Saturday, November 21, 2015

One Size Fits Few

Bless me, Father, for I have sinned. It has been about three weeks since my last Lab IT confession. I have harboured sympathy in my heart for my competitors.

How can this be? Allow me to complain. I mean, explain.

I am often asked why a given LIS is so [insert bad quality here]. Much as I often agree with specific complaints about specific systems, I usually feel a hidden stab of pity for the team which produced the system because that team was asked to provide a single solution (the software) for a large problem area ("the lab.")

The fact of the mater is that the typical case of "the Lab" is not a monolith. It is not even a collection of more-or-less similar parts; rather it is a patchwork of very different subgroups who happen to share a need for a particular kind of work area.

Specifically, the requirements of the different workflows vary over such a large area that I am not surprised that a "one size fits all" approach usually fails: either the one size is the wrong size or the one size is also a collection of loosely-affiliate software modules which interoperate rather poorly.

Consider those requirements: on one end is clinical Chemistry:
  • high volume, low relative cost (although vital to more valuable services)
  • highly automated (very reliable auto-verification and analyzers)
  • significant time pressure
  • well-suited to an industrial approach such as Six Sigma
  • high throughput required, turn-around-time is very important
At the other end is Microbiology or much Genetic and Molecular testing:
  • lower volume, higher relative value
  • difficult to automate
  • poorly suited to industrial process control
  • takes a long time--no way around it
  • yields an often complex result requiring expertise to characterize
 Throw Haematology into the middle somewhere. Immunology is somewhere closer to Microbiology. Slot your favourite lab section into the appropriate place on the fast/simple vs slow/complex continuum.

So how does one provide a solution which is optimized for both of these extremes? Very carefully.

All to often vendors pick a section, optimize for that section and then claim that all others sections are "easier" in some way so most systems are not optimized for most of the users. Why is there so much complaining about lab systems? Because the situation makes it inevitable. Perhaps we should be surprised that there is not more even more complaining about lab systems.

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