Lab Software v2.0

Bruce Friedman has a nice analysis of where lab software is moving, especially with regards to federation. He argues that with the proliferation of ancillary lab systems, sometimes called best of breed, or modular systems, the main LIS system will be relegated to a viewer or aggregator. The corollary is the way many EMRs are now viewers into a number of different subsystems.

I think parts of this are very true. Any plan that doesn’t count on software fracturing off into modules better suited to the user and business case is dangerous. Software is only going to get better, easier to make, and faster. The days of an immunology lab and a cytogenetics lab using the same software to do their work are over. The idea that they ever used the same software for their work is a conceit of vendors anyway, I think. They used the same software as a cash register, and did their work on paper most likely.

So the central point, that the LIS software environment will become more fractured and specialized I think is true, but the idea that the current LIS will serve as a viewer I think is giving too much credit to the current LIS. The current versions are not nearly as open and easy to integrate with as they need to be for this to happen.

EMRs are becoming this federation hub viewer already though, so do we really need another viewer? Especially one that is years behind? If I’m in the immuno lab, using special immuno software, do I need to see a federated view of lab info independent of the EMRs view? The case can definitely be made that such a federated system needs an LIS-side aggregation point for the data, but I don’t know how much user viewing functionality that needs to have. Most users would be happy to view one level up, at the EMR side I think.

Federation allows jobs to be done on the software most suited for the task. Many tasks are being lost to the central LIS (molecular, and other ancillary testing). This doesn’t mean that the main LIS isn’t still the best solution for some tasks though. Often reporting, and billing are its strong suits, and they may continue to be. I don’t think the future for “classic” LIS is in viewing things from disparate systems, that job is now the EMRs. The classic LIS needs to define and focus on its strengths though, (probably reporting and billing) and work to improve them, and their interoperability. If all the jobs get stripped away from the LIS they are in trouble. In a federated system if your app isn’t contributing then it’s not needed.