Laboratory Information System (LIS)

A laboratory information system (LIS) is software that helps record, manage and store the samples’ details in the clinical laboratory. It is a convenient way to track samples before, during, and after collection. Not only sample collection and processing, but it also aids in report generation and monitoring of the overall well-being of the patients of the hospitals/clinics.

In the past, LIS and LIMS (laboratory information management systems) were thought to differ in their use significantly. But recently, software like Thermo-scientific’s Clinical LIMS and Abbott Informatics Cooperation’s STARLIMS has blurred the differences to insignificance.

Overall workflow of LIS — Image source: https://www.scirp.org/journal/paperinformation.aspx?paperid=49352

Table of Contents

Components of LIS

The proper functioning of the LIS requires three different components working in a synchronized form. They are:

Tracking Sample

It is the main component of LIS because samples are the most valuable possession of any clinical laboratory. It includes adding the details like unique ID, name of the patient, the department in which the patient is admitted to, type of the sample, date or batch number, and volume in the software. As a single sample processing occurs in different parts of the laboratory, having the details written in an electronic format helps the sample to reach its analysis destination. Similarly, using sample barcode with the details will help locate the progression of the sample. Likewise, the sample tracker helps to generate the concise result of all the tests performed from the sample in a single document.

Implementing Protocol

Another component of LIS is implementing the protocols, steps, processes, and procedures to improve the standard of the laboratory workflow. Similarly, by digitizing all the steps, the system helps generate standard operating procedures (SOP) for processing samples and accurate result interpretation. The SOP helps maintain consistency in sample processing despite different laboratory personnel conducting the tests. Likewise, LIS helps provide a strict protocol for maintaining quality tests and gives visibility based on authorization. LIS also helps generate concise results, send them to the approval queue, and then distribute them as per the requirement.

Managing Storage

Finally, the last component of the LIS is managing sample storage. The samples with the same batch number or date of collection are grouped, which helps in correctly storing the sample for future use. The batch is placed in the same container, box, or shelf rack. Along with the shelf rack, the system tracks the freezer or area where the rack is placed. The storage hierarchy is essential in locating samples quickly in a busy laboratory and maintain organized and efficient productivity.

Source: Autoscribe Informatics

The overall workflow of LIS

The precise working of LIS has a specific workflow. The overall workflow of LIS is as follows:

Pre-analytical

The pre-analytical workflow of LIS includes:

Login to software for accessing the sample: It includes logging in of the person collecting or testing the sample.
Sample tracking using barcode/id number/date: It includes giving the sample an id/batch number. And then placing the sticker with barcode/id number and date of collection in the container with the sample.
Chemical and reagent inventory: It includes checking if the amount of chemicals and reagents required for performing tests are enough in the stock. It also includes confirming the chemicals’ expiry date before using or storing newly purchased chemicals.

Analytical

The analytical workflow of LIS includes:

Schedule testing: It includes inputting the required tests for the sample into the software.
Chain of custody: It means adding any additional details required for processing the sample in the software.
Instrument integration: It means starting the test procedure. It also gives tentative idea of the time required for the completion of tests.
Result entry: It includes entering the result in the software once the test finishes. It can be manual or direct linking to the software by using cables.
QC/QA/specification checking: It includes quality testing of the instruments and chemicals. It also includes confirming the result by authorized personnel.

Post analytical

Finally, the post-analytical workflow includes:

Reporting result: It means reporting/distributing the entered result after it is entered and verified as accurate in a standard format.
Archiving data/result: It includes recording the patient’s data and result for future references in the software even after distributing it.

Functions of LIS

The functions of LIS are as follows:

Patient management: It includes determining the admitted department of the patient, the physician assigned to the patient, and the type of specimen required from the patient.
Tracking patient data: LIS helps track patients’ demographic and laboratory data (laboratory results). Also, it helps in monitoring the status of sample processing. In case of readmission, it helps in retrieving the historical information of the patient so that the laboratory personnel and the hospital staff can choose the right path to provide care.
Consistency and accuracy in generating results: Since LIS helps standardize laboratory protocols and verify the results, it helps maintain consistent results for each patient. Likewise, the accuracy of the testing is verified and rechecked by authorized personnel.
Quality assurance: LIS not only helps in standard laboratory workflow but also helps maintain the quality of the tests in the laboratory. The LIS records data of every quality testing which helps generate any instrument’s health status report.
Billing: During admission and patient bill registration, the total amount is easily generated, and there will be no discrepancies in service charges for patients. Without billing, laboratory instruments can not run decreasing the chance of patients cheating the hospital for free service.

Benefits of LIS

The benefits of LIS are broadly classified into two groups. They are:

Benefits to the patient

Firstly, the patient will know the status of their laboratory test.
The results are available in digital as well as paper format.
It decreases the risk of duplicating the collection of samples because the processing and storing of the samples are well managed.
Shorter stay in the hospital/clinic due to digitalization and organized way of getting results.

Benefits to the laboratory personnel

It increases productivity due to a well-managed laboratory as well as inventory.
It decreases miscommunication between staff during change of shift about the procedures already carried out or needed to be performed because the results, as well as the tests, are digitized.
Likewise it makes obtaining the details of the patients like samples required/already used, and status of patients like the department they are situated in, their health conditions easier. These data help in eliminating false results during diagnosis.
It also helps obtain a history of a patient so that the right treatment can be given to the patient.
It also helps in forming a confirmed and concise report in a single file of a single patient.
Focus time on manual work increases because the laboratory’s samples and inventory management becomes easy after using the software.

Criteria for Choosing LIS

Choosing the perfect LIS for your laboratory depends on four main characteristics. They are:

Its speed

A good LIS has a very rapid response time. The program loading should occur in less than 2-3 seconds. The speed of the LIS depends on the storage capacity and application software. Firstly, enhancing the speed of LIS depends on the design/outlay of the application like an on-screen help menu, data attributes, and on-screen navigation. Another factor, the storage capacity, depends on the efficiency of the storage disk and retrieval of the stored data.

Its connectivity

Connectivity of LIS means how easily one can access the data from different departments of hospitals like a laboratory, patient’s room, hospital floor, clinics, or doctor’s office. Connectivity to the available network of the laboratory is also very crucial. LIS acts as a processor by using a cable to the already available PC (personal computer), printers, and other components of your laboratory computer system. Likewise, if the cabling is adequately done, adding a new computer or other instruments and upgrading the LIS will be easier. So during the selection of LIS, one should also consider the type of hospital information system (HIS) used.

How adaptable it is

The need for laboratories like new instruments and rotation of laboratory staff keeps changing from time to time. So, LIS needs to be the most adaptable to any change. Similarly, the LIS should be able to modify as per the time requirement.

How reliable it is

The LIS should be reliable in such a way that the software functions without interference or constant maintenance. The downtime in any reliable LIS is very low. The disk mirroring and real-time backup of the LIS software determines its reliability.

References and further reading

BD EpiCenter. Bd.com. (2022). Retrieved 27 June 2022, from https://www.bd.com/en-uk/products/diagnostics-systems/information-management-system/epicenter.
LIMS- Laboratory Information Management Systems | Thermo Fisher Scientific – UK. Thermofisher.com. Retrieved 27 June 2022, from https://www.thermofisher.com/np/en/home/digital-solutions/lab-informatics/lab-information-management-systems-lims.html.
Dr Salleh, A. (2014). Laboratory Information System (LIS). HEALTHCARE SERVICE DELIVERY. Retrieved 27 June 2022, from https://drdollah.com/laboratory-information-system-lis/.
DelVecchio, A. (2015). What is laboratory information system? – Definition from WhatIs.com. SearchHealthIT. Retrieved 27 June 2022, from https://www.techtarget.com/searchhealthit/definition/laboratory-information-system.
Laboratory Information Management Systems (LIMS) Information.
Analytics, T. (2022). What is LIMS? What is a LIMS System Used for? | Lockbox LIMS. Third Wave Analytics. Retrieved 27 June 2022, from https://thirdwaveanalytics.com/blog/what-does-a-lims-do/.
Laboratory information system – LIMSWiki. Limswiki.org. Retrieved 27 June 2022, from https://www.limswiki.org/index.php/Laboratory_information_system.
Staff, M. (2004). Lab info systems (LIS) ease workflow. Mlo-online.com. Retrieved 27 June 2022, from https://www.mlo-online.com/home/article/13002648/lab-info-systems-lis-ease-workflow.
Laboratory Information Management Software (LIMS) | LIMS Systems. Autoscribeinformatics.com. Retrieved 27 June 2022, from https://www.autoscribeinformatics.com/lims-laboratory-information-management-system.
Sanjana. (2018). What is laboratory information management system?. Mocdoc.in. Retrieved 27 June 2022, from https://mocdoc.in/blog/what-is-laboratory-information-management-system
Forest, J., Rheault, C., & Dang-Vu, T. (1985). The Laboratory Information System (LIS): I-Application to the clinical chemistry laboratory. Clinical Biochemistry, 18(2), 78-84. https://doi.org/10.1016/s0009-9120(85)80085-0