just the EHR,” he adds.
The vast majority of the data entered into a patient’s EHR comes from pathology, so “why is it that pathologists are being bypassed in some instances?” Rondinelli asks. “There’s no real way of knowing, but I can think of two possible reasons: They’re not visible enough, and maybe hospitals don’t want pathology to be involved because they would like to buy the lab system for us as a cost-cutting measure.”
At the same time, EHR vendors are increasingly bundling LIS functionality with their core billing, registration, and general medical record modules. “That allows the hospital to avoid the costly interfaces required to link a foreign LIS with the central EHR system,” Rondinelli says. “However, these large EHR vendors aren’t experienced in supporting operating departments such as the laboratory.” But if a lab system fails in the middle of the night, “it’s the pathologist who gets the phone call. You’re the one who has to live with this system and its shortcomings.”
Also learned from the survey was that the vast majority of pathology departments represented (16 of 21) do not have a dedicated director of pathology informatics. “Being a faculty member and an informatics expert carries weight in an academic center,” Rondinelli said in his presentation at the APF spring conference.
The bottom line, says Rondinelli, is that pathologists “either become part of the process or become a victim.” And the first step in becoming involved is determining what committees are relevant to the lab and requesting that the laboratory be represented on those committees.
Participants in last summer’s Association of Pathology Chairs workshop concluded that the association should offer guidance in system design to EHR vendors and that the APC should approach the American Hospital Association about working together to develop a role for pathology in health care information management.
Siemens Healthcare and Psyche Systems have signed a strategic alliance under which Siemens will market Psyche’s WindoPath anatomic pathology system as the AP component of its Novius Lab laboratory information system.
By way of Novius Lab, WindoPath will integrate with Siemens’ Soarian, Invision, and MedSeries4 health care information system product lines.
Siemens Healthcare, 610-448-4500
Psyche Systems, 800-345-1514
Sysmex America has launched Sysmex WAM Select, middleware for small to medium-sized clinical laboratories.
WAM Select is a hematology product for clinical laboratories that use Sysmex X-Series instruments and the XE-AlphaN hematology analyzer with the Sysmex SP-1000i slidemarker/stainer. The system includes a hematology-specific rules library with auto-validation capability.
WAM Select is the second product in the Sysmex WAM middleware portfolio.
Sysmex America, 847-996-4500
Psyche Systems has released its MicroPath microbiology system.
MicroPath offers customizable work-up protocols; intelligent batch result entry; automated culture aging and reporting; support for serology, parasitology, and virology; integration with instrumentation and automation systems; antibiograms; epidemiology reporting; and advanced data mining.
The system was built using input from microbiologists.
Psyche Systems, 800-345-1514
Aspyra has announced the newest release of its browser-based CyberLab laboratory information system, version 7.2.10.
This latest version includes enhancements to the system’s order-entry decision support tool, such as the ability to route tests based on patient insurance requirements and track patient pre-authorization and consent forms. The system can also be used to set up medical necessity validation rules and pre-authorization templates. In addition, the product offers users the ability to create multiple client-defined requisition forms to distribute to clients that do not have online order-entry capability.
Aspyra, LLC, 818-880-6700
Sunquest Information Systems has introduced Collection Manager 5.0, the latest release of its core point-of-care product.
This latest release allows users to collect any type of specimen in the operating room, radiology suite, dermatology clinic, or other collection location following positive patient identification and label printing at the bedside. Through integration with Sunquest CoPathPlus 6.0, the system will scan the label on a specimen when it reaches the laboratory, capturing all data associated with that specimen. Version 5.0 also offers emergency department workflow support, including automated rainbow draw functionality for labeling trauma patient specimens in the emergency room.
Sunquest Information Systems, 877-239-6337
PathCentral has entered into an agreement to provide its Web-based anatomic pathology system, AP Anywhere, to the University of Southern California’s Department of Pathology and Laboratory Medicine at the Keck School of Medicine.
Dr. Aller is director of informatics and clinical professor in the Department of Pathology, University of Southern California, Los Angeles. He can be reached at email@example.com. Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at firstname.lastname@example.org.