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Pioneers in Healthcare IT

LIS technologies must grow into the 21st century

By Jack Darnell

Editors Note: The is the 11th installment in our year-long 30th anniversary “Pioneers in Healthcare IT” celebration, featuring articles from past issues of Health Management

Technology, formerly called Computers in Healthcare.

This article appeared in the September 1993 issue. At the time, Jack Darnell was senior product manager of labora- tory information systems at Houston-based CHC Corp.

O

perating a laboratory in the 1990s and be- yond will require managers – and laboratory information systems – to closely consider four trends: quality outcomes measurement, patient view of clinical information, point-of-care test- ing and community health networks.

In the 1970s, a few forward-thinking healthcare institutions took a bold leap into the future by imple- menting a system to automate and track certain tests and procedures in their laboratories. Although these fi rst laboratory information systems were a rudimentary precursor to today’s LIS, the systems represented a new way to address the trends in laboratory use. Ad- vances in patient care translated into a greater volume of tests processed through hospital laboratories. This, in turn, dictated the need for automation in the lab. Even then, laboratories were under pressure to handle more patients and process test results faster and more effi ciently. Automation not only achieved these goals, it enabled healthcare institutions to operate their labs more profi t- ably and effi ciently.

The healthcare landscape in the 1990s, however, reveals a much different picture. Although only two decades have passed, the pressures facing healthcare institutions center on the trend toward greater cost control and managed care. Laboratory information sys- tems, in turn, are evolving to meet the new demands of the healthcare market. Hospital labs still are expected to process more results in a faster, more effi cient and accurate manner. But processing, tracking and recording

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June 2010

test results in only the fi rst step. For an LIS to remain a competitive tool, it must also create and support a database of knowledge to assist physicians in analyzing data and solving management problems.

Four trends

Hospitals that were quick to adopt early labora- tory information systems are beginning to consider features that are required for the 21st century. Other institutions are evaluating their existing systems. Both will need to consider key trends affecting their evolving information systems strategies. Four general trends will play the most prominent roles in utilizing laboratory information systems in the coming decade: quality outcome measurements, patient view of clini- cal information, point-of-care testing and community health networks.

The managed-care environment will place greater emphasis on hospital labs to help track quality out- come measurement. In a managed-care environment, healthcare providers will be forced to place a greater emphasis on measuring the quality of the care and cost- effectiveness they provide.

As a result, laboratory information systems must be able to store and analyze in-depth cost and clinical data to help measure patient outcomes. In doing so, the LIS can provide input to clinicians and administrators on protocols of care that target various cost and quality benchmarks. An advanced LIS enables an institution to more easily monitor the progress of a patient’s treat- ment plan, ensuring appropriate tests are ordered and analyzed.

In addition, the lab system must correlate ordered tests to patient eligibility. Managed care reduces spend- ing by eliminating unnecessary tests. The LIS must confi rm that all tests will be approved for payment by the insurer. It must also ensure that these tests conform to the practice guidelines defi ned by the healthcare institution for that patient’s diagnosis.

A “rules-based” laboratory information system

HEALTH MANAGEMENT TECHNOLOGY

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