College of American Pathologists
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  How to pick PO—lab links that are free of kinks





cap today



May 2007
Feature Story

Raymond D. Aller, MD

In the market for physician office-laboratory links software? CAP TODAY information systems expert Raymond Aller, MD, offers tips on how to proceed in order to succeed.

Tip No. 1
Know what’s in a name.

Physician office-lab links products, in a nutshell, transfer a provider’s orders for laboratory tests to the laboratory that will perform them and then transmit the results back to the provider. Beyond this basic functionality, such systems can relay demographic and billing information from the physician’s office practice management system to the laboratory information system. Many POLL systems can also load test results back to the physician’s electronic medical record system.

POLL products have, through the years, morphed into two types of applications, with a few exceptions. Most vendors offer either a thick-client module, in which the software resides in the physician’s office (with the installation and maintenance requirements that implies) and connects by various means to the host lab, or a Web-based application, which eliminates the need to install linking software in the physician’s office. However, with this latter model, no functionality is available if the Web link is down.

Tip No. 2
Talk to those in the know—that is, current system users.

Only the current users of a vendor’s system can tell you if that company will be a reliable long-term business partner. Vendors’ offerings of extensive functionality or a selection of hardware mean little if they aren’t backed by adequate vendor support.

Ask a prospective vendor for the names and contact information for all of its installed sites. Call all, or a random selection of most, of those sites to verify that they are operating the system and to determine what level of support the vendor provides. Steer clear of vendors who provide only a short list of “reference sites,” as they may have something to hide.

Tip No. 3
Learn from history.

Some POLL vendors have, over the years, offered a product, then abandoned it, offered another, then abandoned it, and so on. When you are considering a vendor’s product, examine the history of that company.

Several vendors have been providing POLL software for numerous years, and examining the evolution of those companies and their systems can be a valuable tool. By comparing past issues of CAP TODAY containing POLL surveys,* you can determine whether a company’s client base and the number of staff dedicated solely to its POLL business have grown steadily, remained static, or declined. Furthermore, comparing past surveys will show you how long vendors have been marketing a particular version of their POLL software and how they’ve adapted their products through the years to the changing needs of laboratories and physician offices.

For example, I tracked three POLL vendors over time using CAP TODAY’s surveys and found that vendor A has had virtually the same number of installations for the past six years; vendor B offered products for a short time, dropped out of the market for two years, then re-entered the market with a new product; and vendor C experienced steady growth through the years with the same product.

Tracking companies over the years, however, can be challenging as several have changed names—sometimes numerous times—as a result of being acquired, merged, reorganized, or for other reasons.

Tip No. 4
Don’t repeat the mistakes of others.

Don’t assume it will be easier, more efficient, and more economical to install a POLL module developed by your primary LIS vendor than purchase a focused module developed or supported, or both, by a different vendor. While this may be true in many instances, the following examples illustrate otherwise.

LIS vendor 1 was contemplating offering a POLL product. One of its clients, a large reference laboratory, had developed such a system. Vendor 1 met with that lab several times and examined the product in detail to determine whether it should license it. After several months, vendor 1 claimed it was not interested in the product. Meanwhile, the laboratory continued to improve its product, correcting several design errors. Eighteen months later, vendor 1 released a POLL product that looked remarkably similar to the system developed by its client—to the extent that it incorporated most of the errors the client lab had eliminated. A few years later, vendor 1 abandoned this product and introduced a new one. The brand-new product was quickly installed in a dozen sites but then leveled off and stayed at that level for years. Vendor 1 has hundreds of lab clients—lmany looking for POLL functionality—so why have so few of them chosen to go with the product provided by their primary LIS vendor? One can only assume it’s because vendor 1 has not devoted proper attention to developing, implementing, and supporting the necessary functionality.

LIS vendor 2 had the insight, in the late 1990s, to purchase the leading and most highly respected vendor of POLL functionality. Vendor 2’s customers were told that the resources of this large company would strengthen and accelerate product development. Instead, about a year later, vendor 2 pulled the plug on the product, offering the vague explanation that it was not aligned with the company’s strategic direction. Vendor 2 went so far as to contact the four labs networks that had already purchased or installed the product to remove the system. Then, two years later, and with great fanfare, vendor 2 introduced its new POLL product. To no one’s surprise, this product has dragged along for a number of years with only a few installations.

Tip No. 5
Read the following survey tables.

The tabulation of 22 POLL systems from 17 vendors on pages 38–58 provides an overview of the POLL marketplace. Because the survey is based on vendors’ responses to a written questionnaire, we urge readers to verify the accuracy of the information provided before making a purchasing decision. Make sure you get unequivocal responses to all of your questions before selecting a system. For example, is the quoted price truly all-inclusive? Is there a separate fee for hosting services? Can the vendor really provide all of the features indicated? Tell the vendor you would like to see all of the features that are important to you operating on a live system during a visit to a client site or, at the very least, in a live demonstration.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles County Public Health Acute Communicable Diseases. He can be reached at raller@


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