I received a comment to my note of March 29 from "LIS Vendor" that I have copied below. My note was entitled "Measuring the ROI of Middleware Solutions" and you can link to it here.
There are very good LISs on the market that provide the very features you mention here. I'm not sure why you have a fascination with middleware. It can and often does become a critical point of failure. Trying to prop up an old or poorly designed LIS with middleware is like trying to keep that old car running with rubber bands and duct tape.
The comment raises the question about why I comment frequently about middleware in Lab Soft News and I agree that I have a special interest in the topic. You can read some of my recent notes about middleware here and here.
I will provide below a bulleted list of why lab middleware appeals to me but first I want to raise a definitional issue. Middleware and LISs are both types of software designed to support clinical lab functions. Middleware provides modular solutions that are frequently not provided by the broader LISs or that are superior to the LIS alternatives. If this were not so, there would be no market for the products and they would disappear from the market. Middleware, in my judgment, does not serve to "prop up" an installed LIS but rather to extend its usable life and also continue the monthly maintenance fees for the LIS vendor. Having dealt with this point, I will now proceed to present my bulleted list of reasons why middleware interests me so much:
- The middleware market has drawn the major IVD companies into the lab software market. I look upon this as a very favorable trend because the lab business is their only business. Although companies like Cerner, Misys, and Meditech started in the LIS world, this segment of the market is no longer their total focus. I prefer having my LIS vendor focused in this single area.
- As noted above, middleware allows the lab purchaser the opportunity, at a lesser cost, to buy a focused "solution" that one's current LIS vendor can't or won't supply. This cost issue grows increasingly important as the capital costs for lab software undergoing increasing scrutiny by hospital executives.
- The middleware product line has brought into the lab software market a host of new products, producing a more dynamic and competitive market. Middleware purchases come with an additional price, however, and that price is the challenge of integrating a number of heterogeneous software components into an interoperating lab-based network. This integration challenge has produced a new market opportunity -- I hope that the LI'S vendors who are unhappy about the increasing sales of middleware will see this as an opportunity to develop and sell this new type of product.
:: Update on 4/3/2006
William Shipley of Schuyler House added a comment on 4/3/2006 that is worthy of note. Read the whole thing. Here is a portion of his comment:
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.
It is absolutely correct that various IVD vendors have entered the lab software market before with only limited success. It is also correct to say that their core business is selling analyzers and reagents. I have heard IVD vendors in the past say that they are in the information management business as opposed to the information creation business, but not necessarily understanding all of the implications of total lab information management. One of the litmus tests for the IVD vendors entering the middleware market will be whether their middleware products will be able to interact with information from their competitor's analyzers.