Information

Management
LABORATORY INFORMATION SYSTEM

GROUP 6
1A - BSMT
Learning Objectives
At the end of this activity, you will be
able to:
 Define Laboratory Information System and
its functions
 Differentiate a computer-based system
from manual, paper-based information
system.
 Describe the advantages and
disadvantages of a computerized
information management system.
Scenario
“You manage a laboratory for a
300 bed hospital and the
administrator has just notified
you that funds are available for
the purchase of a computerized
laboratory information system.”

 How do you assess the relevancy of

such a system for your laboratory?
The Quality Management System

Organization Personnel Equipment

Purchasing Process Information

& Control Management
Inventory

Documents Occurrence
& Assessment
Management
Records

Process Customer Facilities

Improvement Service &
Safety
Role in Quality Management System

 Thetest result is the final

product of the laboratory.

Quality Lab
Report
Information Management
Establish processes for
managing data

Paper- Quality Lab Report

based ID 0905120047

Patient  accessible
information
 accurate
 timely
 secure
 confidential
Electronic  private
 Unique
identifiers
samples,
Effective patients Standardized
communication request forms

Effective
Logs,
reporting Important worksheets
systems elements
Checking
Confidential
processes
Data
protection
Unique Identifiers

Patient
identifiers

Laboratories need to assign unique

sample identifiers:

Code: YYMMDDXXXX - 0905120047

means sample #47
received on May 12, 2009
Test request form

Laboratory

 ISO
ISO 15189 requirement
Logs/worksheets and checking processes

Laboratory
Data Protection

Paper-based systems
use durable materials for recording

store records properly

Computerized systems
schedule regular backup of data
Protect confidentiality / security
The laboratory director is responsible
for establishing policies and
procedures to:
safeguard a patient’s privacy
assure laboratory data confidentiality
Test results reporting systems
Patient: Mary J Johnston DOB: 28 Mar 1949
Address: 1234 Littletown Road, Bergly Bay
Patient ID No.: ab907823_001
Quality
Lab
Report timely
ID
0905120047 accurate
Sample: MSU
Test: C&S legible
Report to:
Dr RB Brown easily
Date:09.06.27 understood
Communication
Develop a good system for
communication:
 within the laboratory
Different
 with clients shifts
 other health care providers
 reference laboratories
 with official agencies
 Data
incomplete
Computer
ID
systems
insufficient
incompatible

Common
Transmission problems Forms
errors inadequate

Data
Archiving
organized
poor
poorly
Manual paper-based system
Requires registers and
logs with good design
that are:
practical to use and easy
to complete
make it easy to find data
make summarizing data
and writing reports easier
Data entry

Age not
recorded
Results
recorded
in village
column
Village name
not recorded
Unreadable-
thick felt-tip
pen used on Writing illegible
other side
Manual paper-based system

 final report is primary product –

make it professional
 need a system for obtaining
duplicates or copies of reports for
archiving
 assure safe storage of paper records
Manual paper-based system-storage
Goals:
 find results
 trace samples
 evaluate occurrences

Useful rules:
 keep everything for a designated time
 ensure easy access
 use a logical system for filing
 number in chronological order
Laboratory Information System
 a software system that records,
manages, and stores data for
clinical laboratories.
 traditionally been most adept at
sending laboratory test orders to lab
instruments, tracking those orders,
and then recording the results,
typically to a searchable database.
 Rationale for LIS

hardware, software, people,

procedures
and data
History of LIS
 Early 1960s advances in computational
technology led some to experiment with
time and data management functions in
the healthcare setting. Company Bolt
Beranek Newman and the
Massachusetts General Hospital
worked together to create a system that
"included time-sharing and multiuser
techniques that would later be essential
to the implementation of the modern
LIS.
 Late 1960s aside from the
Massachusetts General Hospital
experiment, the idea of a software
system capable of managing time
and data management functions
wasn't heavily explored primarily
because of the lack of proper
technology and of communication
between providers and end-users.
 Mid-’60s the development of the
Massachusetts General Hospital
Utility Multi-Programming System
(MUMPS) certainly helped as it
suddenly allowed for a multi-user
interface and a hierarchical system
for persistent storage of data.
 1980s, however, the advent of
Structured Query Language (SQL),
relational database management
systems (RDBMS), and Health Level
7 (HL7) allowed software developers
to expand the functionality and
interoperability of the LIS, including
the application of business analytics
and business intelligence techniques
to clinical data.
 Early 2010s, web-based and
database-centric internet
applications of laboratory
informatics software changed the
way researchers and technicians
interacted with data, with web-driven
data formatting technologies
like Extensible Markup
Language (XML) making LIS
and electronic medical record (EMR)
interoperability a much-needed
reality.
 LIS decision

 Type of lab
 Reference/research/public health
 Clinical
 Hybrid
 Volume of specimens
 Types and number of tests
 Size of staff/users
 Existing system
 Determine which areas will be affected
 Requirements and expectations
 Avoid ‘culture shock’
Functions of LIS

 Patient focus
 Enable determination of
patient outcomes
 Integrate patient and
specimen information
 Support patient management
and care/treatment
LIS Functions

 patient management, including

admission date, admitting physician,
ordering department, specimen type,
etc.
 patient data tracking
 decision support, including
comparisons of lab orders with their
respective ICD-9 codes
LIS Functions
 standard test ordering and specimen
tracking
 test ordering for point-of-care,
molecular, and genetic testing
 quality assurance
 workload and management reporting
 analytical reporting
 workflow management
 billing
 third-party software integration
Clinical vs. anatomic pathology LIS

 The laboratory information system

has been primarily segmented into
two broad categories (though other
variations exist): the clinical
pathology and anatomic
pathology LIS.
Clinical vs. anatomic pathology LIS
 In clinical pathology the chemical,
hormonal, and biochemical
components of body fluids are
analyzed and interpreted to
determine if a disease is present.
 Anatomic pathology tends to focus
on the analysis and interpretation of
a wide variety of tissue structures,
from small slivers via biopsy to
complete organs from a surgery or
autopsy
Clinical vs. anatomic pathology LIS
 Specific dictionary-driven tests are
found in clinical pathology
environments but not so much in
anatomic pathology environments.
 Ordered anatomic pathology tests
typically require
more information than clinical
pathology tests.
Clinical vs. anatomic pathology LIS
 A single anatomic pathology order
may be comprised of several tissues
from several organs; clinical
pathology orders usually do not.
 Anatomic pathology specimen
collection may be a very procedural,
multi-step processes, while clinical
pathology specimen collection is
routinely more simple.
 Why have a LIS?

 Improve data management in lab to

increase lab potential
 Enable centralization of information
 Support and enhance business
processes of the lab
 Take advantage of new lab
information technology
 Provide easy access to data
 Computerized LIMS
Software options
 in-house developed systems using commercial
database software
 fully developed commercial systems

Look for:
 permanence
 computer system maintenance, backups
 security
 access
 confidentiality
 traceability
 system speed, flexibility
 Advantages
Error
Integrate reduction QC
with other
sites
Data
Financial
retrieval
management
options

Detailed,
Access
legible
control
reports
Track,
Track
analyze
reports
trends
Advantages of LIS Use

 Fewer transcription errors & faster

processing with direct instrument
uploads
 Real time control of data quality with
built in QC criteria
 Direct report generation meeting
specific client requirements
 Direct electronic reporting to clients
or direct client access to data
Disadvantages Training:
time
and money

Adapting
Back-up
to a new
requirements
system

Costs:
purchase
and
maintenance
Disadvantages/Concerns

 Customization of LIS/interfaces
required for specific lab/client needs
 Adequate validation to ensure data
quality
 Data integrity and confidentiality,
especially when clients have direct
access to data
 Limited interface between lab & field
computer systems
Differences between a LIS
and LIMS
LIS LIMS
LIS is patient based. It stores and LIMS is a comprehensive
manages patients' data and their software tool used for centralizing
test results. laboratory's operational
workflows and is sample centric
rather than patient centric.
LIS has been designed primarily LIMS has traditionally been
for processing and reporting data designed to process and report
related to individual patients in a data related to batches of
clinical setting. samples from drug trials, water
treatment facilities, and other
entities that handle complex
batches of data.
A LIS must satisfy the reporting A LIMS, however, needs to
and auditing needs of hospital satisfy good manufacturing
accreditation agencies, HIPAA, practice (GMP) and meet the
and other clinical medical reporting and audit needs of the
practitioners. U.S. Food and Drug
Administration and research
scientists in many different
industries.
A LIS is usually most competitive LIMS is most competitive in
in patient-centric settings group-centric settings (dealing
(dealing with "subjects" and with "batches" and "samples")
"specimens") and clinical labs. that often deal with mostly
anonymous research-specific
laboratory data.
Examples

KIDMS
Reports
Information available on LIMS

 Project, samples, tests

documentation
 Sample tracking history within the
Lab
 Reporting results (hardcopy,
electronic file)
 Financial information by test, client,
dates
 Information on Productivity
Benefits of LIMS
 It improves the efficiency hence
productivity.
 Improve data quality (all instrument
are integrated).
 Saves time because the information is
obtained at the snap of the button
 Improve level of data access for all
stakeholders of any project.
 Automated customer reports (TAT,
Work Load)
Laboratory Responsibilities

 Evaluate LIMS capabilities

 System validation/maintenance
 Interfacing capabilities
 Confidentiality/data integrity
protection
 Regulatory compliance/accreditation.
Summary
 System for managing both incoming and
outgoing data.
 May be paper-based or computer-based
 Both require a similar framework,
including unique identifiers, forms, logs
and worksheets.
 Cost is a major factor in using a
computer-based system.
Key Messages
A good information management
system will:
 ensure all data—the final product of the
laboratory—is well managed
 consider all the ways laboratory data will
be used when planning a system
 assure the accessibility, accuracy,
timeliness, and security of data
 ensure confidentiality and privacy of
patient information
References
[1] "Laboratory Information Systems". Biohealthmatics.com.
Biomedical Informatics Ltd. 10 August 2006. Retrieved 06 May 2011
[2] Park, S.L.; Pantanowitz, L.; Sharma, G.; Parwani, A.V. (2012).
"Anatomic Pathology Laboratory Information Systems: A
Review". Advances in Anatomic Pathology 19 (2): 81–
96. doi:10.1097/PAP.0b013e318248b787
[3] Blum, B.I.; Duncan, K.A. (1990). A History of Medical
Informatics. ACM Press. pp. 141–53. ISBN 9780201501287.
[4] Jones, J. (March 2012). "What is the difference between a LIS
and a LIMS?". LinkedIn. Retrieved 14 September 2017
[5] Jones, John (September 2012). "Are LIMS and LIS the same
thing?". LinkedIn. Retrieved 07 November 2012.
[6] system?". AgiLab SAS. Retrieved 14 September 2017.
Jump up↑ "Difference Between LIS and LIMS". CloudLIMS.com, LLC.
01 October 2016. Retrieved 14 September 2017
[7] Reisenwitz, C. (11 May 2017). "What Is a Laboratory
Information Management System?". Capterra Medical Software Blog.
Capterra, Inc. Retrieved 14 September 2017.