Close ties: instruments, middleware, and more

Create PDF

July 2021—Laboratory instrumentation from an IT perspective and as one solution to the labor shortage were the topics explored April 27 in a virtual roundtable of instrument vendors and laboratory medical directors, led by CAP TODAY publisher Bob McGonnagle. Part one of their conversation about core labs was published in the June 2021 issue; part two follows.

View CAP TODAY’s guide to chemistry and immunoassay analyzers for mid- to high-volume laboratories.

We include IT people when we talk about products and analyzers because for many lab directors and administrative heads of departments, the connectivity, interoperability, and ease of interface, not only to and of instruments and middleware but also electronic medical records, are top of mind. Jeff Watson, has Sunquest had a chance in the past year to look at that again and renew interest in serving that need in the laboratory?
Jeff Watson, MT(ASCP), MBA, senior director, product management for clinical solutions, Sunquest Information Systems: Integration to the EMR is core to our business so we have user groups that are dedicated to that. We have a Cerner special interest group that’s made up of users that have the Cerner EMR, and we have the Epic group, both of which we’re getting customer feedback from. But we also meet regularly with the EMR vendors, so we have an ongoing roundtable meeting with people from Epic. We sometimes talk about an issue that has come from that client special interest group, where they might say, “Why can’t you do X, Y, or Z?” and we say we need to talk it over with our partners at Epic. And we’ll sit down and hash through that and come up with solutions. While they have their competitive modules and want to put those in, they also are customer focused just as we are, and when we are servicing those joint customers, they’ve been good partners in working with us to solve some of the challenges we have around integration.

Curt Johnson, I’ll ask you that same question, and I know that in the Orchard user base there are many EMR systems you’re interfacing with all the time. Correct?
Curt Johnson, chief commercial officer, Orchard Software: That is correct. We’re not only looking at where the technology is today in regard to the interoperability, but we also have a strong focus on user interface design with a goal of making the user interface intuitive and easy for users to learn. Working closely with all the EMR vendors is also important. The laboratory information system serves a different purpose than the EMR but is a vital component of an integrated health care system. An important aspect of our role as an LIS vendor is to develop software that supports our end users, to make their jobs easier while simultaneously integrating with the EMR and the lab analyzers, and we work closely with many of the diagnostic vendors on the call today. I have monthly standing calls with them to understand where the analyzers are going, how the middleware they’re implementing for their analyzers not only benefits the end user but how that information can be integrated with us to give a more global view within the LIS. If these diagnostic vendors have integrated delivery networks, for example, and there are point-of-care analyzers throughout the organization and you’re putting middleware into the system to benefit the end user with your analyzer, the question is what can we add to that and how can we benefit not only the diagnostic vendor but also the end user and make sure that the information is easily transmitted upstream to the other systems. We are that vital piece that sits in the middle.

Looking at where integration is changing, we also have to start taking into consideration iPhones, iPads, handheld devices, and the patient and where data needs to go. That’s the next frontier for us from an integration point of view—how are we going to interact directly with the patient but also make sure we keep in mind the diagnostic vendors, the pathologists, the physicians, and the laboratory so that everyone who is involved in patient care can effectively use the data?

Dr. Faix

James Faix, do you have thoughts about this conversation on the importance of IT issues?
James D. Faix, MD, medical director, clinical chemistry and immunology, Montefiore Medical Center: I would add only that I think middleware is becoming so much more important than either the laboratory information system or the software on the instruments. Middleware has become a major place where we work. More and more you’re tied to the middleware version of Data Innovations that the company provides, so you’re sort of stuck with that version of DI if you want to use the power of the middleware.

Sunquest and DI are sister companies owned by Roper Technologies, and there is a great deal of coordination, as I understand it.
Jeff Watson (Sunquest): Yes, there is, and Dr. Grenache can talk to that relationship since he has DI and Sunquest together.

David G. Grenache, PhD, D(ABCC), chief scientific officer and medical director, core laboratory, TriCore Reference Laboratories, and clinical professor of pathology, University of New Mexico: I agree with Dr. Faix: Middleware is where we spend a lot of our time and it’s the engine that powers the output from our instruments. It goes through our middleware solutions and then out to various EMRs. But more than that, it’s powerful in that it allows us to do customized reporting. We can apply some logic rules so that if certain conditions are met, then we will be able to attach appropriate comments to results as needed. It’s powerful, and laboratories that aren’t leveraging it are doing themselves a disservice.

I’m sure all of our IVD participants would agree. Brittany, Roche has begun to tag itself much more as in the world of informatics. I also know Roche is an enormous customer of middleware vendors, not the least of which would be DI. How are the views of IT shifting at Roche if at all?
Brittany Greiner, U.S. marketing manager, Roche Diagnostics: It has been and will continue to be a focus for Roche. The one thing I’ll add is that it’s critical to have an overall picture of what’s going on—the holistic view from both the patient and laboratory perspectives. It’s a huge focus for us. This is where we’re investing heavily, with feet on the street as well as from an IT perspective, because it’s not just the solutions we’re bringing but also that partnership and the support for our laboratory customers. We want to be there hand in hand helping to implement and figure out the best solution. And we need that overall view so we can tailor our products to every laboratory. We all know if we’ve seen one lab, we’ve seen one lab.

Pastore

Denise Pastore, can you speak to the view of IT from the Siemens Healthineers perspective?
Denise Pastore, director of global marketing, laboratory diagnostics, Siemens Healthineers: It’s key for Siemens Healthineers as well with our Atellica Diagnostics IT platform for data management, program management, and inventory management because it’s important for our customers, the laboratorians, to be able to manage the patients, manage their data, manage their KPIs. We want to be able to bring that forth to them, even looking at the data and helping them troubleshoot, down to maybe “It was a phlebotomist and that’s why my samples are hemolyzed.” We can help with all of that with the Atellica Diagnostics IT.