In my blog note of two days ago, I began to present my personal interpretation of some of the significant ideas that surfaced during the recent API Strategic Summit (see: Lessons from the API Strategic Summit: Beaker LIS Is Not "Free"). The conference was convened to discuss the future of the LIS and pathology informatics in the era of powerful EMRs. For today's note, I would like to discuss the concept of the "pathology/LIS layer" as presented by John Gilbertson, representing the Harvard pathology department and Massachusetts General Hospital, part of Partners HealthCare.
In his lecture, John defined the pathology/LIS layer in the following way: a common LIS as a foundation for clinical collaboration between the [various clinical] departments [within Partners HealthCare]. He went on to say that the pathology/LIS layer was the key tool for executing an "enterprise pathology service." He then listed the following reasons why the departments of pathology were able to negotiate the deployment of this pathology/LIS layer with health system executives:
- There is a functionality gap
- The healthcare system must understand that pathology is foundational, unique, complex, and valuable
- Know what you want...and have a plan
- Pathology has to speak and with one voice
- A strong, trusted vendor in place
- Have a vision [for] the future
- Unfettered access to data
As I understand this approach, all of the Partners hospitals will use a common LIS to deliver pathology services to each hospital in the health system. The hospitals will collaborate on IT projects such as this one relating to pathology. As a preface to his lecture, John announced that MGH has a ten-year-agreement with Sunquest to help co-develop aspects of the Sunquest AP-LIS. For me, the most important idea underlying this idea of a "pathology/LIS layer" is that the pathology departments within his health system were able to "speak with one voice" and lobby the executives for the deployment of a common, highly functional LIS to be used collaboratively across multiple hospitals.
An important facet of these negotiations was that pathology was willing and able to "take ownership and responsibility" for this software layer. For me, this would seem to be an effective remedy to passively accepting an inadequate LIS embedded within an enterprise-wide-solution (EWS) (see: Lessons from the API Strategic Summit: Beaker LIS Is Not "Free"; Lessons from the API Strategic Summit: Defining the Best-of-Breed (BOB) LIS). Part of this ownership will involve the integration of the "pathology/LIS layer" with the enterprise EMR. Because the deparments are working so closely with Sunquest, the burden of this task should be eased.