College of American Pathologists
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One alternative strategy: cold or hot?

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January 2002

Eric Skjei

That virtually all lab information systems must be able to assemble and print a report has long been used as a key to unlocking data that are resistant to other strategies. In many cases, the system being replaced does not have a built-in tool for data export. So, says Gregory Francis of Korchek Technologies, "What we’ve done is taken standard reports that come from the system and captured them in a flat text file, from which we can extract the information we need."

Today, at least one vendor—Mesa Corp.—has used this simple truth to develop a comprehensive set of data-conversion and archiving solutions. "If the LIS that is being replaced can generate an electronic report, it can be ‘printed’ to one of our products," says Tom Manning, Mesa’s vice president of sales and marketing. "Our products look just like a printer to whatever system that happens to be, and no vendor can keep us from capturing a print stream."

Once captured in a text file, this information is keyed (that is, indexed) in a variety of ways, Manning adds. "We extract high-speed look-up keys—for example, patient name, medical record number, date of birth, Social Security number, whatever the client wants—and we provide search and display tools so the client can quickly find information of interest, view it, and reprint it."

Mesa’s mainstream product, Archive Plus, is generally regarded as a "cold" solution. But Manning makes a persuasive case for the viability of Mesa’s solutions as an alternative to other, more conventional strategies, typically used to create "hot" data-integration solutions. "Many people try to take a copy of the old system’s database and then figure out what each record is, how it relates to every other record, what the fields mean, and so on—essentially trying to grasp and replicate the logic of the entire system." By contrast, he says, "by simply taking the report output from those old systems, Mesa’s tools and solutions can find everything we need, with only very occasional and manageable exceptions, such as, for example, having to build a table to automatically translate old physician identifiers into new identification numbers, or something like that."

What’s the catch? The only limitation Manning can imagine might arise in the case of a data element that could not be identified and accessed from the report output. That, in essence, is consultant Hal Weiner’s view as well. "This approach does have some drawbacks," Weiner says, "as some reports do not always offer a consistent method of identifying where a specific data element is on a page." However, Manning reports he has not yet encountered such an element.

Cold or hot, regardless of the tools, technologies, and strategies employed, finding the data is only part of the battle. "Once you have gotten that data out, you still have to get it into the right format for the new system," says Francis, "and that means cleaning up a lot of junk, delimiting that file somehow, and solving a number of other potential problems."