Richard Craven, chief executive of CliniSys, considers how the tumultuous events of 2020 will impact on 2021, and how they will affect the company, the NHS, and the world of pathology for years to come. Twenty-twenty was an exceptional year. I doubt any of us will forget the arrival of the coronavirus or the impact […]Read full article
Welcome to the CliniSys Group Blog
With over 30 years’ experience in developing and installing healthcare IT solutions, our skilled and dedicated teams have much to share. From useful advice from a recent multi-site deployment to generic handy hints to support and maintain IT solutions in a critical 24/7 healthcare environment, our blog posts are designed to educate, inform and interest all.
Richard Craven, chief executive of CliniSys, considers how the tumultuous events of 2020 will impact on 2021, and how they will affect the company, the NHS, and the world of pathology for years to come.
Twenty-twenty was an exceptional year. I doubt any of us will forget the arrival of the coronavirus or the impact it had on our NHS, our working lives and our family lives. The impact of Covid-19, and our response to it, will shape next year and will be felt well into the future.
So, here are my top ten thoughts on how Covid-19 has changed CliniSys, the NHS, pathology and the clinicians and patients it serves, and how we will all continue to feel its effects in the future.
One: Remote working works: One of the things that has worked exceptionally well for us as a company is remote working. I know people value the flexibility it offers and the way in which it has enabled them to achieve a much better work-life balance. It has also made us more outcome focused: within limits, people can do what they need to do when they need to do it. That will continue: not just in 2021, but probably for the rest of our working lives.
Two: The office is not dead, but it is changing: As the UK went into its first lockdown in March, I thought we might close all our physical offices or downsize them hugely. Now, I don’t believe that will happen, but I do think that the office will change. Our office in Chertsey is showing the way and we are looking for a more contemporary office space for our Glasgow teams. It will be much more café-style: a place where people can meet together as a team, redouble their energy and enhance their creativity by being together before they return to remote/flexible working until the next office-based get together.
Three: The NHS has embraced digital technology: We have seen the changes at CliniSys reflected in our customers. The NHS has gone through a very rapid uptick in terms of the adoption of digital technology, but we are only just at the start of that. There has been a significant adoption of remote working and virtual consultation technology, but the next step will be a move towards digital everything: health and wellbeing advice, remote follow-up and monitoring, patients becoming more active participants in their care via apps and other digital technologies.
Four: In pathology, surveillance is here to stay: Twenty-twenty is going to lead to some permanent changes to pathology services. We have seen a huge investment in testing to track the spread and impact of Covid-19 and I think surveillance will get more investment and development. Some of that will be about making sure we are ready for the next public health incident. But there will also be further investment in diagnostic services and technology to increase capacity as demand for diagnostic testing increases and as new diagnostic innovations become mainstream.
Five: Data is key: Twenty-twenty has also underlined the importance of data. In the absence of good data, decision makers and clinicians have struggled to make good decisions about Covid-19. CliniSys processes data for something like 60% of pathology in the UK, so we need to help our clinicians to use that data to manage their business, predict and manage demand, speed up and aid diagnosis and fully digitise processes.
Six: Data needs to join-up: We also need to start joining up pathology data with other kinds of medical data, from the observations that doctors and nurses make, to the genomic information that will be handled by our new genomics LIMS, GLIMS Genomics. We continue to develop ways in which our software can link to the collaborative tools that so many people have started using this year, so we can get data into multi-disciplinary team meetings and other settings where clinicians are discussing results and taking treatment decisions.
Seven: We’re on the cusp of computational pathology: We continue to explore how AI and machine learning can further enhance our solutions so that, as diagnostic data becomes fully digitised, smart use can be made of data to help our customers run their labs and clinicians at the workbench make better, more informed decisions. As this happens, pathology will move from the back room to its rightful place at the heart of the clinical process.
Eight: Pathology work will be reimagined: “If people can work from anywhere, they will work from anywhere. We have already seen this in radiology; radiologists have set up at home or in shared offices in ways that suit them, with large, high resolution screens, and instead of them going to work, work has come to them. As digital pathology becomes the norm, I think we will see the same happen in pathology, which will enable pathologists to work for multiple hospitals and organisations. Our challenge will be to build tools to support them.
Nine: There’s no equilibrium in business: One of the first things that I learned in my career is that ‘there is no equilibrium in business’ and Covid has proved it. At CliniSys, we are thinking constantly about how to remain durable and relevant in a world that can change – snap of fingers – just like that. We need to help our customers respond to the new environment, whether that’s by doing simple things, like building some smarts into our Integrated Clinical Environment (ICE), to direct tests away from labs that are becoming overwhelmed, or complex ones, like developing technology that will meet the need of new services, like regional diagnostic hubs.
Ten: Amazonification is here: Finally, we should not forget about the patient. Even before the pandemic, people were starting to think about the Amazonification of healthcare services, and that trend has just been given a significant boost, as work, shopping and socialising has moved online. Patients are going to want to be able to order their own tests and get direct access to their results, book and cancel appointments. The immediacy of digitisation is something that healthcare is going to have to deal with and I expect it to have some interesting impacts in 2021 and beyond.
‘Joining the dots’ – Newly appointed Group Marketing Director at CliniSys, Paul Jackson, provides an introduction and some initial observations
When you look at some of the stats from the CliniSys Group, our success is impressive.
- CliniSys processes data for circa 60% of pathology in the UK and has leading market shares across Europe for Laboratory Information Management Systems.
- The UK’s leading order communications platform – Integrated Clinical Environment (ICE), with over 40 million tests ordered by GPs each year and 35% of the acute sector market share. The software also underpins national NHS services such as England’s HPV screening
Such an impressive background and pedigree lays a great foundation for a senior marketer to build further at CliniSys. For this unassuming organisation, that quietly and efficiently developed solutions that have become the backbone of many healthcare systems across Europe, now is the time for CliniSys to step out of the shadows.
A graphic designer by trade, I have spent over 20 years working within healthcare IT supplier organisations developing and building their marketing infrastructure to maximise strategic and commercial goals. In its simplest form at CliniSys, it is about ‘joining the dots’ and bringing the organisation together as one powerful brand and voice. Marketing planning is already underway and starting in the first quarter of 2021 there will be a series of initiatives to support the CliniSys Group’s marketing and corporate goals.
‘Joining the dots’ already seems to be my common phrase for 2021. A positive consequence of 2020 was the significant improvement in the way we collaborate, and it will continue to develop in 2021. Also, 2020 drove our ability to look at things in a different way to maximise (and enhance) the benefit, by extending technology that already exists, so it can be applied further and wider across health and social care. CliniSys has been adept at extending its existing technology and deployments to meet some of the most challenging aspects of the pandemic, specifically in support novel and mass testing and the rapid reporting of COVID-19 results back to key workers and citizens.
Whilst I am new in post, attributes that became quickly clear are the strength, determination, and passion right across the organisation to get the job done, even with the challenges that 2020 brought. Incorporate marketing into this and you can amplify those attributes and the outcomes further and wider.
The continued success of the CliniSys Group is also another mechanism that marketing will continue to use to strengthen the message. And it is not just about the ongoing contract wins, which are fantastic, but it is also about successful deployments or new product releases, and the tangible benefits and improvements they bring to our customers. Whether it be an individual deployment or network approach, our customer stories will continue to be told and shared. The recent launch of GLIMS Genomics in the UK has also been positively received and we are already speaking to several Genomic Laboratory Hubs and Local Genomic Laboratories.
2020 has reset many things and marketing is very much included, especially around physical face to face events, which are always an important part of the calendar. Marketers have had to change approaches and look at things in a completely different way, enabling the use of different media and creative approaches. This will continue in 2021 and become adapted as another element of the marketer’s toolkit.
CliniSys has brought GLIMS Genomics to the UK. In a launch webinar, experts explained how the new laboratory information system built for genomics labs can put them in charge of their IT, drive standardisation, and deliver reports that clinicians can use as they move into the exciting world of precision medicine. And Dr Fabienne Dufernez explained how these benefits are already being delivered in Poitiers University Hospital.
This summer, Steve Abbs pointed out that we have reached an interesting point in the development of genomic medicine in the UK. The experienced laboratory director, who is acting as a genomics consultant to CliniSys, blogged that genomic testing is no longer the preserve of few, small, research groups.
Instead, it is on the verge of becoming an established diagnostic tool for some cohorts of patients, and on the way towards becoming a routine part of precision medicine. In recognition of that, the NHS in England established a national Genomic Medicine Service, delivered by seven genomic laboratory hubs that will, between them, deliver the National Genomic Test Directory.
However, Abbs argued that if the GLHs are going to do what is hoped, they are going to need good IT; both to deliver an effective, standardised service, and to make sure results are accurately interpreted and linked back to patient histories.
Now, CliniSys has formally launched GLIMS Genomics in the UK; a laboratory information system built for genomics labs with these requirements in mind. It is already being successfully deployed at Poitiers University Hospital in south west France, and will soon be deployed in seven further genomics laboratories across Europe.
Why not just use the EPR?
Genomics labs do have other options, Abbs acknowledged on a launch webinar. For example, they could choose to use the electronic patient record of the trust hosting them. However, he argued that a LIMS and an EPR are fundamentally different creatures – “an EPR is based around patient encounters, while a LIMS is built around specimens” – and there are other factors to consider.
For instance, if the EPR ‘goes down’ then the laboratory will ‘go down’ with it and might not find itself at the front of the queue when it comes to getting up and running again. Or, if the lab needs a bug fix or new feature, it could find itself competing with other departments for the limited resources of the trust’s IT team.
With a “bespoke” LIMS, these issues don’t arise. Or, as Abbs put it: “You, as a lab, are in complete control of it, along with your supplier. With an EPR, your hospital is in control. Whereas, with a purpose built LIMS, you are in control.”
Built for the needs of genomics labs
Plus, there is that very important distinction that an EPR and a LIMS are built to do different things. Emma Huntridge, genomics business development director at CliniSys, told the webinar that GLIMS Genomics builds on the company’s extensive experience of working with laboratories to handle specimens in the most effective way possible.
“The CliniSys Group is based in the UK and Europe and has more than 30 years’ experience of delivering IT solutions,” she said. “We are now the largest European LIMS provider, while in the UK we predominantly work with trusts to implement pathology network solutions.
“Our new LIMS for genomics laboratories combines the strength of a mature LIMS for routine diagnostic laboratory areas with functionality to meet the special requirements of genomics.”
For example, Huntridge showed the webinar one of the graphical features of GLIMS Genomics, which enables labs to build simple or highly complex workflows, known as “approach plans”. These lay down the standard procedures for all workflows in the laboratory, including booking in samples, determining how their genetic material should be extracted, running tests, concluding this process, and reporting results.
The approach plans are visible at the bottom of the screens that laboratory technicians use at each step, so they can readily see what has been done and what should happen next. The approach plans and the screens themselves are highly configurable, so labs have flexibility about how much information is recorded throughout a procedure, and privacy controls ‘screen’ sensitive fields from users who do not need to see them.
Solving the IT puzzle at Poitiers University Hospital
Another graphical feature of GLIMS Genomics is the “pedigree tool” which enables the user to construct a family tree for a patient and to map their genetic inheritance onto it. Huntridge demonstrated how she could construct a family tree for pregnant ‘Anne Long’ showing that her parents were carriers of the cystic fibrosis gene and her brother died from a complication of the disease.
She also demonstrated how she could create a report for her clinicians that can include interpretive data from leading global databases and charts or tables from different systems.
Earlier in the webinar, Dr Fabienne Dufernez, senior cytogeneticist and quality manager at Poitiers University Hospital, was able to show a real (but, of course, anonymised) report from her hospital populated with data from GLIMS Genomics, which is just in the final stages of being deployed.
Dr Dufernez explained that all genetic testing is carried out in university hospitals in France because of its complexity. Her own hospital wanted to streamline its workflows and to standardise the approach taken to the different tests that it conducts.
“We needed a way to bring together different parts into one system,” she said, “because previously it looked like a puzzle [as] everybody used different tools to do the same work.” Now, she added, “GLIMS Genomics handles all the work, from reception, to extraction, to analysis, validation and reporting” and the hospital is seeing significant benefits as a result.
Supporting labs now, ready for the precision medicine future
One of those benefits is that the laboratory has access to dashboards that make it simple for managers to see, at a glance, how much work has been completed, and what tests are being run.
Additionally, Huntridge explained: “The system can generate a report on whatever data has been collected. So, if you have data that needs to go to NHS England/Improvement, for example, then it can be sent to them; or it can be analysed internally to drive efficiency and quality improvements.”
Still, that is hardly where the true potential of GLIMS Genomics lies. As Huntridge, who was formerly national genomics informatics lead for NHS England/Improvement pointed out, the system has been designed as “an optimised genomics LIMS that will meet current and future requirements.”
And, as such, it is: “Aligned with the strategy for greater inclusion of genomics in broader healthcare, and particularly the development of personalised patient care and precision medicine.”
Dans le cadre de la gestion de l’épidémie, la détection et le traçage des cas positifs de Covid-19 sont déterminants pour la réussite de la sortie de crise et à la protection de la population française. C’est l’objectif du projet national SI-DEP, mis en place par le ministère des solidarités et de la santé, pour lequel, MIPS en partenariat avec l’AP-HP a été choisie et missionnée. Sa solution de prescription connectée et de consultation de résultats en ligne CyberLab est le cœur du processus informatique de la plateforme SI-DEP.
La plateforme a été réalisée en moins de deux mois. À ce jour il y a au total 374 centres hospitaliers et environ 4 500 laboratoires privés connectés à la plateforme. Cette connexion est bidirectionnelle : d’un côté la prescription de tests Covid-19 et d’un autre la diffusion des résultats. Dans la première phase, seul le dépistage PCR était remonté dans SI-DEP. Ensuite ont été intégrés les tests sérologiques, puis les tests rapides. Depuis mi-novembre, les pharmaciens, les infirmières et les médecins libéraux alimentent également la plateforme, ainsi le nombre de tests journaliers sera amené à dépasser 500.000.
« Nous sommes fiers d’avoir réalisé la plateforme SI-DEP en seulement six semaines, » souligne Nicolas Blanc, directeur commercial France et Suisse chez MIPS. « Cette réalisation est le fruit d’un travail collectif, et nous tenons à remercier nos partenaires, et notamment les équipes de l’AP-HP qui ont fait un travail remarquable ainsi que la société Enovacom, spécialiste de l’interopérabilité et de la sécurité des données. »
Repérer, tester et isoler
Mettre en œuvre un dépistage virologique de grande ampleur au niveau national, afin de contrôler et limiter une reprise de l’épidémie et piloter finement la dynamique de contamination sur le territoire, dépend de la capacité à repérer, tester et isoler les malades et les cas contacts. Cette mission d’intérêt public et prioritaire est assurée par le projet SI-DEP, qui repose sur un partenariat entre le ministère français des solidarités et de la santé, l’assistance publique – hôpitaux de Paris (AP-HP), Santé publique France, ainsi que les laboratoires de biologie médicale et les éditeurs de système d’information de laboratoire.
Une plateforme temps réel et sécurisée
Visant à informatiser ce processus de dépistage, SI-DEP (Système d’Informations de DEPistage) est une plateforme sécurisée d’enregistrement et de transmission des résultats des laboratoires de tests Covid-19, permettant de s’assurer de la prise en charge des cas positifs. Il s’appuie sur une collecte en temps réel, exhaustive et immédiate des résultats qui permet de briser la chaîne de contamination.
Pour ce projet, contraint dans le contexte par des délais particulièrement serrés, le ministère des solidarités et de la santé a missionné MIPS, dont la solution CyberLab permet aux laboratoires, de manière fluide, fiable, transparente et sécurisée, de gérer les demandes d’examen et la communication de résultats.
Avec sa capacité à s’interfacer avec tous les systèmes d’information de laboratoire (SIL), sa grande facilité de déploiement sous la forme d’une application web, sa capacité à traiter de grands volumes sur plusieurs établissements, CyberLab répondait aux exigences hors normes d’un tel projet et s’est ainsi placée au cœur de l’architecture du SI-DEP. MIPS bénéficiait en outre dans ce domaine d’une expérience en Belgique où la solution CyberLab a déjà été exploitée dans un contexte similaire pour une plateforme nationale de tests.
Moins de deux mois pour être opérationnel
Opérationnel depuis le 13 mai, avec une montée en charge progressive, le projet s’articule autour de quatre fonctions principales :
- La mise à disposition d’un outil de prescription connectée multi établissements et multi SIL.
- La centralisation de l’ensemble des résultats de dépistages PCR et sérologiques du territoire national (privés et publics), sous la forme d’une base nationale, les données étant hébergées par l’AP-HP, l’ensemble du traitement opérationnel s’effectuant dans le respect des principes posés par le RGPD et la CNIL (Commission Nationale de l’Informatique et des Libertés).
- La diffusion sécurisée des résultats aux patients qui peuvent ainsi appliquer immédiatement les mesures de prévention, ainsi qu’aux prescripteurs et la mise à disposition des codes d’activation uniques pour l’application STOP COVID.
- La mise à disposition de données de qualité, consolidées et pseudonymisées en temps réel à destination de Santé public France, de la direction de la recherche, des études, de l’évaluation et des statistiques (DREES) et de la plateforme Health Data Hub (mise en place par le gouvernement français), à des fins statistiques et de surveillance épidémiologique.
Dans une première étape, les sites publics, principalement des centres hospitaliers universitaires, équipés de système MGI, ont été connectés à la plateforme SI-DEP. Ces automates sont venues soutenir la forte augmentation des capacités de tous les laboratoires équipés pour la réalisation de tests RT-PCR Covid-19.
Dans une deuxième étape, ce sont l’ensemble des laboratoires français, privés comme publics, qui sont venus intégrer la plateforme nationale. Au total il y a à ce jour 374 centres hospitaliers et environ 4 500 laboratoires privés connectés à la plateforme.
« Ce projet a conduit à la mise en place d’un outil de surveillance qui joue un rôle crucial dans la politique de santé publique, dans un contexte de crise sanitaire inédit. Mené de façon exemplaire grâce à l’engagement de tous les collaborateurs de la société MIPS en France, mais aussi en Belgique, il a pu être mis en production dans des délais exceptionnellement serrés et avec succès puisqu’aujourd’hui, quasiment 100 % des laboratoires sont connectés, » explique Thierry Ginod, directeur du service clients, MIPS.
« Dans un temps record, MIPS a réussi à fournir la solution pour des plateformes nationales de test Covid-19,» conclut John Lebon, président directeur général de MIPS. « En France, notre solution CyberLab a été déployée au cœur du projet SI-DEP ; en Belgique, GLIMS et CyberLab sont exploités pour la plateforme nationale de test et, aux Pays-Bas, tous les laboratoires avec GLIMS ont pu être connectés sur la plateforme nationale CoronIT. Nous sommes particulièrement fiers de soutenir les professionnels de santé qui luttent pour conserver cette crise sanitaire sous contrôle. L’expérience acquise dans différents pays a permis à MIPS de soutenir ces trois projets d’envergure nationale, dans des conditions et des délais exceptionnels. »
Steve Abbs is working as a genomics consultant with CliniSys. In the first of a series of blogs on the developing field of genomic testing and precision medicine, he argues how the genomics laboratory hubs being set up in England can benefit from deploying a modern LIMS to enable them to run more efficiently, deliver results effectively to clinicians, and lay the IT foundations for precision medicine.
We have reached an interesting point in the development of genetic medicine in the UK. It is no longer the preserve of a few, small research groups. It is on the cusp of becoming a routine part of medical practice, and an established diagnostic tool for some cohorts of patients.
To support these developments, genomics labs will need to change and the technology they use will need to change with them. They will need to move away from the paper-based management of samples, adopt standardised processes, and deliver results to clinicians in a meaningful way that can be integrated seamlessly with the electronic patient record. In short, it is time for genomics labs to adopt a modern laboratory information system; a genomics LIMS.
Moving from lab to hub requires a LIMS
How have we got to this point? Genetics was originally two disciplines. Cytogenetics looks at genetic material under a microscope in order to identify chromosomal abnormalities. While molecular genetics looks at changes at a more detailed level of the DNA sequence within genes and the genome.
As a discipline, cytogenetics made big advances in the 1960s and 1970s, while molecular genetics came along in the 1980s. The first human gene to be sequenced was the gene for cystic fibrosis, in 1989. Since then, 20,000 genes have been sequenced, while the first whole genome, for Haemophilus influenza, was sequenced in 1995, and the first human genome followed in 2003.
So, there has been rapid and impressive progress in this area. On the lab front, the developments encouraged the NHS to set up labs to provide clinical genetic services. Most of them came out of a research setting and initially were very small. But to build on the 100,000 Genomes Project that ran from 2014-18, the NHS in England decided to establish a national Genomic Medicine Service.
This is being delivered by seven genomic laboratory hubs or GLHs that were chosen through a national procurement process. The GLHs are delivering the National Genomic Test Directory, which is in two parts, covering rare or inherited diseases, and cancers.
Historically, genetic and cancer tests have generally been provided in different laboratories, as molecular and cytogenetic tests have been. In theory, the GLHs are uniting the two disciplines of cyto and molecular genetics and testing for both cancer and inherited disorders.
However, in practice, we know that the degree of integration is variable, and any process that involves changing traditional practice is lengthy and difficult. This is one area where the deployment of a modern LIMS can help; as pathology networks have proved, using a common IT system encourages common working practices [a subject I’ve blogged about in more detail here].
Replacing risky, costly paper processes
One of the principal reasons for setting up genomic laboratory hubs is that it would be impossible for any one lab to deliver all the tests in the National Genomic Test Directory. All seven GLHs will provide the more commonly requested or core tests, while samples will be sent from one lab to another for specialist, rarer tests, or to a national central laboratory for whole genome sequencing.
Sending samples around the system requires a considerable amount of administration and, at the moment, this is a very paper-based process. Many orders come into a lab on paper, they are sent on to other labs with accompanying paperwork, and if they are sent to the central lab for whole genome sequencing they have to be transcribed onto the new national genomics informatics system.
This is where a modern LIMS would really come into its own, because the whole purpose of a LIMS is to keep track of orders, samples and results. Similarly, when genomics labs are running tests there is a lot of paper involved. Without a functioning LIMS, there is reliance on Excel spreadsheets to keep on top of the workload, which means there is a lot of transcription and manual manipulation of data.
Integrating the analysers with a LIMS would make genomics labs safer because there would be less potential for human error, and more efficient because there would be a massive reduction in the amount of time spent keying and checking data. It would also mean the labs were ready for scaling up to the next generation of analysers, which are coming.
Supporting the interpretation of complex data
These arguments in favour of a LIMS will be familiar to pathologists – who would probably find it hard to imagine running a modern path lab without one! But a genomics LIMS needs some specific features.
One is that it needs to be able to report results to clinicians in a way that is useful. The output from a genetic test is rarely a simple number. There tends to be a qualitative element that explains how the result was arrived at and what it is likely to mean for the clinician, their patient and their family.
That’s because for most of the inherited conditions that you might be running a test for there is no treatment available, currently. Instead, the test is initially a diagnostic test for the index case, and after that the results are available to be used in a predictive manner. For example, they may be used to advise a family on their chances of having another severely ill child, or to let relatives know that they are at greater risk of developing a condition later in life, like Huntington Disease.
A genomics LIMS will bring all that complex information together. The genomics LIMS that CliniSys has introduced to the UK market, GLIMS Genomics, facilitates this through its integrated pedigree drawing tool. This enables the family tree to be drawn, using data on relatives that is stored in the database. Laboratory results can then readily be displayed on the pedigree drawing, providing a visualisation of how genomic variants are tracking within a family.
A genomics LIMS will also give direct access to expert interpretive resources; GLIMS Genomics can integrate with leading databases (ClinVar, dbSNP, HGMD and others) and, importantly, it includes a function for reviewing the ACMG classification of variants that have previously been reported from the LIMS and that may need re-reviewing in light of new evidence that has meant a re-classification.
Integrating LIMS and EPR lays the foundation for precision medicine
What is the future for genomic medicine? One positive development is that therapeutic interventions for severe inherited conditions are starting to become available. However, they are often very specific to a very specific pathogenic variant.
This means that, if a patient is going to benefit, the causative variant needs to be recorded accurately in their medical history to enable clinicians to readily identify whether a patient is suitable for treatment, or could be added to a patient registry used to source patients who are eligible for clinical trials.
Another positive development is that whole genome sequencing is becoming more common. Although the primary indication for receiving whole genome sequencing is likely to be a diagnostic test, the fact that the genomic sequence data is available means it can be interrogated to guide clinical management.
One important reason for doing this interrogation is to identify genomic variants associated with pharmacogenomic implications. A nice example is the application of four sequence variants in the DPYD gene that control how drugs are broken down in the liver.
These can affect the risk of a patient experiencing a severe or fatal side effect from the fluoropyrimidines that are commonly used to treat a number of cancers. The genotypes at these four loci are used to indicate the starting dose for treatment with fluoropyrimidines, or whether patients are given a completely different treatment, in order to minimise the risk of an adverse effect.
Adverse reactions to drugs are a huge and expensive problem in the NHS, as in all healthcare systems, so being able to avoid them like this is a major benefit for patients and for healthcare funding bodies. But to do that, the genomic data needs to be readily available to the clinician treating the patient.
These examples of precision medicine mean that a final – and very important – justification for genomic laboratories to deploy a modern LIMS is to enable full integration with hospital electronic patient record systems so that the benefits of personalised medicine can be fully realised.
Making the right IT investments, now
These kinds of scenario are only going to become more common as more personalised therapies become available, as more clinical trials take place, and as whole genome sequencing becomes cheaper and more embedded in routine healthcare. Already, genomic data is being pulled into clinical multi-disciplinary team meetings, to help clinical teams decide how best to manage a patient.
Having direct connectivity to all the relevant information from the genomic LIMS via the EPR would greatly facilitate these meetings. But in the future, it may be possible for clinicians to enter a patient’s symptoms into a rules-engine within an EPR, pull up a standard genetics order set, and send off for the tests they need to get an answer.
There is no doubt that precision medicine is sending ripples of excitement through the clinical community and that it holds out enormous potential for delivering more accurate treatment and prevention strategies to patients. However, it can only happen if we have good integration between the systems that are used to order tests, to run genomics labs, to interpret and report results, and to record patients’ histories.
GLIMS Genomics is designed for clinical genomics laboratories and can help labs improve their efficiency, catalyse transformation and standardisation across genomic networks, handle and communicate complex genomic data, and integrate with numerous local, national, and international informatic systems and resources to support patient management and precision medicine.
GLIMS Genomics is a comprehensive, modern LIMS for state of the art genomics laboratories, and can help transform genomic medicine in the NHS.
El nuevo coronavirus que causa la enfermedad COVID-19 todavía tiene el mundo bajo su hechizo. Los laboratorios de todo el mundo han incrementado su capacidad de pruebas PCR en los últimos meses para detectar el virus. Esta prueba implica muchos reactivos para realizar una prueba de PCR y conlleva desafíos logísticos para todos los laboratorios de todo el mundo en aras de maximizar el rendimiento en el laboratorio con equipos existentes, reactivos y suministros disponibles para realizar la prueba.
Aquí es donde las pruebas agrupadas entran en juego. Las pruebas pooling, que consiste en la agrupación de varias muestras y análisis para hacer el testeo a la vez, pueden mejorar sustancialmente la eficiencia y el tiempo de respuesta de una prueba. A nivel mundial hay muchos laboratorios que han desarrollado técnicas para realizar estas pruebas agrupadas, y más específicas en los países donde MIPS está activo, vemos un interés y demanda en esta prueba agrupada.
MIPS está apoyando nuestros clientes de muchas maneras, en su búsqueda de incrementar la capacidad de pruebas PCR. MIPS, como proveedor de GLIMS y CyberLab, apoya la plataforma nacional de pruebas PCR en Bélgica y al gobierno francés en el proyecto SIDEP en Francia.
Nuestro siguiente nivel de soporte se dirirge a nuestros clientes internacionales con el fin de proporcionar apoyo a la tecnología pooling en GLIMS. Estamos soportando muchos diferentes flujos de trabajo para implementar pruebas agrupadas mediante la configuración en GLIMS. Nuestros equipos han elaborado pautas para nuestros clientes sobre cómo implementar esto rápidamente.
Esto confirma el valor que aportamos a nuestros clientes con un producto como GLIMS.
Si está pensando en implementar pruebas agrupadas en su laboratorio, póngase en contacto con su contacto de MIPS para saber cómo se puede aplicar esto en su configuración.