AZ Turnhout and AZ Herentals (B) laboratories centralise activities with CliniSys | MIPS portfolio
To support its goals, the different hospitals had to set up a single laboratory information system (LIS) with one, central database.
With GLIMS, CyberLab and CyberTrack, the merged laboratories can work more efficiently and provide better service to referring physicians and patients.
2 merged laboratories
2750 staff (for 2 hospitals)
Turnhout, Herentals (B)
For more than a decade, hospitals AZ Turnhout and AZ Herentals, in Belgium, have been working together, with their laboratories taking the lead in this collaboration. In 2018, the labs fully merged with each other, sharing a single bacteriology laboratory, and centralising all non-urgent tests.
“The goal of this merger was not only to work more efficiently, but also to optimise expertise and enable more specialisation of our medical staff in the various subareas,” explains Juul Boes, director of the laboratory.
To support the goals, the hospitals had to set up a single laboratory information system (LIS) with one, central database. AZ Herentals was a long-time user of GLIMS, and their colleagues in Turnhout were quickly convinced. “MIPS could offer us all the modules and functionalities that we needed. It was the logical choice,” says Tom Spiritus, project manager for the GLIMS project.
Large project requires thorough preparation
As Juul Boes describes: “We wanted to make the move to a centralised laboratory in one day. This involved moving the bacteriology department, installing a new sample transport system including increased transits between the hospitals, and implementing different software packages: GLIMS, CyberLab and CyberTrack (MIPS’s blood transfusion module). Such a huge project has to be thoroughly prepared!”
At the outset, all processes were critically reviewed and redesigned in GLIMS. To prepare the centralisation of the laboratories, a common order form was developed. The team wanted to have this form ready before the new systems were operational.
Regular steering committee and status meetings involved clinical biologists, board members and IT managers. A risk analysis and tests across the three campuses were performed before going live.
“For the project management, we were able to rely largely on MIPS’s roadbook,” says Tom Spiritus. “This allowed us to monitor that all the necessary steps were carried out effectively. At the request of MIPS, we also set up a ‘war room’ where people could focus on the project undisturbed.”
About five people worked on the project almost continuously, but many more were involved. Tom Spiritus: “A year before going live, MIPS started training 18 system administrators. We, in turn, trained all end users. All of this helped to motivate people and create broad support for the project.”
Launching on time and budget
The launch date was set far in advance, on a Sunday to ensure any issues were resolved before the laboratory had to run at full speed on Monday. During the first days, laboratory staffing was increased, day and night, and four experienced project representatives were continuously present to assist them.
“Thanks to the careful preparation, and the commitment of everyone, everything went smoothly,” Juul Boes describes. “MIPS, and in particular the experienced project manager, guided us very well throughout the process. MIPS also monitored the budget with us during steering committee meetings. And that paid off: the project was not only completed within the predefined timing, but also stayed within budget.”
Juul Boes explains, “Already – barely two months after the go-live – we can see numerous benefits.” He highlights some of the effects felt:
- “Much less paper is used, as everything is done electronically: worklists, test ordering and test result communication.
- The entire flow is traceable: we can always see exactly where a sample is located and who has produced or changed which result. No samples have been lost.
- Data exchange with the other software packages in the hospital is smooth: the hospital information system, billing system, electronic patient record, etc.
- All results, including microbiology, are LOINC-coded.
- The statistics module is also a substantial improvement. Public health reports, including on germ resistance, are automatically generated in the correct structured format. GLIMS also automatically generates internal hospital notifications about hygiene, for example if a patient has a positive MRSA test.
- Patient safety has improved enormously in terms of blood transfusions. We can import all data from the blood bags, including the antigens, into GLIMS. As a result, the system can perfectly indicate which blood bags can be administered to patients who have antibodies. And the transfusion certificates are automatically stored in the patient’s medical record.
- The centralisation has many more advantages. For example, if something changes in the nomenclature, we only need to adapt it once. We can also bring together all hardware in one location, offer better support, and at the same time make savings, for example on maintenance and licensing costs.”
From order request to results viewer
The dynamic nature of the MIPS systems is also an advantage, says Jan Verschaeren. “The order entry module in our previous system was not flexible enough to grow with our needs. The upgrade to MIPS’s dynamic CyberLab order entry module was certainly useful.”
The requirements were extensive. The module had to:
- be fast for the end users;
- have an integrated results viewer;
- make it easy to request additional tests;
- smoothly integrate with other packages;
- provide the tariff for the tests to the ordering physician;
- allow simultaneous use at different sites, each with their own ADT system and active directory;
- comply with the GDPR, offering password management and an automatic fax functionality for the exchange of results.
Jan Verschaeren explains, “MIPS could offer all of this with CyberLab. Our general practitioners can now order tests from their electronic patient record. The result is that we now perform fewer incorrect tests.”
The hospitals in Turnhout and Herentals are also using the CyberLab results viewer, which is fully integrated into the medical record. And the order-entry module is gradually gaining ground: the doctors particularly appreciate being able to create their own test panels.
Tom Spiritus: “You can set up the MIPS systems specifically to your needs and ways of working. For example, we assigned different roles to laboratory staff, and set up the screens according to their preferences. The GLIMS user interface of someone in microbiology looks different than that of someone in the chemistry laboratory. Thanks to the customisable screen layouts, GLIMS is exceptionally user-friendly for the end user.”
One laboratory, one LIS, one supplier
“Previously we had a very mature system in our laboratory. In my opinion, with MIPS’s new systems we have reached the same level of maturity after just two months, which is an achievement,” says Jan Verschaeren.
Tom Spiritus continues: “We see benefits from working with one supplier for all laboratory modules. You always have the right people around the table, and you can work more efficiently, for instance during the go-live. And if a problem pops up, you can solve it in a more targeted manner.”
“I recommend that everyone start with good preparation, invest energy in motivating your team, and stay open to your supplier’s proposals. MIPS has an enormous amount of experience with other deployments and that has proven to be extremely valuable,” he continues.
“The centralisation of our laboratories gives us numerous benefits. But it doesn’t stop here: with the hospital networks that are currently being established, a new wave of centralisation is coming. So you need a software system that can handle this, and a supplier that can guide this process. MIPS was the right partner for us. They carefully take into account the wishes of their customers. They work with us to find solutions, and they realise them in a relatively short term. This is quite unique,” concludes Juul Boes.
The laboratories use the entire MIPS portfolio
- GLIMS: laboratory information system that manages the activities of the various laboratory disciplines;
- CyberLab: module with which doctors inside and outside the hospital can request tests and view results;
- CyberTrack: application for registering and tracing blood transfusions online;
- LIS DaVinci: software package that manages the workflow in the pathology laboratories.