Here at U.S. HealthTek, we’re seeing greater interest in new and upgraded Laboratory Information Systems (LIS). This is a little something I know about. When I started my career in the healthcare industry in the mid-1980s, one of my initial projects was to build a lab system for National Health Labs. It took us six months to design a system and another year to build the software that was to go into 19 different locations. From initial conversations to total implementation, the whole process took five years. That project got especially complicated because just as we were finishing, the company merged and became LabCorp. We ended up carving up that system, and I believe to this day they still use part of it as a work-sheeting system. It’s one of the few things I did during the 1980s that is still relevant – unlike those Flock of Seagulls cassettes.
Why a new LIS? It’s a simple equation: Getting work in and results out quickly is really the most important aspect of the business. Doctors want the results, and patients deserve them, rapidly. Also there is this: There was a lab I worked with in Virginia where a single day’s delay in turnaround was costing the company $1 million. They did that kind of volume. As I reflect back on the many organizations who we worked with, there are a couple of critical points that laboratories need to consider before implementing one today.
Operational Workflow Must Change. Tailoring a new LIS to an existing, rigid workflow culture is not practical. We always prepare clients to understand that implementation of a system goes smoothest when there is an understanding that staff adaption will be required. Here is where a good project manager comes into play. You want to bring both sides together and get buy-in from the staff. Who can make this happen? An experienced project manager. What’s the two-word definition of what a project manager does? “Herding cats.” But it’s even more complicated than that…
The project manager typically represents the lab client when they don’t have the resources or personnel to dedicate a manager to the system deployment themselves. The first thing they do is go in and meet everyone and understand the psychology of the lab culture. Lab work is stressful, and volume-based. By design, LIS is ‘moving the cheese’ and even changing the layout of the input screen is stressful. But the experienced project manager is prepared for that, and knows about the studies that prove we can increase the speed of inputting patient information from 12 minutes to three minutes by setting up practice sessions for the staff.
Understanding and Communication. The management at the top who is implementing a new system should understand the nuances of the current workflow, and communicate what is happening, why, and on what time frame. Communication is especially important. When I walk in and say, “I’m here to do your new LIS,” and everybody just looks at me funny, I know it’s going be a bumpy ride. Like deer caught in headlights, I can see from the look in their eyes that they have not been involved in the process for change. The opposite is a best-case scenario: When everyone is plugged in, when they know it’s coming, and they are all up for the initial challenges and rough spots, that’s when it goes the smoothest. Also needing to be communicated is the why. You want them to understand that in the end, their lab will be more efficient and profitable.
Clearly Defined Leadership Roles. There needs to be a point person with the lab organization with the authority to make the call in the field. We’ve occasionally experienced “decisions by committee” and when there is no single decision-maker in power, it can cause tremendous delays. We’ve seen a small lab take three times the length of implementation when the process is overseen by committee.
Embrace Disruption. Lab installation conversions are by their very nature disruptive. There’s no way around it. BUT… if you prepare, if you have the right team doing the work, if it’s properly planned and coordinated, it can be minimalized. Understand that even in the best situations something will get missed, some staff members will need extra time in adapting, etc. If it’s done well, a lab can recover within six weeks (larger, more complicated ones can take six months).
Commit and Invest. In addition to the cost of the system, make sure you budget for ancillary purchases. This can include new printers, additional instrumentation, new bar-code readers, new supporting software applications, etc. Yes, the ultimate cost can be prohibitive in some cases. But what is driving all this is that when your current LIS is not performing smoothly, when it’s not to up to the scale of your work and inefficiencies are adding up, the ability to grow is stagnating… so yes, capital is involved, but the investment results in a lab that ultimately is more profitable.
You want a veteran team with a refined process that that is straightforward. We discover how the lab operates today, and look at everyone’s process when we start a project. We collect the data, configure the basics of a new system, and plug all that in, and that gets us in the ballpark. Then at some point we do some custom work that is involved. Then there is testing, validation, and then user acceptance testing and training.
The point is: If it’s worth considering, it’s likely worth doing. If it’s worth doing, it’s worth doing right.