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Title: LAB RESPONSIBLITIES
Thank you so much for the informative and sometimes amusing responses to my question. Many of you requested a compilation of responses to my question about where the line is drawn between IS and the LAB for support. The consensus seems to be that, where lab resources are available, the lab does most setup and configuration because they understand the details so much better. There also seems to be quite a few LAB techs/coordinators who are unhappy with their salaries for this reason;) The world just isn’t fair. See below for individual comments (identifications removed, of course).
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1-I am the LIS coordinator for our Lab but I am under Lab's budget, not IS's. I do everything related to lab. Even NMI interfaces. I don't trouble shoot background job issues or serious printing issues that involve our print servers but the rest of it I do. I know enough about BKG jobs that I can give direction. I create new tests and consult with our Nursing Informatics person who does live in IS to consider mnemonics etc. I build in Lab test and Live and coordinate the Live date for new Lab, MIC and BBK activities.
2- In our shop, that type of test & calculation would be set up by the Lab manager or one of the more experienced Lab techs. As the Meditech LAB analyst (among other modules), I'll help with module upgrades & add-ons, analyzer setups, interfacing issues, send-out (Mayonet) issues, as well as report creation, device activation, repetitive test or rule changes & corrections, troubleshooting, etc. But for specialized and new test design as described in the question, our Lab staff does the setup.
3- We are a 5 hospital system with one lab application coordinator, one IS Lab analyst, and one Programmer/Analyst partially dedicated to lab. The application coordinator works the closest with the techs in the departments, and handles all Meditech set up, except for complicated calcs, rules, and reports. He also handles most issues with Meditech, with the IS people handling the others. He is the bridge between the working lab techs and the IS. The working techs use the system, don't have dictionary access, and don't have the authority to contact Meditech.
4- I am a med tech that has moved to IS. I still support all our lab modules. The section team leaders all have dictionary access and staff techs have access to certain dictionaries as needed. This includes standards and controls and canned text, but very few others.
The specific answer to your question is that it depends on the expertise of the individual. Our microbiology team leader is much better at writing antibiotic calculations than I am so he just does them. I let the blood bank team leader manage most things in that module and also manage anything relating to reference lab testing since she is responsible for that.
In general rules writing, npr reports, and lab module calculations come to me. Also if there are questions about how things are supposed to work, they get sent to me. I have responsibility for many things that do not directly relate to lab since I moved to MIS and lab staff knows that the old days of me sitting down there with my job specifically as the lab coordinator are long gone. They do what they can and refer things to me when they are not sure or cannot do it. I do review the edit log monthly to screen for anything that might have caused a problem.
5- We (the lab) superusers do all the test creation, from start to finish, and do not get paid for it. What a deal huh!
6- Our lab maintains all dictionaries to which we have access; including calculations, rules, and CDS's with attributes,
7- Does the Lab have a trained LIS coordinator? If so, that person should set up dictionaries, calculations, etc. But, if no one in the lab has been assigned those responsibilities, trained how to do it, and given the time off the bench in which to do it, you cannot expect the lab to do it. The average tech would not even be given the dictionaries for test set up and calculations on their menus. We are a large facility, so we have three people (med techs) in LIS who do all of the tasks you listed and more, including instrument interfaces, installing label printers, writing NPR reports, etc. I only contact IS for network and hardware issues that I do not have the authority or knowledge to handle. So, I think the answer to your question will depend on what resources the hospital has given the lab. Given the resources, I bet most labs would rather do it themselves.
8- I am the lab IS analyst and I work totally out of the lab. Not in IS. So I “do it all”.
9- I am a Medical Technologist working in IS for the last 4 years. We are a small hospital without a traditional department management structure. I do almost all of the Lab IS set-up and testing. I just get requests from the Lab on what they would like, it is up to me to make it happen.
10- Depends on how much time I have to spend with something. Most of the time they build and test their own new tests, but I recently helped them research the calculation for GFR, built and tested it and added it to several of their profiles. Right now I am assisting them by researching positive id applications for bedside phlebotomy, contacting vendors, setting up demos and getting pricing. I am also assisting them with new analyzer interfaces, coordinating all the pieces of the puzzle that are entailed with that. If no big projects on the horizon, I only help troubleshoot issues that they can't resolve. It helps that I'm a med tech that worked about 15 years in the lab before moving to IT.
11- I require my lab lis coordinator to do the leg work and testing. If there is a problem we open a task but he is involved the whole way. He knows the day to day routine so I depend on him to do most of the work.
12- As a recent (about 2 months) clinical analyst (formerly Administrative Laboratory Director), and new at this facility, I can offer that something like your question is handled by me at this point. We are just starting to develop and train a superuser group within the Laboratory that could handle such things (with my knowledge) in the future and I would provide any needed support and troubleshooting. My facility has had Meditech since 1992 and those initially trained are history. The core of 4 people I'll be working with contains 2 with the aptitude to tackle a task like the one you present. Currently, they only add new procedures and canned text. One is capable enough to attempt some simple calculations. Because I have 8 other modules to support, including Pharmacy, I'll be working to train and develop the superusers quickly. We'll also be going live with 5.5 in early December, followed by Blood Bank module implementation, then BMV, then barcoded specimen collection, etc.. Add to that development of a regional user group for Lab within Oklahoma, a new reference lab interface, and pathology interface. My supervisor, with the buy-in of Administration here, is very supportive of the development of the superusers and a regional support network for most modules - part of the reason I came here. A long response, but the answer to your question lies with the ability, attitude, and aptitude of the Laboratory staff. If they're able and can prove it in the TEST system, I say go for it. If it would require more work later to clean things up, keep it with the analyst.
13- I am full time LIS and a member of the lab team. Certain other managers in Lab have dictionary access, so all of our maintenance is done by lab staff. Lab support provided by IS is only in the form of NPR. I work closely with IS folks on interfaces and other modules.
14- In our health system, the lab has total control of the lab application dictionaries. This includes writing rules and calculations. We also write the vast majority of NPR reports needed for the lab. Unless you have someone in IS with a lab background, it will be easier to teach lab people the minimal amount of NPR programming necessary for these tasks, than it will be to teach a non-clinical IS person how the lab is structured. You will find that there are probably already people in the lab that have some programming or database background, and would be good candidates. This is probably more true in the lab than in other disciplines.
15- When I was still in the LAB, I pretty much did everything and only called my IS analyst for network issues, NPR reports etc. Now that I am in IS, I still pretty much do everything. My lab superuser should do more but doesn’t. He really only does dictionary building(adding new test). I try to encourage more BUT…..
16- I am very fortunate to be the IS Clinical Analyst that supports the LAB application who has an LAB LIS Coordinator who does the clinical dictionary building and testing. My primary role is to act as the liaison and communicator between our LAB and Meditech and also with other vendors when interfaces are involved. The LIS Coordinator and I both have access to create and edit Meditech tasks and we work very closely together, however the Clinical expertise is left to the coordinator. On the other hand NMI Delivery Services testing and implementation is the shared responsibility of both IS and LAB. This cooperative arrangement has worked very well for our facility and we've found that it's truly a necessity to have the LIS coordinator physically based in the LAB and an active part of the day-to-day operations. The application Analyst falls under the direction of IS and the LIS Coordinator is under the LAB Director.
IS Senior Consultant
CentraState Healthcare System
Extension 732.294.2719
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