College of American Pathologists
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cap today

May 2005

Raymond D. Aller, MD
Hal Weiner
Michael Weilert, MD

From classic to virtual: the morphing of lab information systems
New release of materials management software
General Data teams with TimeMed Labeling Systems
Wolters Kluwer Health adds SNOMED CT mapping file to database
Pathology informatica scholarship for residents and fellows

From classic to virtual: the morphing of lab information systems

The following item is based on the paper, "The decline of the classic LIS, technical and strategic considerations," written by LIS industry consultant and CAP TODAY contributing editor Hal Weiner and Bruce Friedman, MD, director of pathology data systems, University of Michigan Medical Center, Ann Arbor. Weiner presented the paper at the Lab InfoTech Summit in Las Vegas in March.

The laboratory information system as we know it may soon go the way of eight-track tapes and typewriters, due in part to new industry standards and state-of-the-art software development tools.

The classic LIS is slowly being phased out by a networked set of discrete systems referred to as virtual LISs and supplemental lab application modules, or SLAMs. The latter include all functions that do not reside in the classic LIS and handle front-end, middle, and back-end processing.

The LIS market in 1990 was composed of approximately 76 LIS vendors who sold more than 700 systems. Market statistics indicate that last year, fewer than 50 LIS vendors were in business, and they sold less than 300 systems. Why the marked decline? Many LIS companies have been acquired for their client base, and their products have been sunsetted. Furthermore, some of last year’s LIS sales were part of a total hospital information system installation, where one system is now serving many hospitals. With the exception of physician office labs and small hospitals, this is a replacement market. Labs are keeping systems longer, and many vendors have failed to add significant new functionality to their products, so there is no impetus to change. This has created an environment for smaller niche vendors with innovative products.

Spawned from this new environment is the virtual LIS, a set of interoperating modules that may include a traditional, or classic, LIS. The birth of the virtual LIS is squelching the need to pay large amounts of money to an LIS vendor for an interface to a third-party product. These new systems will incorporate true plug-and-play-compatible components that can be added as labs evolve.

The past three years, in particular, have seen an explosion in SLAM products for the laboratory market, including such products as Web portals, quality assurance and quality control systems, enhanced analyzer work cell managers, total lab automation systems, business and financial systems, and blood bank, telepathology, and imaging modules. More than 100 companies are marketing SLAMs to laboratories. Products are being developed to meet the unique needs of genomic and proteomic testing as well as the burgeoning areas of drugs-of-abuse and home testing. These new systems will be truly virtual in that they will be related to a health system for specific patient care and, at the same time, used on a global level for ongoing research.

Development of the virtual LIS has been accelerated by the recent convergence of many separate efforts at standardization. These efforts are directed at overcoming the difficulties of integrating heterogeneous systems. One of the first to establish formal standards for integrating health information was the federal government’s Consolidated Health Informatics Initiative. The initiative’s goal was to provide access to medical data across all federal governmental systems. The agency’s efforts have focused on the use of HL7, LOINC for laboratory test results, SNOMED CT for medical terminology, DICOM for imaging, CPT for billing, and HUGN (Human Gene Nomenclature).

Another series of standards is now emerging that fosters the development of software in a Web-based environment. This set of standards is a modular collection of Web protocol-based applications that can be mixed and matched to provide business functionality through an Internet connection. When these standards are deployed, the need for interfaces as we currently know them will dissipate.

The virtual LIS operates in a complex computing environment, and the traditional consulting companies and LIS vendors, in general, are not yet equipped to tackle this new modality. This has led to an evolving class of health system integrators—companies whose sole purpose is to integrate systems supplied by other companies, in part by using software tools they have developed. New rapid-development tools and reusable off-the-shelf components from these companies, as well as from LIS vendors, are cutting development times by as much as 70 percent. Pathology informaticians may also play an increasing role as the architect and driver of the decisions and of the vendors chosen to implement their systems in conjunction with the health care organization’s information systems department.

Some vendors are already accepting the inevitable and deploying systems based on open-systems technology. Shrinking laboratory dollars coupled with the need for greater data access will continue to feed the demand for faster, cheaper solutions. But until virtual LISs become widely available, laboratories will continue to maximize their investment in their classic LIS by adding on various SLAMs.

The total sales dollars for SLAMs in 2006 is projected to exceed the amount of money spent on classic LISs. But until the classic LIS is replaced with SLAMs and EMRs, plug-and-play integration standards and technology will offer vendors and providers the most direct path to saving time and money.

New release of materials management software

Cove Laboratory Software has released version 5.0 of its InvMan materials management software application for the laboratory.

The new version offers greater segregation of supplies by departments, better control of supply distribution to remote sites, and a more flexible custom query function.
InvMan is a Windows-based application that runs on a PC network. It provides for the tracking of all supplies, including their associated lot numbers and expiration dates. Purchase orders can be automatically generated based on reorder point and quantity available. The physical inventory can be counted using bar-code labels and a portable scanner.

General Data teams with TimeMed Labeling Systems

General Data, a provider of specialized labeling and identification products, has signed a marketing and distribution agreement with TimeMed Labeling Systems, a provider of labeling products, systems, and services.

Under the agreement, TimeMed will integrate into its product line General Data’s health care ID solutions, including PersonalID patient identification wristbands and StainerShield, a patent-pending bar-code ID system for prestainer labeling of tissue and specimen slides.

The partnership combines General Data’s research and product development with TimeMed’s outside sales force and customer service departments. Together, the companies will offer hospitals complete bar-code labeling and identification solutions.

Wolters Kluwer Health adds SNOMED CT mapping file to database

Wolters Kluwer Health, a drug and disease database and health care information provider, has added the SNOMED Clinical Terms mapping file to its Medical Conditions Master Database.

With the addition of the mapping file, database users will be able to link pharmaceutical, pathological, and clinical condition coding using the SNOMED CT clinical vocabulary and translate between SNOMED CT and other terminology languages.

Pathology informatics scholarship for residents and fellows

Impac Medical Systems, the CAP Foundation, and the Association of Pathology Informatics have announced an unrestricted educational grant to provide additional training for pathology residents and fellows.

The pathology informatics scholarship supports further training in pathology informatics through two, three-week rotations: one at Impac’s headquarters and one elective rotation at a facility specializing in pathology informatics. The grant will provide up to $5,000 to offset expenses incurred during the program.

"This grant helps emphasize the value of diagnostic data to an overall informatics program to refine clinical outcomes, improve patient outcomes, and advance population-based cancer research," says Joseph Jachinowski, president and CEO of Impac.


New Jersey-based Raritan Bay Medical Center has signed a contract for Mediware Information Systems’ HCLL transfusion system. Raritan Bay will use the system to manage its multi-site transfusion services.

St. John’s Regional Medical Center, Joplin, Mo., has also signed a contract for Mediware’s HCLL transfusion system.

Axolotl Corp., Certify Data Systems, and Lanier Worldwide have executed an agreement with Western Medical Associates of Santa Cruz (Calif.) to provide the scanning hardware and software, interfaces, and database applications needed to move Western Medical Associates to a paperless office.

The partnership brings together Axolotl’s Elysium electronic medical record and interface services with Lanier’s multi-function hardware devices and Certify’s scan-management software.

Wyndgate Technologies, a division of Global Med Technologies, has signed an agreement with Florida-based Suncoast Communities Blood Bank to provide its SafeTrace donor-management system to all SCBB facilities.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles County Public Health Acute Communicable Diseases. He can be reached at Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at Dr. Weilert is director of laboratories, Community Hospitals of Central California, Fresno. He can be reached at