The Goals of an LIS Compared to Goals of a Hospital EMR

Rob Bush of Orchard Software submitted a comment about a recent post (see: Cultural Barriers to Medical Innovation). His points were so interesting that I am promoting his comment to the level of a blog note, copying it below in its entirety (boldface emphasis mine):

Commenting on the success of the LIS vs the EMR:
The common objective of the laboratory is to provide accurate results in a timely and cost effective way. Everyone working in the lab can agree upon the goals, and behave as a part of the overall solution. The EMR’s goal is not that well defined. Although it is often stated to be improving healthcare for the patient, I believe the working goal is to make each healthcare professional using the system more efficient at doing their job. Naturally, if the goal is to make you personally more efficient, there is a different goal for each person using the EMR. The mentality of the people involved is very different. In the lab the people ask “What can I do to help with the process?” With the EMR, people ask “What can the software do to make me more efficient?”

I have some minor quibbles with Rob's comment but his overall logic is correct in my opinion. The overarching role of the LIS, and the clinical labs that it supports, is to provide accurate results to clinicians in a timely and cost effective way. Similarly, the role of the hospital EMR, and the physicians and nurses working in an inpatient unit, is to provide efficient and effective healthcare to patients admitted to that unit.

Both lab professionals and hospital nurses tend to operate as teams and emphasize teamwork. Both the LIS and EMR are tools to enhance the work of these teams. The role of physicians in hospitals is somewhat different and more attention needs to be paid to their individual responsibility and productivity. As proof of this statement, you need only recall the common conversations of hospitalized patients, who will often refer to "my surgeon" or "my anesthesiologist." The pathologist plays a critical role in the care of a patient in the diagnosis of disease but their role is largely anonymous. Few patients will will make reference to "my pathologist."

So what can we make of all of this? Only that the EMR must serve to increase the productivity of all of the various teams in a hospital, including lab professionals, but also the individual productivity of physicians working in the same environment. Failure to do so will result in opposition from the physicians and I will defend their right to take such a position.