LESSON 10: LABORATORY MANAGEMENT INFORMATION SYSTEM

Overview of Laboratory Information Management System

10.1.1 Overview of LIMS
A laboratory information management system (LIMS) is software designed to make labs more
efficient and effective, especially those that process massive amounts of samples for research
and development (R&D), manufacturing, and medical research.
Any kind of lab can gain from a LIMS or a laboratory management system (LMS). However,
they are more commonly found in manufacturing and quality assurance. A few examples include:

 Labs dealing with R&D for oil and fuel companies

 industrial chemical creation and testing
 Water treatment plant testing
 food safety
 Environmental facilities

The form of lab you run will decide which type of software you ought to go with. LIMSs are also
used in the medical and pharmaceutical industries. And, in conjunction with laboratory
information systems (LIS), LIMS is also a form of medical lab software program.
Almost each top pharma lab presently makes use of a LIMS, consistent with Gartner’s 2016
life Sciences Hype Cycle (full content available to Gartner clients). They’re beneficial for
biobanks and genomics testing centers together with labs that study drugs and develop
formulations (Reisenwitz, 2017).
10.1.2 The purpose of a LIMS
The ultimate motive of a LIMS is to enhance efficiency in lab operations through reducing
manual responsibilities. As an example, a LIMS automatically records information that might in
any other case need to be typed in or written down, thereby saving time and reducing mistakes.
What information your LIMS automatically captures, the way it enters the system, and where
and how it’s saved relies upon on which LIMS supplier you select. Some LIMS might be
better at supporting certain kinds of labs function more successfully, but not be as suitable for
others (Reisenwitz, 2017).

Functional Requirements and Features of LIMS

Reisenwitz (2017) elaborates on the functionality of an LIMS as follows:
Sample management
As samples move from person to person and place to place, it’s easy for them to get lost or
mixed up. Accurate, detailed records are essential to making sure everything gets done and
done right. For example, a good record should tell you whether a sample meets project criteria,
but they can be a pain to create and maintain.
When you create a sample, most LIMSs will record and store information such as:

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
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  Who or what the sample was taken from?
 Which researchers/providers are working with it?
 Where it's been, and where it needs to go next?
 How to store it?
 When it needs to move?

Ideally, the LIMS will automate as much of this as possible. Some use RFID to create and
update audit logs and chain of custody to automatically track where the sample is in every stage
of the process. Barcode also works for this purpose.
Workflow management
You should use an LIMS to automate workflow for the same reason you should use it to
automate records keeping, but instead of saving work, this function saves you time. When you
codify existing methods and procedures in a LIMS, you delegate decision-making to the
software. For example, it can automatically assign work to scientists and suggest instruments
based on preset rules. And instead of looking up what you need to do with a sample and where
it needs to go next, a good LIMS will automatically provide this information.
Reporting
It's good to be able to quickly pull reports that can answer questions such as which instruments
get used the most, how long your sample backlog is, and how long it takes your lab, on average,
to process a sample. This kind of data is extremely useful for data analysis auditing and audit
trail.
Some LIMS will be more granular in their reporting than others. For example, one LIMS might
be able to tell you what your average sample processing time is, but another might tell you your
average time broken out by type of sample. It's helpful to know what kind of reporting and level
of reporting you need before you begin comparing vendors.
Keep in mind, just because a LIMS can run a report doesn't mean it's easy. Some reports
require custom coding to set up and run. And some systems can export to Adobe PDF and
Microsoft Word, but not Google Drive.
EMR/EHR
Electronic health records (EHR) is its own type of software, but some LIMSs have EHR
functionality built-in, including patient check-in and billing. If you don't have a software package
offering these features, choosing a LIMS with this kind of functionality can be a huge asset
when managing your clinical lab.
Mobile
Gartner's Hype Cycle says that mobile LIMS offerings are limited right now. But as smartphones
become more acceptable in the lab, consider whether it will be useful to you in the future to
have a mobile-friendly LIMS.
ERP
ERP software helps manage inventory, and it can be very helpful to have a LIMS that performs
this function. Being able to view what you have on hand at a glance, getting alerts when
supplies are running low, auto-calculation of storage and freezer capacity, and location
management can be extremely useful in a clinical lab.

Core Components of LIMS

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
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LIMS software suites usually involve multiple components in order to provide a variety of
functions for different levels of the laboratory. IEEE GlobalSpec (2015) specifies that
components may include:

 Electronic lab notebooks

 Sample management programs
 Process execution software
 Records management software
 Applications to interface with analytical instruments or data systems
 Workflow tools
 Client tracking applications
 Best practice and compliance databases
 Enterprise resource planning (ERP) software

Figure 10.1 below displays a view of the primary components and interfaces of a Laboratory
Information Management System.

Figure 10.1:Components of an LIMS

Source:https://www.globalspec.com/learnmore/industrial_engineering_software/engineering_sc
ientific_software/ laboratory_information_management_systems_lims

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
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 Laboratory Standards
The Occupational Safety and Health Administration (OSHA) released an "Occupational
Exposure to Hazardous Chemicals in Laboratories standard (29 CFR 1910.1450)" in 2011 to
facilitate laboratory safety. Some important provisions are excerpted from the standard below:
“Laboratory” means a facility where the “laboratory use of hazardous chemicals”
occurs. It is a workplace where relatively small quantities of hazardous chemicals are used on a
non-production basis.
“Laboratory use of hazardous chemicals” means handling or use of such chemicals in
which all of the following conditions are met:

 Chemical manipulations are carried out on a “laboratory scale” (i.e., work with
substances in which the containers used for reactions, transfers, and other handling of
substances is designed to be easily handled by one person);
 Multiple chemical procedures or chemicals are used;
 The procedures involved are not part of a production process, nor do they in any way
simulate a production process; and
 "Protective laboratory practices and equipment" are available and in common use to
minimize the potential for worker exposure to hazardous chemicals.
 Any hazardous chemical use which does not meet this definition is regulated under other
standards. This includes other hazardous chemical use within a laboratory. For instance:
 Chemicals used in building maintenance of a laboratory are not covered under the
Laboratory standard.
 The production of a chemical for commercial sale, even in small quantities, is not
covered by the Laboratory standard.
 Quality control testing of a product is not covered under the Laboratory standard.

If the Laboratory standard applies, employers must develop a Chemical Hygiene Plan (CHP). A
CHP is the laboratory's program which addresses all aspects of the Laboratory standard.

 The employer is required to develop and carry out the provisions of a written CHP.
 A CHP must address virtually every aspect of the procurement, storage, handling, and
disposal of chemicals in use in a facility.

Primary elements of a CHP include the following:

 Minimizing exposure to chemicals by establishing standard operating procedures,

requirements for personal protective equipment, engineering controls (e.g., chemical
fume hoods, air handlers, etc.) and waste disposal procedures.
 For some chemicals, the work environment must be monitored for levels that require
action or medical attention.
 Procedures to obtain free medical care for work-related exposures must be stated. The
means to administer the plan must be specified.

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
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  Responsible persons must be designated for procurement and handling of Material
Safety Data Sheets, organizing training sessions, monitoring employee work practices,
and annual revision of the CHP

Registration, billing, contract management, accounts receivables

10.5.1 Patient Registration
When you arrive at the hospital, the Admission Clerk will take some basic information and then
will guide you to a registration window
Figure 10.2: Patient Registration Form

Source:Bizbox.ph
10.5.2 Billing
The process of generating SOAs or Billing Statements of Inpatients, Outpatients, and
Emergencies are the same. In this example, we used Inpatients.
Figure 10.3: Billing

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Source:Bizbox.ph

10.5.3 Contract Management

Most Laboratory Information Management Systems allow the laboratory professional to manage
the billing and payment aspects of their activities and create statistical and billing reports at par
with the laboratory and management needs. They provide parameters for a flexible price
schedule, and enable heightened attention on customer needs. LIMS automate billing
processing, hasten collections, and offer marketing tools which minimizes the time spent on
standard flow and allows billing and accounting personnel to focus on improving collection of
problematic accounts (Informed, 2017).
In addition, common features of LIMS for invoicing and contract management include:

 Customer customizable invoices including balance and charges history analysis, history
balance, detailed services, participation when in insurance coverage, discounts etc.
 Different electronic formats for invoices allow interfacing to customer electronic systems
 Customizable information completion reports for customers
 Managerial reports display laboratory billing status for payer groups including projected
return values for each payer group
 Ability to change the Insurance Organization of a Patient per visit.
 Ability to select which Tests of a Patient's Visit are covered by the Insurance
Organization and which are privately-with automatic modification of the prices
accordingly.
 Supervision-financial data management of the Senders.
 Reminder for amounts due from past visits
 Immediate access to the Billing Card of each Patient.
 Consistency with the International Laws.

10.5.4 Accounts Receivables

Because of the integration of the LIMS, the personnel in charge of managing Accounts
receivables can easily extract information which was already available from the invoicing and
contract management procedures. Additionally, the LIMS can:

 Generate specific or complete Accounts Receivable reports

 Monitor balances for reconciliation and audit purposes
 Export data to other accounting systems
 Ability to change the Insurance Organization of a Patient per visit.
 Customize reports according to specifications

Figure 10.4: Accounts Receivable

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
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Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
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Source: https://adniasolutions.com/wp-content/uploads/2017/03/Accounts-Receivable-
Dashboard-Template-v1.02.jpg

10.6 Work list and Workflow

LIMS assist laboratories in setting priorities of current workloads, based on analyst and
instrument availability. This function allows user to track a sample, a batch of samples, or a "lot"
of batches through its lifecycle. Queueing can also be done by sample or by workflow, a block of
repetitive procedures in a certain process. The queueing and work list feature provides an
insight into when an event occurred, how long it was, and who was involved.
In addition, other features in the Laboratory Information Management System also enable
personnel and workload management, allowing users to plan workload schedules and
assignments, and employee information and training. Ultimately, the work list and workflow
functions operate to facilitate more efficient laboratory processes.
10.7 Quality Control
Diagnostic tests executed inside the clinical laboratory may yield two kinds of results, a patient
result or a quality control (QC) result. The result can be quantitative (in numbers) or qualitative
(positive or negative) or semi-quantitative (limited to a few different values). Quality control
results are used to verify whether or not the instrument is working within prescribed parameters,
confirming that patient test results are reliable (Bio-Rad Laboratories, 2008).
LIMS have functions that enable users to set standards about the relevant range of patient test
results, or extract test result information for the purpose of quality assurance. Outliers and
deviations can be flagged, and appropriate warning signals can notify users of issues which
might involve the quality of the samples or the equipment currently in use.
10.8 Barcode-generation, printing and reading
LIMS modules are commonly linked to a barcoding label generator, enabling a fast and easy
method to identify tubes, samples, documents, among many others. Simply print it on labels
stickers to place on whatever item needs identification. A barcode editor also allows multiple
labels to be printed at a label printer. The barcode series can usually be customized to suit your
organization or classification needs. With this kind of technology, you can effortlessly find and

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
8
retrieve information about a tube, a specimen, or equipment within the laboratory using a
barcode scanner.

Figure 10.5: Barcode ID

Source:Bizbox.ph

10.9 In-built bi-directional interfaces with equipment

Figure 10.6: A Bi-Directional Interface

Source:http://www.medtechnet.com/public_pdf/mtc16.pdf
A bi-directional interface (Figure 10.6) involves true two-way communication between the
analyzer (equipment) and information system interface. The LIMS interface downloads
specimen ID and test orders, while the analyzer uploads specimen ID and test results. More
Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
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recently, bi-directional interface capability has been implemented into various microbiology,
immunoassay, coagulation and hematology instruments.
A bi-directional interface application saves the technologist the time to program test orders into
the analyzer, and eliminates errors in manual entry. This can result in a considerable
enhancement in analyzer productivity. Newer random access testing, bi-directionally interfaced
analyzers also incorporate bar code specimen label scanning which provides automatic positive
specimen ID capability. This can further eliminate manual entry of specimen IDs and/or coding
of specimens by tray/cup position (Selmyer and Cloutier, 1996).

HANDS-0N EXERCISES Laboratory Information Management System (LIMS)

Lesson Intended Learning Outcomes (LILO):

 Simulate retrieval and confirmation or laboratory requests

 Record receipt of specimen and assign the task to a medical laboratory technician
 Review the results, check the patient history and submit the report.

Requirements:
Complete the following using the student portal.

1. Using the LIS retrieve the laboratory request for the following patients and complete the
information in the table below:

2. Assign the following tasks to the following Med Lab Technician:

3. Review the results. Check the Patient history before submitting the results.

KEY POINTS TO REMEMBER

 A laboratory information management system (LIMS) is software designed to make labs

more efficient and effective.
Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
10
  The ultimate motive of a LIMS is to enhance efficiency in lab operations through
reducing manual responsibilities.
 The core components of LIMS are electronic la notebooks, sample management
programs, process execution software, records management software, applications
interface, work flow tools, client tracking, best practice and compliance databases and
ERP software.
 The Occupational Safety and Health Administration (OSHA) released an
“Occupational Exposure to Hazardous Chemicals in Laboratories standard(29 CFR
1910.1450)” in 2011 to facilitate laboratory safety.
 LIMS covers registration, billing, contact management and accounts receivable.
 LIMS assist laboratories in setting priorities of current workloads, based on analyst and
instrument availability.
 LIMS have functions that enable users to set standards about the relevant range of
patient test results, or extract test result information for the purpose of quality assurance.
 LIMS modules are commonly linked to a barcoding label generator, enabling a fast and
easy method to identify tubes, samples, documents, among many others. Simply print it
on labels stickers to place on whatever item needs identification.
 A bi-directional interface application saves the technologist the time to program test
orders into the analyzer, and eliminates errors in manual entry. This can result in a
considerable enhancement in analyzer productivity.

Reference book : Health Information System for Medical Laboratory Science (Jose Jurel M. Nuevo)
Online reference: PASMETH Health Information System Student Portal : https://eruditedevforums.com.
11