The best-of-breed (BoB) LIS vendors have learned from the market that Epic with its Beaker product can be an aggressive competitor. Beaker functionality has improved recently, aided partly by the availability of a comprehensive list of necessary and desirable LIS functionalities (see: LIS-FAT Emerges as a Useful Tool for Assessing LIS Functionality). Epic also continues to enjoy the competitive advantage in the market of being familiar to hospital executives. All of this raises the question about the future direction of BoB LISs. I began to discuss this topic in my recent note about the emergence off MIMS -- molecular information management systems (see: MIMS as a Specialized LIS System; Best-of-Breed Vendors Need to Take Heed).
I believe that the BoB LIS vendors need to focus increasingly on specialized clinical lab software in order to compete more efficiently with Epic and Beaker (see: Time to Abandon the Best-of-Breed LIS Label; Emergence of Specialized Lab Software Vendors). For me, there are four emerging categories of specialized lab software. They are: (1) molecular and genomic; (2) predictive analytics (see: Future of Healthcare Changes Inextricably Bound to Information Technology; Identifying Patients for Remote Monitoring with Predictive Analytics; Relevance of Lifestyle Analytics for Healthcare Organizations), (3) integrated diagnostics (see: Revisiting Integrated Diagnostics and the Integrated Diagnostic Report), and (4) automation middleware. I have discussed these first three in previous notes so I will concentrate here on the last of them.
In the computer world, middleware is the software that acts as a bridge between an operating system or database and applications, especially on a network. In the clinical labs, the term middleware is usually reserved for software located between an analyzer and the LIS which performs functions not provided by the analyzers. I began a discussion of middleware in a note ten years ago (see: The Appeal of Lab "Middleware"). Here is an excerpt from it:
It is absolutely correct that various IVD vendors have entered the lab software market before with only limited success. It is also correct to say that their core business is selling analyzers and reagents. I have heard IVD vendors in the past say that they are in the information management business as opposed to the information creation business, but not necessarily understanding all of the implications of total lab information management. One of the litmus tests for the IVD vendors entering the middleware market will be whether their middleware products will be able to interact with information from their competitor's analyzers.
The future direction for the larger clinical labs should be toward a totally automated solution. This goal will never be achieved as long as individual IVD manufacturers continue to develop their own middleware that is incompatible with that of their competitors. I believe that the LIS vendors should take a leadership role in the development of automation software for all CP and AP automated lines and analyzers. To achieve this goal, some type of collaborative understanding needs to be developed between LIS and IVD vendors. The reason for the need for such an agreement is that it's unlikely that the IVD vendors can compete in the market with their own LISs nor can the LIS vendors manufacture IVD equipment (see: Five Alternative IVD + Software Business Models).