In response to yesterday's note, Infopathic provided us with a key piece of intelligence via a comment -- the status of Epic's LIS:
The Epic solution for EMR has has indeed been judged to be superior. And for those searching for a superior LIS, one with a seamless integration to this EMR would be epic! or, at least...superior. A recent peek into the EPIC LIS entry - Beaker, reveals that the search is far from over. This LIS newcomer is certainly not ready for prime time. Whereas several basic workfolows are in place and appear to be well designed, in my humble opinion, the Beaker is half-empty as a product for large, complex health systems. The search goes on...
How quaint! The name "beaker" sounds to me like it was the product of a coffee klatch attended by creative, marketing types who had never stepped into a modern clinical lab. You will see high powered automated analyzers, chips, and DNA but nary a beaker. Infopathic's information may be true with some support from the Epic web site:
Beaker Clinical Laboratory Information System supports inpatient and ambulatory laboratory workflows, combining best-of-breed LIS functionality with the benefits of enterprise-wide integration. With Epic's Web-based OutReach application, external submitters to your reference laboratory can enter orders and receive results online.
Here are some more details about Epic's OutReach:
OutReach works with the Beaker Clinical Laboratory System to help build strong relationships with external providers that receive laboratory or diagnostic services from your organization. Intuitive order entry features allow users to send orders to your facility securely over the Internet rather than through staff-intensive telephone, fax or paper-based methods. Decision support and results communication features support users during the order entry process and help route test results appropriately. Integration with our Beaker Clinical Laboratory System allows your users to carry out specimen collection and shipping management tasks online.
Perhaps apocryphal, I have been told the story of the head of pathology informatics in a large academic medical center that had just signed a contract with Epic. He was told by the CIO: "You will, of course, install the Epic LIS." He, like all lab types, has a very practical streak. He said: "Let me see it and test it. If I can't poke it, tickle it, run it through it's paces, it simply won't 't do. We also need to benchmark it against its competitors in the market." He was a best-of-breed kind of guy because he understood that his job was totally dependent on running a reliable, comprehensive, and functional LIS (see: Are You an Enterprise or Best-of-Breed CIO? Access to Cash May Make the Difference.).
I yield to no one in terms of my admiration of EMRs. Patient care is complex. You need to post the results of physical exams. You need to post progress notes. You need to order meds. Building an LIS is a different sort of enterprise, requiring different knowledge and skills. A typical set of labs and LIS in a large hospital offers a menu of a thousand or more tests and performs millions of them a year and stores many more. A lab report can be a sentence long or multiple pages and can contain complex tables, images, or text. The blood bank module tracks an inventory of thousands of blood products. A simple computer error in the blood bank can kill a patient. I am also a strong advocate of the best-of-breed theory as it applies to LISs. An "enterprise, integrated lab solution" may sound good during a power lunch and may be the favorite approach of the CIO but may not be good enough to get all the lab work done.