Feature

The 'Ultra' Effect

Implementing LIS has benefitted Dr Lal Pathlabs in ensuring quality, patient friendliness and has also spurred its growth story, informs Sonal Vij

Dr Lal Pathlabs proudly claims to be the first Indian company in the domestic market to use computerised system in pathology lab. Today, the group has 60 labs and 600 collection centres. Their expansion plan includes 50 labs and 1,000 collection centres by 2010. The group acknowledges the use of high-end IT systems in its spiraling growth story.

Till late 1999, the diagnostic chain made use of a home grown customised IT solution. That posed a problem since that solution was applicable only in a single lab. As major expansion was on the cards, it felt the need for an IT solution that could keep quality check on the growing business.

Explains Arun Mathur, Head IT, Dr Lal Pathlabs, "In 1999, our Chairman Dr Arvind Lal introduced world-class Laboratory Information System (LIS) Centrecity Ultra that he saw was running successfully abroad."

Centrecity Ultra, a software solution from GE Healthcare, was thus introduced in December 1999. It took four months to implement in the main lab in Delhi.

At present, the company invests three to four per cent of its turnover in IT (approximately Rs 3-4 crore).

Modus Operandi

"Currently, direct functionality is not available in LIS system. We would be upgrading that module" - Arun Mathur Head IT Dr Lal Pathlabs

"I would like to introduce the concept of health accounts of patients" - Dr OP Manchanda CEO Dr Lal Pathlabs

There are three areas of a lab- pre analytical, analytical and post analytical. Centrecity Ultra takes care of all of them. Pre-analytical stage includes patient enrollment with the lab, receiving of samples, and distribution of sample for department level testing purposes. Analytical stage includes sample movement within lab, sample tracking and sample processing and data transfer from sophisticated analysers which are generally connected uni or bi-directionally with the LIS system. The last stage is post analytical. At this stage, lab requires a software system to verify/ validate results received from the analyser. It also prepares lab results in presentable form for the doctors. The LIS takes care of all of them. The Centricity Ultra is deployed on high-end IBM p-series servers with high availability environment.

When a patient walks in the facility, he/ she is registered using Enterprise Resource Planning (ERP). The ERP is interfaced with LIS using standard HL-7 protocol. The registration ID/ visiting ID (which also has the lab number) is issued to the patient. It also has a unique visit ID of the patient. That ID is useful in the case when the patients want to get more than one tests done in a lab. The bar code which has the ID is pasted on the vacutainer and the blood sample is sent to various departments for tests. Majority of the analysers are bi-directionally connected. A middle layer which is known as I-Net complements the LIS. It connects the analysers to the LIS system. With the combination of I-Net and barcode scanner available on the analysers, it accesses the information from the LIS like the tests that need to be performed.

After performing those tests, the data is thrown into the I-Net, then after first quality check system pushes data into LIS. Further a pathologist sees all results electronically and validates entire lab report. "Since Ultra is covering all the three stages of lab operations, means starting from the registration of the patient till the lab report generation, entire lab operation is managed with the help of Ultra," says Mathur.

USP

Ultra was chosen over other products because it is especially designed for pathological industry. It is feature rich and provides flexible reporting. It is fast enough to handle large volumes of data. All the functional modules are tightly integrated with reporting engine. It offers layered architecture to build interface with analyser. "The main USP is that it's fast. It provides speed and functionality. We are confidently delivering good quality reports to large volume patients," says Mathur. The LIS has capability of scalability to handle high volume at low costs.

ERP and CRM

The company has recently introduced ERP and CRM (Microsoft Axapta) The main areas handled by the ERP are revenue management, purchase and inventory and finance. Patient registration in most of the centres is done using ERP.

LIS role is related to when the sample hits the machine and the ERP sends the certain details of the sample through Ultra. "To tackle commercial functions, we have discontinued this function from Ultra and have introduced ERP," says OP Manchanda, CEO, Dr Lal Pathlabs

The CRM module is used for sales and marketing activities and customer loyalty.

Manchanda further informs that the CRM module reduces the registration time. The records are maintained in a systematic manner. When the patient revisits, the company does not have to waste time in taking all the details again. The ID issued is permanent and can be used in future to add and delete tests.

Connectivity

The instruments can be connected using Ultra. "It's the backbone of Dr Lal labs. Without the help of this software the expansion up to this level is not possible," adds Mathur. The software is installed in the central lab and all the labs are connected to that. The samples in the satellite labs are monitored using LIS. "It gives flexibility for seamless connectivity between different lab locations, handles bi-directional/ uni-directional interfaces with analysers. It also provides facility to monitor analysers centrally, helps labs to reduce turn-around time, has good built-in workflow to support standard lab practices," adds Mathur.

Every lab facility is connected through the central location. If a sample is collected in one branch and it is moved to the central branch for specialised testing, it can be easily monitored using the LIS system.

Moreover, the same ID, which was issued in one branch, will be identified in the analyser in the central branch. Therefore, there is no need for duplication of data. Moreover, if a test is done in one branch, the data/ results will flash in every branch. It also allows least human intervention. Everything except transportation of samples is automated.

Benefits

Thanks to LIS, no report goes without being validated. Moreover, from the point of view of expansion, all labs can be connected to the central lab. In addition, the patient can register somewhere else and can collect the report at a different location. It also involves least human intervention and reduction of processes-- thus reducing the costs. "Everything except transportation of samples is automated," informs Dr Manchanda.

It also allows systematic maintenance of records. "As far as the customer relationship is concerned, in case of a query, I can access the record of the customer in my ultra software and solve the query," says Dr Manchanda.

Health Accounts and New Modules

In the coming years, the group plans to continue to leverage IT. The company will update the version of Ultra soon. "I would like to introduce the concept of health accounts of patients," adds Dr Manchanda.

He further says that the patient should be able to access all his reports of tests done via Dr Lal Labs over the years in one account (like an e-mail account). He explains that the patient should also be able to correlate say the thyroid value of today, with the thyroid value at various points in the past. This module is available in Ultra and the company will soon implement it.

The company also boasts to introduce 'anytime anywhere concept' whereby the patient can place an order on the internet to get tests done, make the payment on the net and home collection of the samples can be done. Right now, the patients have to dial on a central number for home collection of the sample. The company is promoting this aggressively.

The company is facing the challenge of storing the entire data in one location. "Right now, the data is stored in one location. We have to make sure that if some natural calamity hits that location the data is safe. We are working on that," says Dr Manchanda.

The company is also planning to add new modules with reference to histopathology. Right now, the images seen under the microscope are added on the patient report manually. "Currently, direct functionality is not available in LIS system. We would be upgrading that module," adds Mathur.

It is also working on IT systems that increase patient friendliness and make the entire system hassle free." We want to reduce the patient waiting time to the minimum," says Dr Manchanda.

The company is also working on a tracking mechanism for the blood samples." If a patient query comes, we shouldn't be struggling internally where the sample is. There is a possibility that the sample is tested but not validated. The entire path of the sample must be available to us. That's our vision," concludes Manchanda positively.

sonal.vij@expressindia.com