Clinical Laboratory (LAB) Information Systems

Abstract

The clinical laboratory (LAB) was an early adopter of computer technology, beginning with the chemistry and hematology laboratories, which had similar information processing requirements. LAB systems in the early 1960s were primarily offline, batch-oriented systems that used punched cards for data transfer to the hospital mainframe. The advent of minicomputers in the 1970s caused a rapid surge in the development of LAB systems that supported online processing of data from automated laboratory instruments. In the 1980s, LAB systems increasingly employed minicomputers to integrate data into a common database and satisfy functional requirements, including programs for quality control, reference values, trend analyses, graphical presentation, online test interpretations, and clinical guidelines. By 1987 about 20 % of US hospitals had computer links between their LAB systems and their hospital information systems and affiliated outpatient information systems. In the 1990s, LAB systems began using client-server architecture with networked workstations, and most hospitals had a variety of specialized clinical support information systems interconnected to form a medical information system with a distributed database of clinical data that constituted the electronic patient record. By the 2000s, several hundred different clinical tests were routinely available (there had been only a few dozen in the 1950s). The need for more sophisticated and powerful LAB systems has largely been met by commercially available standalone laboratory information systems (LIS); however, there is now increasing pressure to replace these products with the lab-system functionality of the enterprise-wide integrated electronic health record system, for which there is little reported experience.