Point-of- care testing (POCT) is becoming increasingly important for health systems as healthcare becomes even more decentralized (see: TEN MAJOR TRENDS FACING THE HEALTHCARE INDUSTRY IN THE AMBULATORY SPACE ON A FIVE-YEAR HORIZON; Mobile Health Teams as a Variant on the Theme of Decentralized Acute Care in the Home). Patients are being served via telemedicine visits or in smaller ambulatory care settings such as walk-in clinics in retail drug stores. Remarkably, some surveys show that patients are often more accepting of telemedicine than physicians (see: Telemedicine is getting trendy, but doctors may not be keeping up).
In a parallel fashion, some lab testing is being transferred from central labs in hospitals or bedless hospitals (see: The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology; Some Additional Ideas About the Bedless Hospitals of the Future) to POCT devices (see: Does Point-Of-Care Testing Save Money or Cost More?). In addition to the oversight of central labs, pathologists and laboratory scientists are thus facing the prospect of managing hundreds of decentralized small analyzers. Compounding this complexity is that the operators of POCT devices are not usually pathology employees or extensively trained in lab QC.
In response to this challenge, Orchard Software offers a POCT management product called Trellis that is interposed between the POCT devices and the LIS/EHR. Here is a description of Trellis copied from the Orchard web site:
Orchard Trellis is an advanced POCT management and integration software solution that provides remote administration of all POCT activities across multiple locations, including device and operator competency assessment tracking. It transmits POCT results to the LIS and EHR, reducing manual entry errors and automating POCT billing. Trellis offers a high level of flexibility in its implementation for various POCT scenarios that enable your POCT program to help providers make faster clinical decisions, include POCT results in analytics, and promote patient satisfaction.
With regard to Trellis, I can't help harking back to the early days of LISs in the 1980's. At that time, the LISs mainly supported clinical labs like chemistry and hematology. A large portion of the core competencies of LIS vendors at that time was their ability to create interfaces with the analyzers manufactured by the IVD vendors. Now, most LIS vendors no longer provide such interfaces but allocate this responsibility to specialized interface vendors like Data Innovations that calls itself a "middleware" company.
I suspect that Trellis may offer much greater functionality than the best-of-breed LISs regarding support for POCT devices in order to be successful. I am also struck by the reference in the Orchard web site regrading Trellis that it provides "operator competency assessment tracking." This is obviously a very important feature. For decades, pathologists have been concerned about the performance of some of the operators of POCT devices. I believe that walk-in clinics in drug stores will soon provide a much larger menu of POCT lab tests and the issue of operator competency will become even more important.