Department officials see many advantages to the Beaker laboratory information system, which will be fully integrated with the Epic One Chart electronic medical record.
Dr. Ben Swanson gets excited when talking about the new laboratory information system being installed in the Department of Pathology, Microbiology and Immunology. “It is a better way for pathologists to share information, to analyze it,” said Swanson, MD, PhD, associate professor and medical director of the anatomic pathology division. “It is the only way that we can integrate with artificial intelligence and computer programs. It opens up a lot of opportunities.”
Theresa Faure, associate director of Regional Pathology Services and AP laboratory director, shares his enthusiasm. “We are going into the future, the next level, with our cutting-edge laboratory information system,” she said.
Dr. Swanson and Faure said a number of factors precipitated this effort. Cerner CoPath was sunsetting, and many of the department’s legacy or older LIS systems were no longer modern or meeting its needs. “So it was an opportunity to update and modernize,” Dr. Swanson said.
Faure said they have been making good progress since beginning the system build in November with Epic One Chart software developers and consultants from Nordic. “Build wave one was basically them saying ‘here’s the bones of the system. Will that work for your institution based on the way you have been operating, or do we need to change things?’” Faure said. “Because there are always customizations, and that is what is really nice about Beaker, too, because we have been able to customize to meet our needs instead of us having to change or adapt to a workflow that is foreign to us. So that is going to help when we go live.” Another advantage of the switch is Beaker is part of the Epic One Chart ecosystem, which they have been using for over 10 years.
Dr. Swanson said think of the My Chart phone app. “That is the patient experience, getting information from your medical record to a patient. But there is a bigger version that physicians and providers see on their computer screens,” he said. “It is the bones of a hospital system,” Faure said, “and it allows patients to be scheduled, it allows clinicians to chart and make notes. But in order to make those notes or make diagnoses, there are all these other things throughout the hospital like radiology and laboratory that help them make decisions, that help patients’ care. Epic has created all these little pods you can buy to integrate in with Epic. It is a huge undertaking; it is a two-year-long project.”
Dr. Swanson said the new system is also an opportunity to modernize or adopt best practices. “If there are more efficient ways to do things in the laboratory, Beaker allows us the opportunity to build,” he said.
One advantage of the new system is it allows the integration of anatomic pathology and clinical pathology records. “We have been using two systems, Sunquest and Cerner CoPath, and now we are going to go into one,” she said. “And it will be more discreet data,” Dr. Swanson said, “whereas CoPath creates a Word document or PDF, it will be discreet, individual elements of data that physicians can look at, both in anatomic pathology and in synoptic reports.” This will better support the education, enterprise, and research initiatives.
Another part of the Beaker project is going fully digital with anatomic pathology operations, he said. Currently, less than 1 percent of all slides are scanned. “Just like radiology in the 1990s went from films that radiologists looked at to a computer image, pathology is undergoing the same kind of transformation,” he said. “Most pathologists currently look at glass slides under a microscope. There are machines, tabletop size that you put a glass slide in and it is digitally imaged, so a pathologist looks at those images on a screen. We are building a business case currently for full digitization, which offers a lot of advantages in terms of quality assurance, quality control, efficiency and integration with research.”
Also coming is a new image management system, the computer program that a pathologist uses to look at the images, plus additional digital scanners. “It puts the access to patients’ images at a pathologist’s fingertips,” Faure said. Dr. Swanson agreed, saying, “Absolutely. Anywhere in the world.”
Beaker also allows them to further advance informatics within the department. “It is an opportunity to build the system in a way that it is searchable,” he said, so researchers can go through masses of data and spot trends.
None of these improvements would be possible without an organization-wide commitment, Dr. Swanson said. “The time and devotion that I am really grateful for, from many employees who take time out of their busy schedules to meet with the Epic and Beaker people, as well as the Nordic team,” he said. “We have scheduled meetings, hundreds of hours of meetings. Every week, dozens to hundreds of our employees are engaged in this. It is really every tech and manager and lead putting in hours outside of what they do just to make this work. I would also like to thank our partners in IT and LIS for all of their hard work and the time they have devoted. We would also like to thank Nebraska Medicine for being willing to fund this large of a project.”