[Histonet] LIS questions

WILLIAM DESALVO wdesalvo.cac <@t> hotmail.com
Tue Apr 24 11:27:47 CDT 2012

When we start talking about the issues associated w/ server vs. cloud in healthcare, I think discussion needs to start w/ and be centered on capability of compliance and enforcement, as it relates to HITECH Act, HIPPA and delivery of ePHI. There is a complexity added as more health information exchanges are developed and access to data is expanded and the need to develop complex and sound Business Associate Agreements.  In my mind, the idea of more access and/or ease of access must be directly related to the ability to control and provide security of access.
I believe this very complex issue and process will rely less on the needs of the end user, Histotechnicians/Histotechnologists and more on the need to meet HITECH requirements and very secure delivery. This is a very complex IT issue and maybe not best discussed on the Histonet w/ technical personnel with limited IT knowledge.

William DeSalvo, BS, HTL(ASCP)


> From: mike <@t> pathview.com
> To: kdboydhisto <@t> yahoo.com; Histonet <@t> lists.utsouthwestern.edu
> Date: Tue, 24 Apr 2012 08:52:13 -0700
> Subject: RE: [Histonet] LIS questions
> CC: 
> Good morning,
> I’d like to take up the issue of server vs cloud in Kelly’s original email.
> I have some thoughts that I’d like to share, but more importantly, I’d like
> to hear other people’s opinions. This is going to be a continuing ‘hot
> topic’ in the LIS world for years to come and I think it would be nice to
> have some sort of list for people to start thinking about. I am aware that
> traditionally there has not been a lot of LIS involvement in the histology
> laboratory, but with the advent of 'barcode tracking' and new quality
> initiatives, I am sure that this is about to change.
> Server
> Pros:
> 1. More control – you know where your data resides and you have full
> control over it.
> 2. Ostensibly faster, because you’re just sharing your data traffic
> internally, not across the world web.
> 3. We know this model works in both low and large volume operations.
> Cons:
> 1. You’re responsible for maintaining the server – operating system
> patches which occur every few months it seems and daily backups.
> 2. Cost associated with the server(s) – Often times there will be 2
> servers – production and development, plus there is a license fee. Bottom
> line, think around 10, 000 to 20,000. You also need a ‘place’ to put the
> servers.
> Cloud
> Pros:
> 1. A user can get to the system from everywhere -- great if you don’t
> have an infrastructure already in place.
> 2. No hardware costs for the server, but I would imagine that there is
> some fee hidden somewhere – nothing in life is free, right?
> Cons:
> 1. No control over your data. It can reside anywhere in the world and
> who knows how the local laws protect your data. If the data resides in the
> US, that’s less of a concern. With less control, you never really know if
> your backups are occurring or not. 
> 2. Because you’re on the web, the potential exists for a slower system.
> This is probably not as important when a pathologist is signing out a case,
> but depending on the LIS, it could be a big problem, if there is a lot of
> user interaction. For instance, anything to do with blocks or slides which
> can be numerous and require rapid processing, could be an issue. In my own
> experience, I’ve waited on a ‘web page refresh’ for several seconds from
> time to time. If my specials are due out at 10 a.m. and it’s 9:45, I don’t
> have time for a slow connection.
> 3. With current technology, instrument interfaces can be difficult
> because they require more of a realtime or ‘very fast’ response.
> 4. Does anyone know of a large volume lab that uses a web based LIS
> where the LIS requires quick response time?
> 5. What happens if I change from a web based LIS. I ‘assume’ I don’t
> get access to my data unless I continue to pay some sort of fee. With a
> server based system, I can stop paying maintenance, but I can still access
> my data.
> What do you all think? Do you disagree with the list? Do you have more to
> add? 
> Bottom line, I think for me, and remember, I’m an LIS vendor myself, system
> functionality would still be a priority as far as system selection is
> concerned. The ‘feel of the company’ would be my next critical concern, and
> then I would think about cost and technology.
> Michael Mihalik
> PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Kelly Boyd
> Sent: Wednesday, April 18, 2012 11:31 AM
> To: histonet
> Subject: [Histonet] LIS questions
> Is anyone out there familiar with any of the following LIS systems, if so,
> what are your thoughts??  AIM Path Software systems, Wavefront Software,
> What are the opinions out there for a server based system versus a cloud
> based??
> Thanks!
> Kelly 
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