What to Look Out for and Avoid When Shopping for a New LIS System

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We’ve written before in this space about the truth that not all laboratory information systems (medical LIS) are created equally. This reality places a critical responsibility on clinical laboratories and pathology groups to thoroughly evaluate their options and carefully research LIS software vendors and their pathology lab management solutions to ensure the best possible fit for the lab’s operational and strategic needs. 

This article provides lab information system buyers a head start on the evaluation process and helps ensure their successful implementation of modern LIS system technology by focusing on potential pitfalls, risks, or negative outcomes that must be avoided at all costs. 

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LIS Systems and Red Flag Warnings 

When used metaphorically, “red flag warning” emphasizes the importance of vigilance and the need to proactively address or avoid potential issues before they escalate into more significant problems.

Now take the metaphor and apply it to the medical lab, which relies heavily on laboratory information system software to provide centralized data management and critical diagnostic testing results that underpin effective decision-making and optimized patient care.

Clinical labs and pathology groups simply can’t afford to make a mistake when choosing a new laboratory information system. The stakes are way too high. That’s why it’s common practice for lab leadership to take the time to form an LIS selection committee, prepare a Request for Proposal (RFP), and initiate LIS company evaluations, multiple LIS software demonstrations, thorough reference checks, and site visits before committing to a new medical LIS platform.

‍Editor’s Note: The RFP efficiently allows labs to share their specific needs and requirements while comparing different LIS systems. For a visual example of a filled-out RFP template, click HERE.

At LigoLab, we endorse this level of evaluation and feel compelled to help even more by listing red flag warnings that all medical labs should be aware of when shopping for new LIS system technology. 

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Where to Start Your LIS System Evaluation

When it comes to laboratory information system functions, the more features and flexibility available to the lab, the better. But that statement also comes with a word of caution because some features are so important that, if taken away, they render the LIS system essentially useless. 

Let’s start with sample tracking. 

Sample Tracking Matters: Red Flags That Signal LIS System Failures

We all know the mission-critical role LIS systems fulfill in managing and tracking samples throughout their entire lifecycle, from the moment they enter the lab, through processing, to when results are finalized and reported. If the LIS system fails to track samples accurately, the lab risks serious consequences, including lost specimens, reporting delays, costly mistakes, and a complete breakdown in operational reliability.

With that in mind, here is a list of sample tracking red flag warnings to consider.

Sample Tracking Red Flag Warning Signs:

Frequent Misplaced or Lost Samples: Regular occurrences of lost or misplaced samples suggest the lab information system isn’t tracking samples accurately or consistently.

Duplicate or Missing Sample IDs: The LIS system either fails to assign unique identifiers to each sample or generates duplicate IDs, leading to confusion and errors throughout the tracking process.

Inability to Trace Sample History: Difficulty viewing a sample’s lifecycle, including when and where it was processed, indicates poor sample tracking capabilities.

Data Gaps or Missing Information: Missing records for certain stages of the sample’s handling, such as when it arrived, who handled it, or what tests were performed, highlight tracking failures.

Delayed or Inaccurate Status Updates: The medical LIS doesn’t update sample statuses in real-time or frequently displays incorrect statuses, making it difficult to know the location of a sample at any given time.

Difficulty Locating Samples: The LIS software takes too long to search for and retrieve information on specific samples, indicating inefficiency in the system's search and tracking functions.

Relying on Manual Tracking Methods: Lab staff resort to manual logs, spreadsheets, or other non-system tools to track samples, which reflects inadequacies in the LIS system’s tracking capabilities.

Missing or Inconsistent Alerts: The lab information system fails to provide timely alerts or notifications when samples reach critical stages (e.g., approaching expiration or requiring action), leading to missed deadlines.

Confusing User Interface: A clunky or poorly designed interface that hinders quick sample location or management may be a sign of more serious underlying tracking problems.

Discrepancies in Sample Chain of Custody: The LIS system can’t accurately document the chain of custody for samples, leading to potential regulatory compliance issues.

Insufficient Audit Trail: The LIS system’s audit trail fails to track historical data and trace issues or discrepancies to the source, thereby exposing the lab to potential fraud and errors.

Next, let’s turn our attention to workflow automation. 

Why Process Automation is Essential in a Modern LIS System

Medical laboratories rely on standardized, step-by-step processes to carry out their work efficiently. The best laboratory information system software supports this structure by automating many processes, ensuring each step is completed fully and correctly. 

Remove this functionality, and labs have no choice but to depend on lab techs to manually track each step, increasing the risk of errors and reporting delays. An LIS system without process automation is a pathology lab software that can’t fully support the smooth operation of the lab.

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Workflow Support and Automation Red Flag Warning Signs:

Manual Workarounds: When lab staff routinely perform or track tasks manually that should be automated, it's a clear sign that the LIS system lacks essential functionality.

Reliance on Third-Party Tools: If the lab depends on tools such as Excel or paper to support its laboratory workflow management, both of which create more data silos, this is another indication of inadequate and outdated LIS software. 

Inconsistent Task Sequencing: Tasks are not consistently completed in the correct order, leading to missed or skipped steps in the lab's workflow.

Lack of Automated Notifications: The LIS system can’t send automated alerts or reminders for pending or missed tasks, leading to workflow delays and inefficiencies.

Frequent User Intervention: Frequent user intervention to complete steps or correct errors that the medical LIS should manage signals weak workflow support capabilities.

Inefficient Approval Process: Delays in task creation, tracking, approvals, or excessive back-and-forth due to unclear process workflows indicate the lab information system struggles to automate and track steps.

Difficulty in Customizing Workflows: If the LIS system doesn’t allow easy customization of workflows to fit the lab’s unique needs, it’s a sign of limited flexibility.

High Error Rates in Repetitive Tasks: When simple, repetitive tasks show a high human error rate, it suggests that the LIS software can’t automate effectively.

Task Duplication or Omissions: Workflow automation should ensure no step is repeated or forgotten. If duplication or omission of tasks occurs frequently, the laboratory information system may not be capable of automating and supporting workflows properly.

Time-Consuming Data Entry: If staff members spend an excessive amount of time manually entering data at each step, it indicates that the LIS medical solution lacks both interoperability with third-party EHRs and the automation needed to streamline workflows, eliminate redundancy, and minimize errors.

Inconsistent Reporting or Auditing: Reports or audit trails with gaps, inconsistencies, or unclear workflows are signs that automated processes within the LIS system are lacking.

Now, let’s focus on the importance of instrument integration.

The Critical Role of Instrument Interoperability in LIS Systems

Clinical laboratories and pathology practices depend on a wide range of analytical instruments for sample testing, and just as importantly, on their seamless integration with the laboratory information system. Without this interoperability, lab staff are forced to enter the data manually, a slow and error-prone process. When an LIS system can’t automatically capture and manage instrument data, it fails to streamline workflows and opens the door to avoidable mistakes.

Instrument Integration Red Flag Warning Signs:

Frequent Manual Data Entry: If lab staff frequently input test results or sample data manually into the LIS system software, this indicates issues with integration.

Delayed Data Transfer: Lab instrument results aren’t transferred to the LIS system in real time, leading to delays in reporting and processing. 

Frequent Data Mismatches: If there are frequent discrepancies between the data captured by the instruments and what is reflected in the lab’s LIS pathology solution, it suggests the system struggles to interpret or sync instrument data.

Limited Compatibility with Instruments: If the medical LIS only supports a limited number of instruments or requires custom-built interfaces to connect new devices, this is a certain red flag because it creates obstacles when integrating different or newer equipment, limiting lab flexibility.

Instrument Data Not Automatically Synced: If lab staff must manually retrieve or refresh test results from instruments, it’s a strong indication that the LIS system isn’t fully integrated with the lab’s equipment.

Struggles with Multi-Instrument Management: When the medical LIS has trouble handling data from multiple instruments at once, it can result in performance issues, data mismatches, and confusion about which results came from which device.

Manual Tracking of Calibration and Maintenance: A properly integrated LIS software should automatically log and manage calibration and maintenance records. If this information must be tracked manually or in a separate system, it signals poor instrument integration.

Interruption in Workflow: If a system failure of one instrument disrupts the overall lab workflow, it suggests that the medical LIS doesn’t manage instrument downtime effectively, leading to more manual intervention.

Difficulty Configuring Instrument Settings: In a well-integrated system, lab instruments can be configured or calibrated directly from the LIS system. If this isn’t possible or overly complicated, it suggests weak instrument integration.

Lack of Bi-directional Communication: Proper instrument integration allows the LIS system and the instruments to communicate in both directions, sending orders to instruments and receiving results via the LIS. If communication is only one-way, this limits the system’s capability to integrate.

Other Key LIS System Evaluation Criteria to Consider

Beyond the sample tracking, workflow automation, and instrument integration mentioned above, lab leadership should consider other potential red flags during their LIS system evaluations. 

Hidden Costs: Be wary of laboratory information system vendors that aren’t transparent about the total cost of ownership, including implementation, training, support, upgrades, and customization. These unexpected costs can quickly escalate beyond the initial quote.

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Limited Scalability: If the laboratory information system can’t scale to support the lab’s growth plans, including handling increased sample volume, new test types, or multi-location support, it will soon become a hindrance rather than an asset.

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Poor Customer Support and Training: Insufficient diagnostic lab software support or limited training resources can lead to downtimes and decreased productivity. Check for reviews or testimonials about the LIS software vendor’s customer service quality.

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Lack of Compliance and Security Features: Ensure the LIS medical solution complies with industry standards (e.g., CLIA, HIPAA, and HITECH) and has robust security measures in place to protect sensitive patient data from breaches.

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Inadequate Reporting and Analytics: Medical labs must have detailed, customizable reporting and analytics capabilities for operational insights and compliance. If the lab information system lacks robust reporting features, it could limit your lab’s ability to make data-driven decisions.

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Slow Implementation Process: A drawn-out, rushed, or unclear implementation timeline can disrupt lab operations. The LIS software vendor should provide a clear, manageable timeline for implementation, training, and go-live.

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Negative Feedback or Poor Vendor Reputation: Research the LIS software vendor’s reputation by reading customer reviews, checking for past issues, or talking to other labs using the same LIS system. Poor feedback from existing customers is a significant red flag.

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Limited Updates or Technology Roadmap: A lab information system vendor that doesn’t invest in R&D, fails to provide frequent updates to its LIS software platform, or lacks a clear plan for future developments likely doesn’t prioritize its customers’ future. The foundation of its solutions may also be backed by outdated technology, which will eventually limit your lab's capabilities.

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Lack of Data Migration Support: Migrating data from your old lab information system can be a complex process. Ensure the lab vendor offers comprehensive data migration support, including testing, validation, and troubleshooting assistance.

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Inflexible Contract Terms: Be cautious of lab vendors with inflexible contracts, high upfront costs, long lock-in periods, high exit fees, or restrictive clauses that limit your options if the LIS system doesn’t meet expectations.

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Yes, there’s a lot to consider and be aware of when shopping for the best LIS system for your clinical or pathology lab. Before selecting the LIS medical platform, evaluate all potential red flags that could affect system performance and reliability. 

Key factors include sample tracking, workflow automation, and instrument integration. A robust LIS lab solution should accurately track samples throughout their lifecycle, support workflow automation, and be highly interoperable with lab instrumentation. 

Beyond these core features, labs should also consider the LIS system’s scalability, transparency in pricing, and vendor reputation. Hidden costs, limited growth potential, and poor customer support are other red flags that could escalate long-term issues. 

Additionally, the LIS should comply with industry security and regulatory compliance, offer flexible contract terms, and provide ongoing updates and technology improvements. 

Thorough evaluation of all these aspects, including the laboratory information system vendor’s reputation and customer feedback, is essential to ensure that the LIS can meet your lab's current and future needs.

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