Survey shows laboratory information systems not likely to cope with change
A survey of Australian laboratory scientists carried out by information systems vendor InterSystems has found that the quest for cost savings and an increase in automation are driving change in the pathology sector, but for public laboratories at least, current laboratory information systems (LIS) are not up to the task of coping with these changes.
InterSystems, which markets a laboratory module as part of its TrakCare suite and is due to launch what it calls a laboratory business management system (LBMS) early next year, conducted one of its annual surveys of the sector at the Australasian Association of Clinical Biochemists (AACB) conference in Sydney in September.
InterSystems surveyed 60 people representing 29 public pathology labs, 18 private pathology labs and 13 related organisations including government. Over half (53 per cent) of those surveyed were biomedical or clinical scientists and 19 per cent were lab managers or heads of department.
The survey found that 75 per cent of respondents cited cost savings and efficiencies as drivers of change in their laboratories, with 63 per cent singling out automation. Other drivers were consolidation of labs or formation of laboratory networks, the introduction of electronic health or pathology patient records, and point of care testing (PoCT). Only one-third said patient-centred care was driving change.
There were differences in emphasis between public and private labs – for public laboratories, the biggest driver was cost savings and efficiencies (83 per cent), while private labs were more likely to cite competition with other laboratories and increased demand for genomic testing.
Public labs also cited consolidation of laboratories and the formation of laboratory networks.
The survey found that in Australia, only 29 per cent of public laboratories thought their current LIS was capable of supporting these changes, with 36 per cent saying they disagreed or strongly disagreed that their systems were up to the task. 36 per cent were neutral.
Private labs look to be in better shape, with 45 per cent saying their systems could support the changes and only 17 per cent thinking they couldn’t.
The two sectors were more in alignment when it came to what laboratory system capabilities were the most important to the success of the lab in the future, although the public sector cited the ability to integrate the pathology record with the organisation’s EHR and interoperability with other organisations much more highly than private.
Three quarters (75 per cent) of respondents cited ‘Complete visibility, control and accountability over the testing process’, and ‘Support for laboratory workflows occurring across a number of sites’ as important.
‘The ability to predict laboratory workloads and pinpoint bottlenecks’ was chosen by over 83 per cent of public laboratories and only 44 per cent of private.
Capabilities also rated as important were:
- Configuration and management of key performance indicators (KPIs)
- Maintenance of a patient pathology record (PPR)
- Support for offsite point of care testing equipment and test results
- Enforcement of protocols/standard operating procedures
- Secure connectivity with any computing device with Internet access
- Integrated asset management with visibility of equipment data alongside test results.
The public pathology sector in Australia uses a relatively small number of systems, including InterSystems’ TrakCare, which was recently installed at Macquarie University Hospital in Sydney and has a long-standing relationship with St John of God Pathology.
A new system from PJA Solutions is currently being implemented as part of an alliance between Royal Melbourne Hospital, The Austin and the Peter MacCallum Cancer Centre in Melbourne. PJA Solutions was bought by the publicly listed, Canberra-headquartered Citadel Group in June for $45 million.
SA Pathology is due to roll out a new system from Cerner to replace its Ultra system as soon as SA Health can get its enterprise patient administration system (EPAS) from Allscripts working. The Cerner product, called the enterprise pathology laboratory information system (EPLIS) by SA Health, is likely to run alongside Ultra until then.
Both Pathology Queensland (PJA’s Auslab) and PathWest (Ultra) are likely to issue tenders for new systems over the next few years.
The private sector uses a mixture of provider-owned or bespoke systems, including Sonic Healthcare’s Detente system and Healthscope and Primary Health Care both using a version of Ultra, which was originally developed in Australia by Triple G, was then sold to GE and is now owned by a Northern Irish company called Cirdan.