Our chief executive, Richard Craven, reflects on some of the profound changes that the novel coronavirus has brought to CliniSys, to healthcare, and to pathology, and how they are likely to play out in a post-Covid future. I was appointed chief executive of CliniSys a year ago, and it is certainly been an eventful year. […]Read full article
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Our chief executive, Richard Craven, reflects on some of the profound changes that the novel coronavirus has brought to CliniSys, to healthcare, and to pathology, and how they are likely to play out in a post-Covid future.
I was appointed chief executive of CliniSys a year ago, and it is certainly been an eventful year. We moved into our new offices in Chertsey on 1 February, and as part of the move we refreshed our IT.
All our key systems jumped to the cloud, we became virtually paperless, and we deployed the latest Microsoft collaboration technology and Oracle business systems. So, when the novel coronavirus arrived in the UK, we were well-equipped to work remotely.
Which was fortunate, because on 23 March that is what we all did, as prime minister Boris Johnson instructed the country to ‘stay at home’.
Supporting the NHS through Covid-19
Remote working has worked exceptionally well for us. There is still a place for the office and, as long as we can do it safely, we will use our new headquarters to get our teams together to share purpose, hold creative meetings, and re-energise our colleagues.
We will also need to start to visit our customers again, combining on-site working with the best of our new delivery methods. Yet, in four months, we did not skip a beat. We did not record a single business or customer issue related to remote working. And yet we have been exceptionally busy.
We engaged with Public Health England as it put its communicable disease surveillance onto a new footing. Data liquidity was key, so we sorted out lab to lab connectivity. We delivered more than 60 connections to the National Pathology Exchange, NPEx, and have just a few left to do.
We delivered something like 80 analyser integrations, to help labs play their part in getting to the government’s target of 100,000 tests per day. We also developed Covid-19 specific order sets and dashboards to help labs handle Covid-specific requirements.
Virtual LIMS deployments and ICE innovation
We were involved with the first three Nightingale Hospitals in London, Birmingham and Bristol. In Bristol, that meant responding rapidly to a request from Severn Pathology for a piece of integration work to link the IT systems used by the labs at North Bristol NHS Trust with the IT systems deployed at the Nightingale, which are run by another city trust that uses a different instance of ICE.
We had a number of virtual go-lives. Two big projects were for Black Country Pathology Services and the labs at Luton and Dunstable University Hospital NHS Trust, which have deployed WinPath Enterprise as part of the development of the pathology network with Bedford Hospital NHS Trust.
And we worked with customers who wanted to innovate. A great example was a piece of work that we did with Hampshire Hospitals NHS Foundation Trust, which wanted to integrate ICE with its communications system, so staff could be given negative results by text.
New product developments, a genomics launch and a plan for cloud
CliniSys was also very busy in Europe. In Belgium, we delivered a LIMS to a new reference lab that was set up in just eight weeks to conduct testing for the whole of the country.
We did something very similar in the Netherlands. While in France, we worked on a new system to get results back to hospitals and GPs nationwide. All of this has made us faster and more agile about deploying our products, and that will continue. That will be an ongoing change for us.
At the same time, we have continued to develop our products. We have made enhancements to ICE and to WinPath Enterprise. Most significantly, WinPath Enterprise 7.24 was released and is in beta in Black Country Pathology Services and a couple of other networks.
We also launched our genomics product into the UK, which is very significant because it takes us from the wet lab into the genetics space, and we announced that the next generation of our products will be cloud native applications.
Healthcare reaches a digital tipping point
Many of the changes that we have seen at CliniSys have been mirrored in healthcare. At the start of the outbreak, the NHS also deployed Microsoft Teams. It rolled it out to 1.2 million staff in just four days to enable remote working, and trusts are reporting that thousands of staff are now doing their jobs from home.
The corollary for patients has been a rapid expansion of virtual clinics and consultations. In 2019, just 7% of GP consultants were carried out online. In July, a survey by the Royal College of General Practitioners found that just 11% of GP consultations were carried out face to face.
Those changes are here to stay, and they have pushed healthcare to a digital tipping point. The pandemic delivered the ‘radical shock’ that was needed to overcome professional concern and resistance to change. It also created a new backdrop of data enabled services as the backdrop to people’s lives, as they visited family on Zoom and sent shopping on Amazon.
Changes to pathology
There hasn’t been quite the same impact on pathology. Laboratories have been disrupted by the pandemic and will need to get back to conducting a different balance of tests as the NHS looks to ‘reset’ and get on top of the enormous backlog of elective work that has built up.
However, some of the changes that we have seen over the past few weeks are here to stay. For example, I think the focus on surveillance and testing for infectious diseases will continue, if only because we are already seeing how important that will be to control localised outbreaks of Covid-19; and to head off any second wave.
I also think the focus on data will continue and that it will benefit pathology. We will be able to work on ‘computational pathology’, on bringing data together for multi-disciplinary team meetings, to create more sophisticated diagnostic tools, and to stand-up digital and precision medicine supported by machine learning and AI.
The post-Covid world
I further think some of those bigger technology trends will impact pathology in the longer term. If we can work from home, we can work from anywhere, and that has the potential to make pathology a global business.
Some years ago, I worked in Holland, and I have a friend from that time who now lives off the coast of Venezuela, in Aruba, for six months of the year. In the US, it is common for pathologists to work from home for clusters of hospitals.
Work is going to come to people, instead of people going to work, and as part of that rules and regulations will need to change. At the same time, I think we can expect more changes for patients. During the coronavirus outbreak, we built a simple portal to support home testing.
The challenge that initiatives like home testing face at the moment is the ‘last mile’ – getting tests through the door and getting samples back again. I think the answer will be Amazonification. We will run our laboratories, and we will integrate with organisations that are experts in covering the last mile.
The CliniSys road map recognises this; particularly in its focus on cloud computing, which has developed to enable systems to be deployed easily, accessed through browser technology, and scaled as required. In the shorter term, it will enable us to deliver smaller, more rapid upgrades, which is something I know that customers want!
The MTV Moment
A colleague suggested that the rapid changes in the adoption of technology that we have seen over the past four months mean that healthcare has had its ‘MTV moment’. Once MTV launched, the way people produced and consumed music was never the same again.
The impact of Covid-19 on some patients and their families has been terrible, and I want to thank everyone who has worked so hard through this crazy time to lessen its impact. But the impact of Covid-19 on CliniSys and pathology has also driven change that will be positive, because it will enable us to use technology to shift our focus from organisations to the work at hand and to delivering for patients.
Das neue Coronavirus SARS-CoV-2, das COVID-19 verursacht, hält die Welt weiterhin in seinem Bann. Medizinische Laboratorien auf der ganzen Welt haben ihre PCR-Testkapazitäten in den letzten Monaten massiv erhöht, um Infektionen schnell und effektiv nachweisen zu können. Für die Durchführung einer so hohen Zahl von PCR-Tests wird allerdings auch eine große Menge an Reagenzien benötigt. Die Aufgabe, die Verarbeitungsmenge im Labor mit den verfügbaren Geräten und Verbrauchsmaterialien zu maximieren, stellt Labore vor immense logistische Herausforderungen.
Hier kommt das sogenannte Probenpooling ins Spiel. Pooling- oder Gruppentestverfahren, bei denen Abstrichproben von mehreren Probanden in einem einzigen Test kombiniert werden, können die Effizienz und Durchlaufzeit von Coronatests erheblich verbessern. Weltweit haben Labore mittlerweile verschiedene Techniken entwickelt, um solche Pooltests durchzuführen – derzeit sehen wir in allen Ländern, in denen MIPS tätig ist, großes Interesse und starke Nachfrage nach dieser ressourcenschonenden Testmethode.
MIPS unterstützt seine Kunden in vielerlei Hinsicht bei der Erhöhung der PCR-Testkapazitäten. Mit unseren Lösungen GLIMS und CyberLab tragen wir sowohl zu der belgischen nationalen Testplattform als auch zum SIDEP-Projekt der französischen Regierung bei.
Unser nächster Schritt auf diesem Weg ist die Unterstützung von Pooling-Verfahren in unserem Labormanagementsystem GLIMS. Wir unterstützen verschiedenste Workflows, um Pooling mittels Konfiguration in GLIMS zu implementieren. Unsere Teams haben Richtlinien für Kunden entwickelt, um diesen eine schnelle Umsetzung zu ermöglichen.
Dies unterstreicht erneut den Nutzen, den wir Kunden mit einem Produkt wie GLIMS bringen. Die Konfigurationsfähigkeit und ein reaktives Team, um jede außergewöhnliche Situation zu bewältigen!
Wenn auch Sie die Einführung von Pooling-Tests in Ihrem Labor erwägen, wenden Sie sich bitte an Ihre MIPS-Kontaktperson, um zu erfahren, wie dies in Ihrer spezifischen Konfiguration umgesetzt werden kann.
Het nieuwe coronavirus SARS-CoV-2, dat COVID-19 veroorzaakt, heeft nog steeds de wereld in zijn ban. Medische laboratoria wereldwijd hebben de laatste maanden hun PCR-testcapaciteiten opgedreven om het virus op te sporen. Het uitvoeren van PCR-tests vergt veel reagentia en gaat gepaard met logistieke uitdagingen voor alle laboratoria wereldwijd, om de doorvoer in het lab te maximaliseren met de bestaande apparatuur en beschikbare reagens en voorraden.
Hier komt pooling in het spel. Pooled tests, waarbij biologische stalen van meerdere proefpersonen gecombineerd worden in één enkele test, kunnen de efficiëntie en de doorlooptijd van een test aanzienlijk verbeteren. Wereldwijd hebben veel laboratoria ondertussen verschillende technieken ontwikkeld om deze pooled tests uit te voeren. In alle landen landen waar MIPS actief is, zien we een groot interesse en vraag naar deze resource-efficiënte testmethode.
MIPS ondersteunt haar klanten op vele manieren in hun zoektocht naar het vergroten van de PCR-testcapaciteit, en is leverancier van GLIMS en CyberLab in het Belgische nationale testplatform en aan de Franse overheid voor het SIDEP-project in Frankrijk.
Onze volgende stap in deze richting is het ondersteunen van pooling procedures in ons laboratoriummanagementsysteem GLIMS. We ondersteunen veel verschillende workflows om pooling te implementeren door middel van configuratie in GLIMS. Onze teams hebben richtlijnen voor klanten uitgewerkt, om een snelle implementatie mogelijk te maken.
Dit bevestigt de waarde die we aan onze klanten bieden met een product als GLIMS.
Als u ook overweegt om pooled tests in uw labo te implementeren, neem dan contact op met uw MIPS-contactpersoon om te leren hoe dit in uw configuratie kan worden toegepast.
Le nouveau coronavirus, cause du COVID-19 est toujours actif dans le monde. Ces derniers mois, les laboratoires médicaux du monde entier ont augmenté leur capacité de test PCR pour détecter le virus. La réalisation de test implique une grande quantité de réactifs et s’accompagne de défis logistiques pour tous les laboratoires afin de maximiser l’optimisation des équipement existants et des stocks de réactif disponibles pour effectuer ces tests.
C’est à ce niveau que les tests groupés entrent en jeu. Les tests en pool, dans lesquels des échantillons biologiques de plusieurs sujets sont combinés en un seul test, peuvent améliorer considérablement l’efficacité et le délai d’un test. Dans le monde entier, il existe de nombreux laboratoires qui ont développé des techniques pour effectuer ces tests en pool, et plus particulièrement dans les pays où MIPS opère. Nous avons donc réfléchi à la meilleure stratégie pour mettre en œuvre ce groupage de tests.
MIPS accompagne ses clients de plusieurs façons dans leur quête d’augmenter la capacité de test PCR. Nous sommes le fournisseur de GLIMS et de CyberLab dans la plate-forme de test nationale belge et du gouvernement Français pour le projet SIDEP en France.
Nos équipes de support ont été formé pour soutenir tous les clients qui veulent faire des tests pool dans GLIMS. Nous pouvons les accompagner sur différents flux de travail afin d’implémenter les tests groupés au moyen d’une configuration spécifique dans GLIMS. Nos équipes ont aussi élaboré des pré configurations afin de permettre une mise en œuvre rapide.
Cela aussi est une valeur ajoutée de GLIMS. Une puissance de paramétrage et une équipe réactive pour faire face à toute situation exceptionnelle !
Si vous envisagez d’implémenter des tests groupés dans votre laboratoire, contactez votre responsable commercial MIPS pour envisager une mise en œuvre rapide.
“Customers don’t know what they don’t know” – day to day usage is one thing but learning about additional or newly developed functionality to speed up workflow and provide other benefits is essential.
John Hamill, Service Manager at CliniSys gives a personal view of a new programme he’s launching – Customer Service Tutorials.
“I was challenged at the beginning of the year to answer the question of what we can do to help our customers get the most out of their solution and present my findings to the Senior Leadership Team at CliniSys.”
“Training has always been something I enjoy doing and I was delighted to have the opportunity to develop a programme for our customers. We appreciate that laboratories have a number of challenges lately to overcome with regards to product training, so any process needs to be simple and easy to access. Inducting new staff members is a time consuming process as there are many different aspects concerning their LIMS solution that needs to be covered. We also mustn’t forget that there are existing staff members who need refresher courses to maintain competency levels and a necessity to introduce and train on new releases of software. Levels of knowledge required for individual roles also varies widely, i.e. System administrators have to know the whole solution and be able to maintain and adapt the solution to meet the many challenges pathology labs face on a day by day basis.
“Ideally we would love to run Training Courses in a classroom style environment where we can interact and provide practical workshop sessions. However, because of time demands and workload pressures this is increasingly difficult to achieve. Our new material that we will publish on-line will make it easier for users to learn about our products and how to troubleshoot any issues they experience. With the material being on-line they can catch up on our content whenever and wherever suits each individual user.
“We already have a number of different options to help with customer training and other tools for assisting with using our products :-
- Product training courses, we have been able adapt these courses to run them remotely via Microsoft Teams or Zoom.
- Knowledge base, available on our Service Portal for rapid triage of common issues
- On-line help files, easy access from our products; easily searchable containing screen shots for simplicity.
- Annual classroom programme, free of charge training courses designed to be completed in one day to maximise opportunity for customers to attend. Due to the pandemic these have had to close and we therefore moved to digital webinars to share information. Now with the added benefit that we can record the sessions and share with a wider audience
- Bi-annual user groups – highly beneficial for our customers to learn about new developments. These include master classes and workshops on specific areas. Again moved to a digital platform this year due to the pandemic. Customers find these events so valuable and take the knowledge they’ve learnt and shared with other customers back to their labs. The recordings of these digital sessions are also available on the CliniSys YouTube Channel
“With these challenges identified, I presented on a number of different options that CliniSys could do to help our customers with their training requirements. We discussed these and many more options and came up with a plan to drive this forward.
- 12 monthly roll out plan for delivering content to be available on-line with the focus on troubleshooting
- Enhancement of our Knowledge Based Articles (KBA) with videos explaining how to resolve issues
- Product surgeries where customers are invited to ask us questions about challenges they have in the lab so we can offer solutions. These will be run and recorded as part of National Customer Service Week. (5th – 9th October 2020)
“In addition, the product team are also doing their own review of how we help our customers get the most out of our solutions and they have some great ideas for enhancing the help files they already provide. Not only will the enhancement or new module be clearly explained but the reasons it was introduced together with the anticipated benefits will also be detailed. This new approach has already been introduced as part of our new Specimen Processing module.
“Our customers have already been notified of our intention to deliver regular monthly on-line tutorials and feedback on this approach has been extremely positive. Our first videos are already available via our YouTube channel and we’ll keep our customers updated as new content is published.”
What’s important in Selecting a LIS for Anatomic Pathology?
If you are about to embark on finding an Anatomic Pathology (AP) LIS supplier, which criteria should you consider when choosing a vendor? Romaric Croes, pathologist and founder of LIS DaVinci and clinical director at MIPS, offers some recommendations.
- Digital workflow and access anywhere
This provides the ability to access your system from anywhere around the globe across different time zones, being able to review digital images and write a report based on the analysis of these images. Having digital workflow capabilities can significantly reduce turnaround times on pathology workload if, for instance, a specialist is located elsewhere globally from the laboratory. This creates an international 24-hour work routine.
- Interoperability and trans-laboratory collaborations
The ability to share slides and communicate within a specialist or group of pathologists, in real-time, greatly reduces turnaround times. This needs a central laboratory information management system (LIS) that can cope with sharing the data as part of an inter-laboratory network of IT systems.
Currently, there is a shortage of pathologists, which is compounded by the fact that not every pathologist specialises in every tissue. Thus, we need specialists to easily see the slides relevant to them. Giving them access to digital collaboration platforms ensures that the best and most appropriate pathologists are looking at the specimen.
We are beginning to see an increasing requirement in the Netherlands, Germany, France and Belgium to be able to register that a sample has been collected in the LIS from a third party order communication systems, hospital information systems, and even other LIS.
A LIS solution in which the key order information arrives without having people interact with it or have to investigate where the sample was taken, when, and who took it is now seen as a vital element. You also need a LIS that sends out the results to all the pertinent people, not just the requesting clinicians but also regulatory bodies and bodies such as cancer services.
Interoperability is key in an automated workflow, your LIS needs to support you in this. A system that aligns with international standards like IHE and HL7 will enable you to achieve this goal
- Integrated and standardised reporting within the AP LIS
Another area of focus is ensuring there is the ability for the production of an integrated and standardised report, collating results from multiple different areas in a format in which relevant data can be retrieved easily.
Another hugely valuable function of a LIS for a pathologist is being able to see all pertinent information about a patient in one place without wasting time searching in multiple different systems looking for a patient’s treatment history or results.
When reporting on a patient you want to see if the patient has had any other treatment or ongoing analyses, and if there are any results from other disciplines outside pathology, such as radiology, clinical and molecular biology. The results of molecular and genetics tests are becoming increasingly valuable within the reporting of an AP case.
- Scalable traceability and support of the Quality Management
This is the ability to track and trace any action and movement of specimens within your LIS. Quite often, third-party track & trace systems are being used to cover this basic need but they are often too limited, do not track through the process, and can bring forward additional challenges for full integration and interoperability.
An AP LIS needs to track and trace any creation or change of a record throughout the whole workflow, any print and communication action, and any movement or shipment of specimens and its aliquots (such as all recipients, blocks, slides and accompanying papers) from and to your lab and – if feasible – between different labs. Therefore, you need a LIS that can scale up (and scale down) as much as you want it to and has the flexibility to exchange information within large networks with other disciplines (delivering required levels of interoperability). All this information gathered in the LIS is of great added value in the quality management system.
- Digital workflow and maximum of automation
Ideally, you want maximum automation of workflows within your laboratory connecting to a multitude of instruments, such as processors, stainers and printers, all connected to your LIS as the backbone of your process management. Additionally, the instruments of molecular biopathology equipped with a data or connection interface should be connected (in a bidirectional way) to your AP LIS.
- Dynamic strategy and future roadmap
Needless to say, we’re witnessing a revolution in Anatomic Pathology in the last decennium and this is just the beginning… If you want to “survive”, your service will need to adjust, to be fit. Change will be the only constant and therefore you need a modern, evolving LIS with a solid future-oriented roadmap. In summary, look for an AP LIS vendor with a wide and dynamic strategic eye on the future!
If you are interested in learning more about selecting an Anatomical Pathology LIS, you can contact MIPS at +32 (0)9 220 23 21 for an informal discussion.
The new coronavirus which causes the COVID-19 illness still has the world under its spell. Medical laboratories worldwide geared up their PCR testing capacity the last months to detect the virus. This testing involves many consumables to perform a PCR-test and comes with logistic challenges for all laboratories worldwide to maximize the throughput in the lab with their existing equipment and available reagent and supplies to perform the test.
This is where pooled testing comes into the play. Pooled testing, in which biological specimens from multiple subjects are combined and tested in one single test, can substantially improve the efficiency and turn-around-time of a test. Globally there are many laboratories which have developed techniques to perform these pooled tests, and more specific in the countries where MIPS is active, we see an interest and demand in this pooled testing.
MIPS is supporting our customers in many ways, in their quest to increase PCR-testing capacity, and is a supplier of GLIMS and CyberLab in the Belgian national testing platform and to the French government for the SIDEP project in France.
Our next level of support for our international customer base is that we can provide support of pooled testing in GLIMS. We are supporting many different workflows to implement pooled testing by means of configuration in GLIMS. Our teams have worked out guidelines for our customers how to rapidly implement this.
This confirms the value we bring to our customer base with a product like GLIMS.
If you are thinking to implement pooled testing in your lab, reach out to your MIPS contact to learn how this can be applied in your configuration.