Clinisys Customer Summit, Ireland 2024 – Insight

Ireland’s pathology services are under scrutiny and on the cusp of change. Clinisys has ramped up its delivery capability to meet the needs of regional pathology networks and can deliver the support that will be required at pace and scale.

It has also continued to innovate, with a focus on digital pathology through the launch of Clinisys WinPath XT, a ‘one stop shop’ for the new world of digital pathology, a meeting in Dublin’s docklands was told.

Clinisys held its third customer summit in Dublin at a moment when Ireland’s pathology services are under scrutiny and could be on the verge of significant change.

Marie Culliton, scientific lead for the Health Service Executive’s Laboratory Services Reform Programme, told the meeting in the city’s docklands that it has been tasked with producing a strategy for the country’s clinical and public health laboratories that will take them through the next decade.

The “mission” is to “provide quality analytical and interpretive services on a sustainable basis as the foundation for health and healthcare” and to do this the programme will draw on a review published earlier this year that made recommendations in 15 areas, ranging from public access to workforce.

It is set to propose regional laboratory services, organised on a hub and spoke model (“in which the hub and spokes are both important,” Culliton stressed) that can make full use of technology, including order communications and results reporting for GPs. Regional services will be supported by National Reference Laboratories

“This is the first HSE plan for lab services in its 20-years,” Culliton said. “It is the beginning and not the end point, but it is intended to guide the development of laboratory services over the next decade [to deliver] more efficient and sustainable laboratory services, leading to better patient care.”

Clinisys has scaled to support pathology in England and Northern Ireland

England and Northern Ireland have already adopted this direction of travel. Following the publication of two reports on NHS productivity by Lord Carter of Coles, NHS England has been encouraging laboratories to join pathology networks and has 27 in place.

While in Northern Ireland, a single pathology network was created over 15 years ago to serve the country’s five health and social care trusts, working alongside the Northern Ireland Blood Transfusion Service and the Northern Ireland Genomics Medicine Centre.

Clinisys has scaled to deliver to both territories and now has 130 people in its delivery team, working on Clinisys WinPath laboratory information system and ICE order communications. Simon Hurst, vice president, business development, said this has enabled the company to deliver eight LIS go-lives in 2022, 19 in 2023, and 26 in 2024 – so far.

Northern Ireland has chosen to deploy a single instance of Clinisys WinPath across all regions, and Melissa Cochrane, head of programmes delivery for the Business Services Organisation’s IT services, confirmed the rapid pace of deployment.

Despite the complex web of integrations required to align the Northern Ireland Pathology Information Management System programme with the wider Encompass programme to create a single digital care record for every citizen, the first two health and social care trusts, Belfast and South Eastern, went live within three days of each other in November 2023.

Since then, the Northern Ireland Blood Transfusion Service, the Northern Health and Social Care Trust and Cellular pathology in all regions have followed, laying the groundwork for innovation, such as the introduction of digital pathology and AI, and a major blood production and tracking project.

“This is something we are very proud of,” Cochrane told the meeting. “Because we have one LIS system, we have vein to vein tracking in Northern Ireland. We know where all the blood is at any given time, which is making the system safer and much more efficient.”

Implementations are happening at pace: creating learning for success

Cochrane said many factors had led to this success. She stressed the importance of standardising workflows and data sets “as much as you can before you begin,” of having good leadership and collaboration in place, and of using good tools for testing and training.

All of this was echoed by Kevin Hall who has spent his career in IT implementation and most recently delivered a LIS implementation and upgrade to North West Anglia NHS Foundation Trust. He showed delegates the familiar ‘quality triangle’ that aims to balance time, cost and quality and pointed out that since the cost and scope of a LIS will be determined by its full business case, the critical factor is time.

“Sticking to a go-live date can be difficult,” he said. “But for me it is a matter of mindset: if you say ‘we are going to stick to this time’ then you’ll have a good chance of sticking to it” – although, he said there would be a lot of engagement, planning, and replanning to make it.

Ireland signed a contract for a national LIS, known as MEDLIS, in 2015; but has seen repeated delays. The Covid-19 pandemic and a major cyber-attack on the HSE have not helped, but the first go-live has only just taken place 9 years after the contracts were first signed.

Culliton said “it is accepted that there will need to be improvement of existing systems” while MedLis progresses. Michael Clancy, regional business development director, told Clinisys’ customers that the priority is to move them off legacy systems that are increasingly hard to maintain and secure.

Prominent laboratories are now on an upgrade path for Clinisys WinPath and/or ICE, with the National Maternity Hospital and the Royal Victoria Eye and Ear Hospital scheduled to be one of the next to make the kind of multi-site LIS development that is common in pathology networks.

Clinisys isn’t just implementing at speed: it’s innovating

Clinisys is also innovating. The next version of Clinisys WinPath will come with improvements to the blood transfusion module and noting. Meanwhile, Jake Morrow, Clinisys WinPath product manager, outlined how the company has just launched WinPath XT as a “one stop shop” to support the adoption of digital pathology.

Many laboratories have started to invest in the technology to turn the traditional slide into a digital image, he said, but they won’t see the benefits unless they can also report digitally through the most appropriate system – the LIS.

So, WinPath XT has been created to make that possible, with full specimen tracking, printing at each workstation, integrated reporting through the VUE Diagnostic Console, support for MDT meetings, support for AI, and management analytics.

“Northern Ireland is saying it has 100% digital pathology reporting, which is impressive, but even if you can get to 100% there is going to be a transition period,” he argued. “With WinPath XT, all the information remains in the LIS. So, your skin specialists might start reporting digitally, and that’s fine, and other specialists can follow. You still have that single source of the truth.”

Opportunities in the use of proven technology

With so many developments underway, Sinead Creagh, president of the Academy of Clinical Science and Laboratory Medicine, urged delegates to get involved in its work. The ACSLM runs mentoring programmes for early-career graduates, publishes the Converse newsletter, runs the BioMedica conference, and is often asked to advise policy makers, royal colleges, and others.

“We get asked for representation, but we can’t get you involved unless you come forward,” she said. “We aim to be a strong voice for the profession, but we need people to step up and make sure it is.”

Meanwhile, Clancy was optimistic about the opportunities for laboratories in Ireland and their adoption of technology. “While it is theoretically possible to deploy a single LIS across 40 labs, based on our experience, a regional strategy seems to be much more achievable,” he reflected.

“There is great potential in a move to a single LIS at that level. It reduces deployment costs and creates a single source of the truth – which saves a lot of time for clinicians and delivers many benefits for patients as well.”