Small hospitals and medical clinics are waging a David and Goliath-style battle for survival against mega medical facilities and health maintenance organizations (HMOs). In an era of industry-wide downsizing, cost-cutting is the goal and state-of-the-art computer information system (IS) technology is the weapon of choice. Large healthcare institutions are arming themselves with these weapons to streamline their operations, enhance their competitiveness, and deliver quality care at the lowest cost. However, such tools come at a hefty price – the big-gun IS software solutions used by these institutions can run into the millions of dollars, leaving less well-funded facilities holding the technological equivalent of slingshots.
Clinics and hospital laboratories are being caught in the crossfire of this battle. As facilities struggle to maintain revenue and contain their costs, they have decreased funding for clinical lab services, forcing labs to consolidate, reorganize, and downsize. In turn, these labs are also striving to keep pace with an increased work load associated with test processing, result reporting, and high-volume data storage, while simultaneously being hamstrung by employee cutbacks and outmoded tools. Adding to their dilemma are the increased documentation requirements driven by quality control and regulatory concerns.
The obvious solution is a specialized laboratory information system (LIS) that enables labs to manage their data, maintain quality, and improve efficiency, while focusing their limited labor resources on high-value tasks. LIS solutions give lab technicians and medical practitioners tools and a database structure specific to their work flow that stores patient demographics, test orders, and results. Manual entry procedures are minimized and data flow is automated by LIS software. This automation centralizes laboratory information, reduces errors, and makes the retrieval of testing information fast and easy from a centralized location. More than just a tool for laboratorians, LIS solutions can be configured to share data with an institution’s central computer system, permitting a detailed track of a patient’s activities and health status from the time he /she is admitted, diagnosed, and treated.
Unfortunately, finding such a comprehensive, affordable lab system can be challenging, if not impossible, for many facilities. In some cases, when laboratories contact information solution vendors, they often find that their budgets and operations are not large enough to incorporate and implement the vendor’s system. Translation: Most of the IS vendors simply aren’t interested in small jobs.
“We needed a computerized system so we could continue to provide high-quality laboratory services instead of shuffling papers,” reports Jean Bearor, laboratory manager for Redington-Fairview Hospital, a 67-bed hospital in Skowhegan, Maine. “Large IS vendors that included an LIS wouldn’t even consider looking at us.”
Additionally, facility administrators have been reluctant to fund software purchases that appear to be tailored exclusively for laboratory use. Healthcare facility purchasers are under pressure to cut costs, while selecting high-tech, long-lasting solutions that ensure efficient use of labor and material resources – a tall order indeed, and one usually filled without regard for the laboratory’s true needs.
While it would be unfair to criticize the important role of such administrators, their IS requirements are clearly focused on reducing expenses and computerizing administrative and billing functions, rather than helping laboratories obtain the best tools to run more smoothly. As such, lab considerations take a back seat during the IS search, which is usually done by a team of consultants seeking a system to accommodate other facility needs. Laboratory managers often feel left out of this IS selection process. When this happens, they must settle for an LIS module as part of an overall IS package, adapting their laboratory processes to fit the system’s inadequacies.
“Currently, many labs have had to ‘go without or make do’ with the LIS that comes with a vendor’s overall information package,” states Jeff Fisher, CEO and president of Comp Pro Med, a Santa Rosa, Calif.-based LIS vendor. “Sometimes these systems are selected by non-laboratorians to computerize facility financial and administrative management functions. These labs could really benefit from a stand-alone, purpose-built LIS that provides technology expertise, allowing them to more efficiently manage their lab data and ultimately control their destiny,” he asserts.
Fisher, a former laboratorian, recognized the need for an affordable LIS while working for a private lab. As the workload increased, he searched for a stand-alone system that would streamline the lab’s test processing and data management procedures. Failing to find such a system, he started Comp Pro Med in 1981 and began developing his own laboratory information system. Today, Comp Pro Med specializes in providing affordable, turnkey PC-based LIS solutions to manage and automate the flow of clinical laboratory information.
“We needed a software system and functionality that didn’t exist,” says Fisher, “and the products that were available were beyond our economic reach, so we set out to build one ourselves.”
The fruit of his labors is Polytech, a flexible, industry-proven LIS solution that helps labs increase productivity, reduce costs, and improve services to their clients. From test order to final report, Polytech streamlines test processing, ICD-10 coding, and reporting processes with an intuitive, user-definable interface that conforms to typical laboratory procedural and workflow pathways. The system interfaces a variety of clinical instruments used in modern laboratories, and automates quality control across analyzer types and laboratory departments. Comprehensive and cost-effective, Polytech performs patient specimen data management, and generates final, interim, and cumulative reports on patients (or the test results?) from the initial requisition entry to final reporting.
“We developed the program to computerize our lab and maintain quality control,” recalls Fisher. “Then we realized that there were many laboratories out there with the same need, and that we could share our solution with them. We want Polytech to be a solution and a tool for labs, not just another problem for them.”
Laboratory managers previously overwhelmed by mountains of paperwork appreciate Polytech’s ability to computerize the lab environment. Boasting a standard data storage capacity of more than two million patient records and 80 million individual test results, Polytech eliminates traditional paper files and their storage hassles, while still maintaining compliance with governmental regulations and CLIA licensure requirements.
“When we were working with a paper system, we had to buy tons of manila folders and rent off-site storage that we filled with boxes of records. Polytech changed all that,” says Ken Brownlee, laboratory director at Laurens County Hospital in Clinton, S.C. “We’re required to store our lab reports for two years, but that’s not a problem since Polytech holds four to five year’s worth of our patient data online.”
Although Polytech shares similarities with file server systems, the program is actually a self-managing, multi-user network. Polytech operates using a redundant distributed database topology called MedLink, Comp Pro Med’s network software that automatically distributes and synchronizes patient databases on each workstation in the laboratory’s network. This is an important fail-safe feature, that prevents catastrophic data loss, system performance degradation, and network failure. If a computer in the system fails, all data files are still active and retrievable from other workstations, minimizing downtime and eliminating patient record loss.
“If one computer fails, the rest of the network will see that failure and automatically re-feed it data when it’s back online,” states Fisher. “Later the repaired computer will seem as though it had never been down.”
The Polytech LIS interfaces laboratory analyzers, allowing lab technicians to order test data from any workstation. When testing is completed, results are uploaded to Polytech automatically, or manually entered through Polytech’s data entry user interface. A technician then evaluates the results and releases them for interim, cumulative summary, and final reporting use.
“Polytech communicates with our host SMS (Shared Medical Systems), accepting floor test orders, and then tells our lab instruments which tests to perform on a sample,” says Ken Kincaid, laboratory manager for the Western Arizona Regional Medical Center in Bullhead City. “When analyzers finish testing, Polytech captures the results and sends reports to the SMS nurse’s workstations, where the appropriate personnel can view the data onscreen or print it out.”
“We use Polytech to get a summary of patient test results as well,” continues Brownlee, “so doctors and nurses can track the changes in a patient’s health status over a specified period of time.”
Another benefit of the Polytech LIS is its ease of use; lab technicians can immediately access any part of the Polytech program via pull-down menus. Patient demographics, test requests, and results are all displayed on a single screen. Technicians perform 90% of their work at a centralized location in the program. Polytech also saves time by giving technicians direct access to the data they need instead of forcing them to scroll through multiple menus and screens.
“Polytech has organized our entire laboratory,” states Kincaid. “We looked at larger laboratory information systems, but they were too expensive and convoluted. We bought Polytech because it met our needs at much lower purchase and operational costs, and it’s easier to use.”
All laboratory charges are accounted for in Polytech’s patient charge summary module, which tracks each patient’s lab work and the related charges. When the work is completed, a charge summary report is produced for each patient. This information can be printed or sent electronically to the accounting department for bill processing.
“Our billing department was specifically concerned with tracking test data accurately so that patients were correctly billed for every test ordered,” said Julie Dacus, laboratory manager at Carolina Multi-Specialty Associates in Greenville, S.C. “Because Polytech records and accurately reports every test, we never lose charges. We have significantly increased revenues, reduced associated billing department labor costs, and are able to submit laboratory charges to our fiscal intermediaries on time.”
If a client has questions or technical support issues about Polytech, Comp Pro Med assists labs through Polytech’s remote diagnostics technology: laboratorians can talk directly with a system engineer who can “run” the system from Comp Pro Med’s support headquarters to rapidly isolate and resolve questions.
“Polytech is strong on telephone tech support,” says Brownlee. “Comp Pro Med didn’t just build Polytech and leave; they called us later to find out if the system was producing the results we wanted. This is very unusual in the IS field.”
– Source: Comp Pro Med