College of American Pathologists






December 2010

Raymond D. Aller, MD
Hal Weiner

Siemens shifting from train-the-trainer to train-each-employee approach Siemens shifting from train-the-trainer to train-each-employee approach

What’s fun about the children’s game telephone, where kids whisper a message from one ear to the next, is that the initial statement often gets hilariously distorted.

Training in pathology laboratories sometimes follows a similar pattern, with one person receiving instruction on a new product or procedure and then verbally passing that knowledge to other employees.

“As it goes down the line, you lose more information,” says Nick Payne, vice president for global product education at Siemens Healthcare, Charlotte, NC.

That reality is, in part, why Siemens created its Personalized Education Plan, or PEP, a new, patent-pending, online learning solution that can be tailored to meet each lab employee’s needs. Laboratorians can log on to PEP from any computer whenever they have a few free minutes or hours.

Unlike with the game of telephone, Payne says, “with PEP, everyone gets straight, accurate, up-to-date information.”

Siemens has been testing PEP for the past four months at 23 sites in the United States, Singapore, Malaysia, Australia, the United Kingdom, and the Netherlands. The company plans to roll out the program to all customers sometime next year and will eventually offer it in seven languages, including German, Chinese, and Korean.

The first time that users log on to the system, a female avatar pops up to walk them through the site’s functionality. Users can request the avatar again if they haven’t used the system in a while and need a refresher. Users then choose training options from three categories: product education for any of 14 Siemens laboratory products, including the Syngo lab process manager and Easy-Link data-management system; general laboratory; or disease-state management.

Each user has a My Planner page that lists the competencies offered for every topic. For example, if users click on a particular instrument, they can choose learning activities about managing results or about daily, weekly, or monthly maintenance. General laboratory competencies include clinical chemistry, hematology, and urinalysis. When users scroll over a competency, a small pop-up window appears that explains in detail the learning activities associated with that competency. The window also lists the total continuing education credits and approximate completion time.

When users pick a competency, a virtual workbook opens to electronic pages that turn like those of a book. After finishing a learning activity and taking an online assessment, users can access practical exercises and demonstrate their knowledge and skills in the lab with a mentor. Users can record in the My Transcript section of PEP each task they have completed. Each user’s transcript holds a record of every learning activity that person has undertaken and when it was completed. It also has a link to print the course and the CEU certificate.

Marilyn Leonard, laboratory manager at White Plains Hospital, White Plains, NY, participated in a pilot test of the PEP program. The White Plains lab had just purchased Siemens’ Dimension Vista intelligent laboratory system last summer when the company approached her about training to use the product through PEP. Twelve of 16 people in the lab participated in the pilot testing. White Plains has since expanded its training through the program to general lab topics, including quality control and troubleshooting.

“One of the biggest [benefits] for me is the consistency of training across all the personnel” and the ability to easily track and document all training, Leonard says.

In the past, Leonard would send key operators to vendors for training, and those operators would then be responsible for teaching other White Plains lab personnel. Sometimes, however, years passed before a new hire needed training, and Leonard doubted that employee got the same standard of instruction as when information was fresh in the trainer’s mind.

Having to arrange time away from daily tasks for a trainer and trainee to meet can be difficult and disruptive, Payne adds.

Siemens will offer the PEP education solution to customers at no charge. It is also developing a specialized option that will be available for a fee. The latter will allow a hospital to request a custom-tailored training topic, as well as provide the ability to mesh PEP transcripts with the hospital’s documentation system to track continuing education.

Siemens developed PEP after determining that its customers would be better served by moving away from a train-the-trainer approach to a “life-long strategy for education,” Payne says. “We decided that we needed a radical change,” he explains. “The success of the training should not be built on the person in the laboratory filling the role of trainer. Instead, it should be based on providing a standardized approach to personalized education.”

Siemens hopes its clients will remember the good customer support they received with PEP when deciding what brand of instrument or information system to buy in the future, Payne says. The company believes, he adds, that “the better educated customer is not only going to be more efficient in the lab but is going to reduce [Siemens’] overall support cost, which is a win-win situation.”

Interface workarounds offer fixes for common issues Interface workarounds offer fixes for common issues

Electronic interfaces between hospital or regional labs and their reference labs have transformed the order-entry and results-reporting process, but they are not without their problems. Fortunately, however, many of these challenges can be overcome.

One issue centers on data being sent to a reference lab and from there to a public health agency. Every laboratory is required to send certain test results to the appropriate public health agency, as well as enough data to follow up on the case when necessary. However, some hospitals don’t automatically send a patient’s address and phone number to the reference lab, leaving the reference lab to contact the hospital for the information before sending results to the public health agency.

Yet hospitals have the capability to include a patient’s address and phone number in their interface transmissions to the reference lab. While such information typically is stored in the hospital’s ADT (admission/discharge/transfer) system, and not in the LIS, it is easy to add the address and phone number to ADT transactions being sent to the LIS so the information can be replicated in the laboratory system.

Another issue arises because most reference lab interfaces do not confirm that the reference lab received the specimen sent by a hospital or regional lab. Yet, as noted by Larry West, director of system integration at Salt Lake City-based ARUP Laboratories, a construct was established years ago in the HL7 standard to send a “specimen received” message from a reference lab to a hospital.

The construct, as written in HL7 2.x speak, reads: “The message is an ORM^O01 message with a value of ‘SC’ in ORC-1. The value in ORC-5 is ‘I’ which means the specimen is IN-LAB.”

However, for this confirmation to occur, the reference lab must have the capability to send the HL7 ORC segment, and the LIS of the hospital or regional lab must have the capability to store the date/time stamp in an appropriate field on the test order.

Also of issue with interfaces to reference labs is the ability of the hospital or regional laboratory to display complex reports, including those for many esoteric tests, as they were presented by the reference lab, not as the receiving LIS has attempted to reformat them. This requires the reference lab to send a preformatted report to the hospital or regional lab as a PDF image—encoded within the body of a standard HL7 message—so the LIS and EMR system can present it to the clinician exactly as the specialists in the reference lab intended it to appear.

If you have experienced other issues with electronic order-entry and results-reporting interfaces, we invite you to share your stories with CAP TODAY contributing editor Raymond Aller, MD, at

—Raymond Aller, MD

Acquisitions in the health care information technology market Acquisitions in the health care information technology market

The medical imaging software company Merge Healthcare has acquired Fletcher-Flora Health Care Systems’ laboratory information systems assets. Merge will now market Fletcher-Flora’s LabPak laboratory information system, FFlex eSuite LIS, FFlex eSuite application service provider system, FFlex eSuite MGR LIS, and FFlex eLink integration software.

Merge Healthcare
Phone: 312-565-6868

GE Healthcare has announced plans to buy the medical testing laboratory Clarient. By acquiring Clarient, GE will be able to develop integrated tools for diagnosing and characterizing cancer, the company reports.

GE Healthcare
Phone: 888-439-6584

Roche and Medical Automation Systems have signed an agreement under which Roche will obtain assets associated with Medical Automation Systems’ RALS point-of-care information technology connectivity system. Roche will also acquire all rights to the names Medical Automation Systems, MAS, and RALS.

Phone: 317-521-2000

CLSI releases StatisPro method-evaluation software CLSI releases StatisPro method-evaluation software

The Clinical and Laboratory Standards Institute has introduced Statis-Pro method-valuation software.

The product is designed to establish and verify the performance of laboratory test methods through statistical analyses that demonstrate compliance with regulatory and accreditation requirements.

StatisPro can produce reports on analytical accuracy, precision, linearity, limits of detection and quantitation, and reference intervals based on CLSI guidelines. It can be used to evaluate performance parameters when introducing a new method or reagents or when replacing laboratory instrumentation.

Phone: 877-447-1888

ONC Web site lists products cleared for meaningful use ONC Web site lists products cleared for meaningful use

The Office of the National Coordinator for Health Information Technology has launched a Web site that provides information about products that have been certified for meaningful use.

The ONC Certified HIT Product List is a comprehensive listing of complete electronic health records and EHR modules that have been tested and certified under the temporary certification program. It is available at

Displayed with each certified EHR technology is the name of the certifying ONC-authorized testing and certification body, ONC certification number, vendor name, product type, and product version number.

New Xifin contracts New Xifin contracts

Xifin recently signed contracts for its revenue cycle management services with Salt Lake City-based LineaGen, New York City-based Signal Genetics, and South San Francisco-based Veracyte.

Phone: 858-793-5700

Dr. Aller is director of informatics in the Department of Pathology, University of Southern California, Los Angeles. He can be reached at Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at