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.