Best-of-breed, as it relates to LISs is a term that I have used my whole career in pathology informatics but it occurred to me that I have never tried to define it.
I know that it can drive sales reps of vendors that offer an entire suite of healthcare software to distraction -- it may work against them when trying to close a large hospital deal. I will organize this discussion about best-of-breed LISs by making three simple declaratory statements followed by a brief explanation of each.
Best-of-breed LIS is an individualized determination made by each laboratory based on its unique characteristics
Selecting a best-of-breed LIS will vary from lab to lab. Some laboratories will seek an LIS that runs in the background with little "care and feeding" on their part and others want to actively manage the system. Lab personnel in tertiary care hospitals, in particular, require state-of-the-art software modules to support emerging science labs like molecular pathology and genetics. Some labs enjoy better capital funding for IT than others. Some labs are required to work with the clinical software suite selected by hospital executives for hospital-wide deployment.
Best-of-breed is determined only through a laborious process
The determination of a best-of-breed for an individual lab can only be determined by a laborious process -- THERE ARE NO EASY SUBSTITUTES. This process starts with a survey of the various LISs available in the market. The choices are then narrowed down to several vendors and an RFQ process is initiated. This is followed by on-site scripted demonstrations by the favored vendors. During this process, vendor personnel demonstrating the system are required to navigate through scripts developed by lab personnel and designed to stress the system to the maximum and highlight weakness and flaws.
This is followed by site visits to lab sites comparable in test volume and test complexity to one's home laboratory. Such site visits are organized to provide an opportunity to view system performance and also interact informally with technologists and pathologists working with the LIS on a daily basis. During this entire search process, lab personnel need to query by phone or email their lab colleagues around the country and discuss which LISs perform the best under varying circumstances. Conferences such as Lab InfoTech Summit or APIII which host LIS exhibitors also provide an opportunity to comparison shop among the various systems.
A best-of-breed system is absolutely essential for a lab to perform up to expectations
Laboratories whose quest for a best-of-breed LIS is not carried out meticulously or who have a "good-enough" LIS forced upon them are headed for trouble. A best-of-breed LIS, just defined, is absolutely essential for efficient lab operations. Any lab director who is told to be a "team player" by hospital executives and accept an unsuitable LIS will quickly learn that, in the final analysis, the lab's performance will usually be based on some quantitative measure like adjusted cost-per-test in the lab. A lackluster LIS always hurts in this department. The determination of "best-of-breed" is laborious but necessary considering the consequences of the lack of due diligence in LIS selection.
Comments