The Laboratory Information System (LIS) is the beating heart of many pathology labs, containing all the diagnostic data needed for day-to-day practice, and in many cases, acting as the center of early-stage digital workflows. As digital pathology has evolved, however, comprehensive platforms have been introduced that promise to better support end-to-end diagnosis, combining image storage, case management, slide viewing, reporting, and more into one easy-to-use interface. For these platforms to be effective in the clinic, it is critical that they work together with the LIS; only by deeply integrating LIS information into a digital pathology platform can labs truly reap the benefits of modern digital pathology and unlock the efficiency gains driving adoption.
At Paige, our goal is to make integration not only effective and seamless, but flexible to each lab’s unique capabilities and needs. The Paige Platform was built to be a completely open and vendor-neutral system that can integrate with any LIS vendor, whether already in use at the lab or being newly onboarded as needs evolve. Further, integration can be achieved in several different ways depending on the lab’s resourcing and preferences, removing any barriers to successful adoption and ensuring that every lab can leverage advanced operations powered by the Paige Platform.
What is integration: key terms
Before making these choices, it is important for all stakeholders to understand what we mean by integration. Simply, integration refers to connecting two separate pieces of software together. In the case of the Paige Platform and an LIS, connection is made through Application Programing Interfaces (APIs), or mechanisms that enable the two systems to communicate with each other.
For pathology, communication comes down to the sharing of a few key pieces of information. First, whole-slide images (WSI) and case metadata, such as accession ID, specimen type, and more, will be sent into the platform. Importantly, the software will also automatically marry that information to create a complete and interpretable case. Next, a notification can be set up to signal that this data has been ingested and is now available in either or both systems. Finally, the platform can communicate actions taken on these cases back into the LIS.
A completely integrated workflow then is one where case information is sent bi-directionally into and out of both Paige and the LIS at designated times, such that all case information, in the preferred format, will be connected and easily accessible and trackable throughout the diagnostic process.
Building integrated workflows
Paige offers 3 main ways labs can connect their LIS with the Paige Platform.
Pre-established integrations
The first is to leverage one of our pre-established connections with common LIS vendors such as EPIC Beaker, CliniSys WinPath, Sectra, and more. An off the shelf integration requires minimal development work, making it a great option for labs without large in-house IT resources and dramatically shortening overall implementation timeframes.
Paige & LIS vendor-driven custom integration
In absence of an existing integration, Paige can collaborate directly with the laboratory’s LIS vendor to set up a standard integration. In such scenarios, either the LIS vendor or Paige’s internal team would take charge of the development process, making this another suitable choice for labs that may not have specialized IT resources available for integration development.
Lab-driven integration (middleware)
Where direct work between Paige and LIS vendor is not possible or preferred, labs can own the development in-house by creating middleware, or a third layer that brings the systems together. Such development affords labs more direct control over the integration and over the addition of future feature functionality. This can also be a more cost-effective option in some cases, particularly when labs already have large in-house resources available to them. However, lack of internal resources does not preclude a lab from choosing this option. Paige has access to third-party partners who are available to create middleware on behalf of the lab where needed quickly and cost effectively.
Finally, some labs may be going through a change in their LIS, but still want to get up and running with the Paige Platform. In this case, Paige can support a non-LIS integrated implementation temporarily, and then adapt the systems later when a LIS has been selected or IT resourcing has been built out.
Regardless of the route a lab chooses to take, they always have the opportunity to accept all the features Paige supports and tap into the full power of the Paige Platform. Paige will also always provide full project plans, timelines, and architecture diagrams at the start of implementation, and be on hand throughout the entire implementation process to ensure that labs are set up for success.
Customizing your workflow
Once the integration method is established, labs can further customize their workflows with Paige, for example in deciding how cases will be launched. A contextual launch allows pathologists to start their day in the LIS. With one click of the desired case, they can launch the slides in FullFocus, Paige’s whole-slide image viewer, for review, and then sign the case out back in the LIS when review is complete. This method supports pathologists in adopting elements of the Paige Platform without dramatically changing their currently understood workflows, which could enable faster adoption in the lab. Alternatively, the Paige Platform can become the core hub at the foundation of the pathology workflow. Here, cases would be managed and accessed in FullFolio, Paige’s AI-enabled image manager. Again, with a click, pathologists could open the slides to view them in FullFocus, and leverage our reporting API to send information, such as Paige AI outputs, back into the LIS for use in the final report. This is the suggested workflow to create a truly end-to-end streamlined user experience and bring the greatest possible efficiency to diagnosis. Plus, with FullFolio’s AI integration, pathologists would have the ability to triage their cases to focus on those suspicious for cancer or send suspicious cases for additional staining earlier in the day, adding organization and prioritization to practice in ways not possible with current LIS-driven workflows.
The goal with every implementation is to make what can seem like a daunting step a simple and productive one. Taking the time to understand all the options available to a lab, how they would impact a pathologists’ day-to-day work, and how they might benefit the lab as their needs and technology systems continue to evolve ensures that from day one, the Paige Platform can deliver on its promise to simplify lab operations and improve pathology practice.
No matter what resources, vendors, or needs a lab may have, Paige is guaranteed to deliver the integration needed to propel the team into the next era of pathology practice, today. Our flexible, customizable, and open platform combined with our dedicated team make Paige the right choice for every lab at all stages of digitization.
If you’re interested in learning more about how we interface with your LIS as a lab, or if you’re an LIS vendor and are interested in working with us, contact us at [email protected]
