The best-of-breed LIS vendors seem to have come up with good solutions for support of molecular pathology labs, although it has taken a while to do so. The next possible challenge for them will be support for clinical genomics, a field that is exploding. I use the term "clinical genomics" to distinguish patient care solutions from more bench research oriented IT solutions that are readily available. In a note last November, I suggested that a portion of the clinical genomics IT solution will be located in what I called the "genomics cloud" (see: The -Omics Cloud: A Healthcare IT Solution Already Developed for Genomics Research). Here is a cut-and-paste from the final paragraph of that note:
Hospitals will continue to install their transaction-based EMRs, LISs, and RISs....Meanwhile, the "-omics cloud" will continuously evolve on the research and reference lab side, providing the answers pertaining to personalized medicine. There will be no need to install "personalized medicine servers" in hospitals. The most likely scenario will be that hospitals will develop working relationships with the developers of the best research-oriented "-omics clouds", sending them relevant diagnostic and clinical data from the hospital-based EMRs, LISs, and RISs. These research clouds will thus support "personalized medicine" as part of their mission but at a fraction of the cost of current EMRs.
Much of the computing talent and most of the IT solutions for clinical genomics are located in research labs. However, clinical solutions are now coming to the forefront. Two IT products that seem to excel in this regard are Sapio's Exemplar LIMS for wet-lab workflow and GenoLogics' Clarity LIMS for clinical NGS. The latter is used in Illumina's service lab. The details of this latter relationship were announced last February (see: Illumina CLIA Lab Subscribes to Clarity LIMS to Augment Existing Informatics Infrastructure). Here is an excerpt from the GenoLogics' press release:
GenoLogics Life Science Software... announced...that the Illumina Clinical Services Laboratory has signed a subscription license agreement for Clarity LIMS. Under the agreement, Clarity LIMS, alongside internally developed systems within the CLIA-certified, CAP-accredited laboratory at Illumina, will be used to support Illumina’s TruSight Individual Genome Sequencing (IGS) test.
One short explanatory note here. Clinical laboratory information systems in the U. S. are called LISs. Historically, information systems that were developed and used for research and industrial labs have been called laboratory information management systems (LIMS). I posted some relevant notes some five years ago about this topic (see: LIS vs. LIMS: Some New Insights; LIS vs. LIMS: It's Time to Blend the Two Types of Lab Information Systems; LIMS and Preclinical Workflow: Another Dimension of the LIS/LIMS Discussion). The fact that Exemplar and Clarity are referred to as LIMSs is proof of their development on the research side of healthcare.
I used to believe that the LIS vendors could license genomics IT solutions from companies such as Sapio and GenoLogics and integrate the product into their own systems. I have now come to the conclusion that this will be impossible or impractical. Companies like Sapio and GenoLogics are fine-tuning their systems for clinical use in labs such as the "CLIA-certified, CAP-accredited laboratory at Illumina" and have no need to partner with the best-of-breed LIS vendors. The hospital LIS databases, however, will continue to contain critical lab information that will need to be correlated with information that is generated in the specialized -omics systems such as those of Sapio and GenoLogics. I hope that interfaces are developed with the LISs rather than only with EHRs. These latter systems will only be able to display reports rather than provide any analytic capabilities.
Not only will companies like Sapio and GenoLogics dominate the NGS field from an IT perspective, but Illumina with its clinical services lab, running GenoLogics software, will also provide esoteric reference lab services. Here's a quote from its web site (see: Illumina Clinical Services Laboratory):
Illumina has been providing high-quality DNA analysis services, including next-generation sequencing (NGS), to the research community since 2001. In 2009, we established a CLIA-certified, CAP-accredited clinical laboratory, Illumina Clinical Services Laboratory, for the purpose of offering human whole-genome sequencing services to physicians and genetic counselors. This laboratory is staffed with certified Clinical Laboratory Scientists who have training and experience with Illumina NGS technologies. In fact, the Illumina Clinical Services Laboratory was the first to generate a personal genome sequence in a clinical laboratory setting.