Interoperability in Laboratory Management Information Systems

Introduction

Medical laboratories are the key departments for healthcare. The tests done in medical laboratories give important information that constitutes the basis for the diagnosis and treatment. The term “Medical laboratories” is commonly used for Pathology, Microbiology and Biochemistry. Genetics and Hematology can also be understood. Medical laboratories may be independent, or part of a healthcare institute such as hospital or health center. They may belong to private sector or government. In all cases, they employ highly complicated information systems, called as Laboratory Management Information Systems (LAMIS).

If the medical laboratory is part of a hospital, LAMIS used in it may be a component of the Hospital Information System (HIS), it has the same database and application platform. In this case, it can exchange data with the other information system components such as order entry, accounting etc. natively. Alternatively, LAMIS may be a third party product independent of the HIS, having different database and application platform. In this scenario, it does not have a chance to communicate with the other HIS components natively. A communication application is needed. If the medical laboratory is independent then this need is inevitable. Because the LAMIS used are different from the systems of the sites, it needs a separate communication application to manage the communication. The notion “Interoperability” has arisen from this need of communication with other information systems.

Healthcare Information and Management Systems Society (HIMSS, 2013) defines interoperability as “In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged”. The Institute of Medicine of the National Academies (IOM,2004) defines interoperability as “the ability of systems to work together, in general through the adoption of standards. Interoperability refers not only to the ability to exchange health information, but also to the need to understand the information that has been exchanged”.

Figure 1 presents the communication needs of LAMIS. LAMIS’ are to communicate

Figure 1.

LAMIS communication needs

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  With auto analyzer laboratory devices used within the laboratory,

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  With public health departments about the mandatory reporting of the infectious diseases and other important data,

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  With wearable and portable devices used by patients,

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  With insurance companies for accounting,

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  With patient provider healthcare institutes.

The term “interoperable” is used to explain that an information system has the ability to communicate with the necessary systems and devices.

Background

Patient providers of the independent laboratories are the clinicians, may be working in a hospital center or working privately. Although most hospitals have their own laboratories, they need services from independent laboratories in the tests that are not studied frequently, and/or in the tests whose kits are not available temporarily. If the LAMIS used in the hospital laboratory is not part of the HIS, which means it is a third party product, then its providers are the clinical departments of the hospital.

No matter who is the provider, interoperability between laboratories and providers, improve clinical care by giving clinicians better access to patients’ longitudinal test results, eliminating errors associated with verbally reporting results, optimizing ordering patterns by making test cost information available to clinicians, and making testing more convenient for patients(CITL, 2004).

Two potential cost savings in interoperability between patient providers and independent laboratories reported by the Center for Information Technology Leadership (CITL, 2004)

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  Computer-assisted reduction of redundant tests.

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  Reduction of delays and costs associated with ordering and reporting of results.