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<br>Dr. Friedman

Dr. Friedman

Hospitals’ Adoption of Systemwide IT Solutions Poses Challenges for Laboratories

Tuesday, October 8, 2013

Medical laboratories are purveyors of mounds of patient data which, if analyzed for patterns to interpret results, has the capacity to drive improvement in the delivery of patient care.

“For pathology and the clinical labs, the functionality of the LIS is extremely important and must be maintained at the highest level.”
— Bruce Friedman, MD, FASCP

As clinical informatics revolutionizes medicine, hospital executives are rapidly adopting a so-called enterprise-wide Information Technology (IT) solutions, such as Epic Systems, with an embedded Laboratory Information System (LIS). Some pathologists who are experts in informatics believe this will seriously disrupt the relationship that pathology and laboratory medicine has enjoyed with specialized best-of-breed LIS vendors for decades.

“Control over the single Electronic Health Record (EHR) database, including all laboratory data, will move from pathology to the hospital central IT group,” says Bruce Friedman, MD, FASCP, Emeritus Professor of Pathology, University of Michigan Medical School.

Dr. Friedman and Ulysses Balis, MD, Associate Professor of Anatomic Pathology at the University of Michigan, both served as panelists in a general session, “Preparing for Seismic Shifts in Pathology Informatics,” moderated by Mark Tuthill, MD, FASCP, on Sept. 20, at ASCP 2013 Chicago. The session underscored the expanding role that pathology informatics plays in personalized medicine, where the ability to interpret and translate clinical data into diagnostic therapies that improve patient care outcomes is critical.

The Epic product consists of an EHR plus an assortment of specialized, department systems such as the Epic LIS called Beaker. Epic Systems currently enjoys a 21.7 percent of market share in the ambulatory market for providers who have achieved meaningful use and 45.3 percent for the inpatient market. Dr. Friedman cautioned that while Beaker could be described as a “good enough” LIS, it still lacked key modules such as blood bank and an enhanced lab outreach module.

“For pathology and the clinical labs, the functionality of the LIS is extremely important and must be maintained at the highest level,” says Dr. Friedman, who is a leader of the Association for Pathology Informatics (API), which has a partnership with ASCP. 

The API has developed an LIS Functionality Assessment Toolkit (LIS-FAT). It consists of the following four components:

  • A white paper that describes the strategic importance of installing/maintaining an LIS with maximum functionality and also discusses how to use the tools provided in the three appendices to it.

  • Appendix I consisting of a list of 850 weighted functionality statements that can be used to evaluate an LIS and also identify functionality gaps.

  • Appendix II consisting of ideas for scripted scenarios that can be used to guide an LIS vendor in an on-site live demo of the system.

  • Appendix III with suggestions about how to develop a total-cost-of-ownership (TCO) worksheet in order to measure the true cost of an LIS plus the cost of plugging functionality gaps.

These four documents can be downloaded free of charge at the API web site:  

To view the “Preparing for Seismic Shifts in Pathology Informatics” general session at ASCP 2013 Chicago, click here.