Public Health Laboratories and Health System Change . Internal Laboratory Information Systems


Virtually all interviewees believe that automation can increase the efficiency of a laboratory. Automation of the commercial reference laboratory market is a well established industry whose vendors include Cerner Corporation, Citation, MediQuest, SMS, and SunQuest Information Systems, Inc. Commercial LIS systems were originally designed to assist automation and efficiency in reporting results back to providers. Most recently, LIS operators have focused on helping reference laboratories adapt to the demands of their managed care customers. One LIS focus involves helping laboratory service vendors use robotics to automate testing and reporting functions centralized on a regional or national level. Another, somewhat competing focus, involves satisfying the increasing demand for point of care testing facilities, which are monitored for quality through a central LIS system and are able to transfer data to and from a central database.

A few products are specifically targeted to PHLs. Epic Systems Corporation is one company offering such services to PHLs (current clients include the state PHLs in Michigan, South Dakota, Wisconsin and Texas). The standard LIS product is able to track specimens from collection to result reporting, and can produce detailed reports using statistics generated from the data. Additionally, the Epic LIS system's open architecture allows for the creation of additional fields and screens for the integration of data from non-laboratory sources (e.g., medical or pharmacy data). A representative from Epic reported that most of its PHL clients are able to use the open architecture to support broader data integration efforts within their state health agencies.

Some states have not relied on comprehensive products, but rather have developed the LIS environment internally (e.g., Washington). There are also a few more products for specialized laboratory areas. For example, Washington State recently purchased NeoMetrics, an automated system for use by PHLs in tracking neonatal screening samples (16 other states have this software currently). Finally, the CDC has also created a Laboratory Information Tracking System (LITS) for use by PHLs.