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Comments

LIS Vendor

IVD vendors will never invest the resources to make their software compatibable with competitors instrumentation. BTW many of our customers have commented that middleware supplied by the IVD vendor is adequate at best. We many times code specific changes to our system to compensate for poorly designed middleware.

William Shipley

I will have to admit that, as an LIS vendor, I found Rob Bush's (Orchard Software) InfoTech talk most in line with my thinking on middleware. Since an LIS is, in a way, a system designed to standardize results from multiple instruments and process them in a consistent fashion, there are processes that are so oriented around a single instrument that it makes sense for them to be provided by the instrument vendor.

Frankly, many of the LIS systems on the market, particularly the newer ones contain the features that middleware systems offer, and in my opinion, if they don’t they should. That goes for us at Schuyler House as well. Of course, if you limit your view to the ‘broader LISs’, then you do find yourself in the $100,000 interface world and the effort involved in integration makes sense. Those prices, however, make my nose bleed and, frankly, are not a part of my world.

To speak to your points:

The introduction of the IVD vendors is not new, and is, in my opinion, doomed to the same fate as their previous ventures. The problem is that they are in the business of selling instruments and, thus, will attempt to utilize their software to lock in a laboratory to their instrumentation. Support for competitor’s instruments, while critical for full functionality, is not in their main interest. I also think that it is a good idea for the companies with LIS experience to also be involved in the EMR world. As you have pointed out, we are in the world of the EMR and the ability of EMR software to properly handle laboratory data will be crucial.

I do agree that separate features can be implemented at a lower cost without replacing your current LIS. I think, however, that there is no reason to excuse your LIS vendor from supplying the needed features.

The integration/data duplication issues will always make the development and implementation of new capabilities easier to do as a part of a complete system rather than separate with the inherent communications issues, the least common denominator nature of interfaces etc. On the other hand, the ability to develop a focused feature without having to worry about an installed customer base is clearly an advantage.

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