Laboratory information system

A laboratory information system (LIS), is a class of Software which handles storing information generated by laboratory processes. These systems often must interface with instruments and other information systems such as hospital information systems (HIS). An LIS is a highly configurable application which is customized to facilitate a wide variety of laboratory workflow models. Deciding on an LIS vendor is a major undertaking for all but the smallest labs. Vendor selection can take months of research and planning. Installation often takes weeks to months in addition to the research phase. There are as many types of LISs as there types of lab work. Only the largest vendors attempt to cover all the sub disciplines of laboratory science which include hematology, chemistry, immunology, blood bank, surgical pathology, anatomical pathology, flow cytometry and microbiology. This article mainly covers clinical lab which encompasses hematology, chemistry and immunology.

= Basic Operation =

Laboratory Information Systems are often part of an integrated informatics system which involve many disparate applications. Use of an LIS frequently begins after after a physician has arrived at an initial diagnosis. For example, a patient enters the hospital looking pale and complaining of fatigue. The physician, suspecting anemia, might decide to order a complete blood count (CBC).

== Order Entry and Check In ==

An order is placed in the system usually by a physician, physician s assistant or office clerk. The order or lab request contains a request of tests to be performed. Each order is tracked with a unique identifier. This identifier (which is usually a number) is called an accession. In this hypothetical case a CBC is ordered which is a panel of sub tests including white blood cell count, red cell blood count and other blood-related tests. The patient is now instructed to go to a phlebotomy station where her blood is to be drawn. When the patient arrives, she is often checked in to the system which will automatically tell the phlebotomist how many tubes of blood to draw. The LIS will automatically print barcoded labels (with the unique accession) for the draw tubes.

== Specimen Receiving ==

After the patient is checked in and the specimen collected, it is sent to the lab for processing. This event is often record in the LIS. At this point either manual or automated lab work can begin. CBCs are often performed by automated hematology machines. After the order is placed it is downloaded to the automated instrument. When the barcoded specimen is inserted into the instrument, the accession is read off the specimen label and matched with the order previously downloaded to the instrument.

== Results Entry ==

When results of lab tests are available, they are entered into the system manually or automatically downloaded from an instrument. Once these results are double checked by the medical technologist, they are released. Released results are often automatically printed to lab reports which are delivered to the attending physician.

== Lab Reporting ==

Lab Reports are the final output of all LIS systems. These can either be printed or faxed in paper based labs, or delivered via email, file or HL7 interface in paperless installations. The degree to which an LIS supports customizable lab reports and flexibility in modes of delivery of results is one major factor in determining its success in the marketplace.

= Basic Features =

Laboratory Information Systems commonly support the following features: Order Entry Patient Check In Specimen Receipt Results Entry Reporting Patient Demographics Physician Demographics

= Additional Features =

In addition LISs commonly support the following: Web based order entry Web based results inquiry Faxing and emailing of lab reports Custom report creation HL7 interfaces with reference labs and EMRs Preliminary reporting Final reporting Med tech worksheets Workload balancing Medicare Medical Necessity checking Billing Public health reporting Rule engines

= Types =

There are many laboratory disciplines requiring the support of computerized informatics. These include: Hematology Chemistry Immunology Blood bank donor center Blood bank transfusion Surgical Pathology Anatomical Pathology Microbiology Flow cytometry

= External Links =

[http://www.cap.org/apps/docs/cap_today/surveys/1104_LISsurvey.pdf College of American Pathologists 2004 Survey of LISs]

Commercial Laboratory Information Systems

[http://www.clinlabinc.com ClinLab LIS] [http://www.healthcare.latentlogics.com Lab Pro 2004] [http://www.impac.com/products/lab/index.html IntelliLab LIS]

[http://www.misyshealthcare.com/solutions/Products/misys+commercial+lab/index.htm Mysis Commercial Lab]

[http://www.orchardsoft.com Orchard Harvest LIS]

[http://www.cerner.com/products/products_4a.aspid=245 PathNet® LIS]

[http://www.softcomputer.com/products/laboratory.php Soft Computer s Laboratory Suite]