Laboratory market transformation drives systems innovation

The clinical laboratory market is in a period of rapid growth. Health expectations have risen globally in recent decades, with all member states of the World Health Organization committed to work towards the achievement of universal health coverage worldwide.

Pathology is involved in 70% of all diagnoses. The global market for clinical laboratory is expected to reach US$149 billion by 2020 if it follows the compound annual growth rate of 6.8% from 2014 to 2020, predicted in a new study by market analysts at Grand View Research.

Driving this growth, along with the rise of universal health care, is an ageing population and the increased prevalence of chronic diseases like obesity and diabetes. We are also seeing an upsurge of new testing methods — such as genetic testing and automated slide results scanning.

Key drivers transforming laboratories

Just as demand for laboratory services is rising, there is also pressure to meet this demand using fewer resources — to increase productivity while driving down costs.

Advances in automation, genomic testing and point-of-care testing are all driving disruptive changes in the laboratory market. Other drivers include healthcare industry consolidation, with increased economies of scale expected to deliver more test results at lower cost. Information will drive the life cycle of medical testing, as IT systems capture information at each stage of the healthcare continuum.

Today's laboratory information management systems do not meet the requirements of this new environment. Instead, modern, agile information systems that enable the lab to capture, share, analyse and act on vast amounts of detailed data will be required to run a smart business. This is necessitating a new breed of system — what InterSystems calls a laboratory business management system (LBMS).

Transformation through information

Information is the core business for laboratories. It's their primary output. Lab professionals will need a laboratory business management system to meet their new challenges.

Patient data will be stored in secure data repositories, accessible via browser from any computing device with authorised access, including tablets, computers, mobile and wearable devices. For laboratories within a hospital group, all patient data will be unified within a shared electronic patient record, and lab workflow will be fully integrated with the care process.

Laboratory business management systems will employ software architectures that enable them to be deployed as a unified platform accessible within a single laboratory, across multiple sites or within a hospital or a group of hospitals. An LBMS will also interoperate with connected care systems and shared electronic health records throughout a region or country.

Extending laboratory information management capabilities across the healthcare enterprise will enable transformational change in clinical laboratories.

For example, the 'hub and spoke' model being implemented in the UK following the Carter Report specifies that high-volume testing be done closer to patient locations, while specialised testing is performed off-site in laboratories that service a number of healthcare organisations. This model also ensures maximum return from expensive specialist equipment.

Models like this require a flexible laboratory business management system that enables information and workflows to be shared and integrated across multiple locations.

Labs to become data-driven businesses

With an LBMS, laboratories will be able to implement their workflow protocols (or standard operating procedures) and cost every procedure. Clinical directors and business managers will run a fine-tuned, data-driven business, with LBMS giving them the visibility, control and accountability over business processes now seen in the best enterprise resource planning software.

Laboratory throughput and turnaround times will be constantly monitored. Software will pinpoint workflow bottlenecks without the need for custom analytics. Each laboratory or group will be able to easily configure relevant key performance indicators and/or service-level agreements and monitor them through dashboards and alerts.

Pathology is a traditionally unpredictable supply-and-demand service. When laboratory systems can capture and access relevant information along every step of the testing process, they will also deliver unprecedented ability to predict and manage variable workloads.

For example, at the same time a doctor completes a pathology test order, before the sample has even been taken from the patient, the data will feed into the LBMS, improving the predictability of workload hours before they need to be resourced.

Faster results and second opinions

When you bring connectivity into the model, you don't need to wait for the postman. Electronic transfer of results is not only faster; it's also more secure. The progress of testing can be tracked from patient to laboratory to clinician.

Reporting will be much faster, with results delivered instantly to care teams, with the single shared data repository automatically directing results to the patient record. Customers — clinicians, hospitals, family practitioners — will have instant access to results via their internet browsers using the latest mobile devices, subject to appropriate security protocols.

The growth of digital pathology and telepathology will also allow digital samples to be instantaneously transferred for a second opinion. LBMS will support second opinions and referrals of digital pathology results rather than making physical transfers of specimens (reducing both the cost and the potential for error.)

Putting patients at the centre of care

The LBMS will support connected care models that put patients at the centre of healthcare delivery with support for a contiguous pathology patient record (PPR). This will be part of the electronic patient record if the laboratory is part of a healthcare group, and integrated with regional or national shared electronic health records. The PPR would include all test data relevant to patients, even point-of-care testing results.

The LBMS will also support connected care functionality such as electronic gatekeeping. Clinical directors will be able to institute pre-approval processes for costly tests so they first satisfy funding rules, for example. At the same time, system workflows can ensure these orders are automatically submitted for approval to multiple connected parties and that they are instantly released when approved — speeding up the process and eliminating paperwork chase within laboratories.

In conclusion, the fast-changing laboratory market is ripe for a new generation of information systems that meet the needs of a modern pathology environment. While the pressure to deliver more test results at lower cost will only intensify, advanced information technology will make laboratory professionals the drivers of change, rather than the victims of disruption.

*Martin Wilkinson is the Sydney-based Laboratory Product Manager for InterSystems and global head of the company's solutions for the laboratory market. He is also a Fellow of the Institute of Biomedical Science (IBMS).