Virtual Laboratory Information Systems Support
By Paul Asbury

The evolution of clinical support has afforded health care institutions the opportunity to diversify the support options available to their patients and employees. The nearly-ubiquitous availability of high-speed Internet connections and server software that provides remote connectivity has made off-site support a feasible alternative for their consideration.

Connectivity for remote support is usually provided by the hospital's information technology (IT) department through the use of a secure connection. Some examples of software used to establish secure connections are Cisco VPN Client, Citrix ICA Client and Juniper Network Connect. The software is entirely dependent on the availability at each institution. Consultants providing remote support usually are granted access to all applications involved in their role, including HCIS access, a hospital e-mail account (though it's not required), access to any third-party or custom applications, and a phone extension (made more readily available by those enterprises with IP telephones installed.)

Traditionally, IT support for the clinical laboratory has been provided by local personnel. Whether staffed by a representative from the hospital's management information systems (MIS) department or a dedicated clinician with advanced knowledge of laboratory information system (LIS) software, having a knowledgeable and experienced analyst focused on the laboratory's myriad of IT needs is an integral part of everyday operations. In the case of the MEDITECH HCIS, the laboratory analyst will typically be tasked with supporting the LAB, BBK, MIC, and PTH modules. This requires that an individual is not only familiar with the installed capabilities of each database, but also familiar with the many customizations available through NPR report writing used to expand capabilities and meet demanding clinical needs.

The responsibilities of a remote support analyst are generally the same as an on-site analyst. The functions they usually perform include:

• Test dictionary builds
• Billing code updates
• Interface implementation and troubleshooting
• Telecommunication and printing services oversight
• Customized report queries
• Software upgrade testing/validation
• Local management of third-party software
• End user training on new features and enhancements

In the case that a consulting company provides transitional support, it is recommended for the consultants assigned to a client to schedule an on-site visit at the commencement of an assignment. This provides opportunities for newly-assigned personnel to interface with the clients they will be assisting and place a face with the voice they'll hear on numerous occasions. This helps both client and consultant grow more comfortable with the role each plays in supporting both providers and patients.

There are some considerations that should be addressed when an outside consultant steps into a support role for a client. Given the customization possibilities inherent in any hospital information system, most hospitals have extended capabilities installed, including third-party software, such as Point-Of-Care workstations, and outside vendor interfaces, such as laboratory HL7 connections, to reference laboratories such as Quest Diagnostics and LabCorp. When possible, consultants assigned to hospitals with enterprise-specific vendor solutions who have not encountered these add-ons in other assignments should have training material and vendor support contacts made available to them in order to familiarize themselves with sufficient information to provide ongoing support for these applications.

The extent of a consultant's role should also be clearly defined from the outset of the project. In the case of a laboratory analyst providing virtual support, modifications to the existing software, such as modified user access or new test dictionary entries, are a frequent request from laboratory management personnel. If the consulting analyst is empowered to make these sorts of revisions, a clear line of communication and understanding of management structure is essential for ensuring that such changes are made only with the proper consent of those empowered to authorize these modifications.

It's also important to ensure that communication between client and consultant is consistent and clear. Both parties must be able to consistently relay their ideas, needs, concerns and progress through phone conversations, e-mail, instant messaging, and/or IP videoconferencing. While these methods of contact provide an acceptable and very reliable method of contact for clients, those individuals more comfortable with one-on-one, in-person conversations may not initially embrace these changes in method of communication. Successfully conveying relevant information between parties requires an effort on all parts to minimize potential miscommunication and foster a cooperative trust that enables all involved to maximize their return on investment.

For more information about our MEDITECH practice and how VCS can help your organization, please call us at 610.444.1233 or visit our website at www.getvitalized.com. You may also email us at vcs@getvitalized.com.