Webinars

^{Michael Kalinowski}: Welcome to this LigoLab webinar entitled “Has Our Laboratory Outgrown its LIS? My name is Michael Kalinowski. I will be serving as your host. But the real key people as part of this webinar are both Suren Avunjian and Dennis Winsten. 

Suren is LigoLab’s CEO, and he’s been with the LIS company from the very start. The laboratory information system provider started operations just over 18 years ago

LigoLab is best known for its enterprise informatics solution, the LigoLab LIS & RCM Laboratory Informatics Platform. 

Joining Suren is Independent Consultant Dennis Winsten. He’s a long-time industry advocate who’s been involved in the laboratory industry for some 30 years.

As an independent consultant, Dennis is somebody who has his eyes and his ears tuned into the laboratory world. It's, let's be honest, a pretty challenging world these days. So your insight, Dennis, will be very valuable here.

As part of this presentation, we'll have a self-assessment document for you toward the end of the slide deck that you'll be viewing. And then please, if you have questions, we welcome them during a question and answer session that will take place at the end of the presentation.

With that, I think I'll turn it over to Suren.

_{Suren Avunjian}: Great. Thank you so much, Michael, and Dennis. We appreciate you being with us. I want to cover and acknowledge a critical fact here. The laboratory industry is undergoing a rapid evolution and we're facing a significant challenge, especially with staffing shortages, dwindling reimbursements, and ever-shifting regulations.

These aren't just minor hurdles for us all. They’re shaping the entire fabric of our industry. So in such a dynamic landscape, it's essential to ask ourselves, how do we not only survive but thrive? This lies in adapting newer platforms and technologies and adapting to change. And we must recognize that relying on the most advanced, automated, and intuitive platform isn't just an option anymore. It's a necessity. So during this webinar, let's explore how the shift is necessary for labs to stay relevant in the ever-shifting world. 

Let's take a look at some stats here. These came from the CLP magazine State of the Laboratory Information Systems Industry Report.

Some key findings are somewhat disturbing. For instance, two-thirds of pathology labs are running on LIS systems that are over 10 years old. I mean, that's a decade of so much in technology that one year counts as three years.

So we're about 30 years behind in the laboratory industry for two-thirds of the labs. More than a quarter of the respondents stated that their lab information systems have known gaps or didn't support their testing needs, and a significant portion of these laboratories identified limitations in their LIS systems’ ability to keep up with long-term growth.

For instance, almost 70 percent of respondents using a custom laboratory information system reported significant scalability issues. And, you know, unfortunately, integration and overall interoperability still is a massive issue for laboratories. 

Approximately 45 percent of respondents were uncertain if their LIS system was on the most current LIS software version, and nearly half of them described their LIS systems as mostly unreliable. ALarmingly, 17 percent reported experiencing reliability issues with their current LIS solution. 

These findings indicate a growing dissatisfaction among labs with enterprise system-based medical LIS modules that are highly custom homegrown solutions, particularly in their ability to scale and meet future growth needs efficiently or effectively.

Now let’s focus on an overlooked aspect of laboratory information systems, and that's the unfortunate status quo that many labs find themselves in. 

First, let's look at the manual workflows and gaps that are created.

Labs rely on these manual processes and try to fill these gaps with staff within an era where technology offers streamlined solutions. These slow down operations and leave a lot of room for errors and inefficiencies.

Coupled with many laboratories, these staffing shortages and these manual processes have a significant impact on the lab and its bottom line and the impact should be considered as part of the total cost of ownership of an LIS system. So just because you might have a LIS system vendor that is quote-unquote cheap doesn't mean it's not costing a ton of money to the laboratory and having to fill up where the laboratory information systems can't provide efficient workflows leads to increased labor costs, staffing frustration, morale issues, longer processing time, and a higher potential for errors, which in turn can affect the patient care and lab revenues. 

It's crucial to understand that investing in an up-to-date LIS system isn't just about technology or keeping up with technology. It's about ensuring overall operational efficiency, financial sustainability, and success in a challenging healthcare environment.

Then there's the widespread use of Excel sheets and paper logs. People get creative here with all the technology that they try to fill these gaps with. While these tools are familiar to all of us, they're far from efficient or secure in managing complex laboratory data. This reliance on outdated methods can hinder our ability to process and analyze data effectively. 

We also see labs needing help with an outgrown LIS system and the LIS system vendors who are supposed to support them. When your laboratory information system can't keep pace with your growth, it becomes a bottleneck rather than a growth facilitator.

It limits your capabilities, affects throughput, and impacts patient care. Speaking of limited capabilities, many labs find their current LIS systems need more features to meet today's challenges. These limitations can severely impact the lab's performance with its inadequate reporting tools and lack of integration options or insufficient data analytics capabilities, allowing you to see where the bottlenecks are in the laboratory.

So another significant challenge is a non-responsive LIS system vendor. As labs come to us in a field where change is the only constant having a laboratory information system vendor that doesn't respond to your needs. or evolving needs can be frustrating and detrimental to your lab's progress and success.

Lastly, the issue of being nickel and dimed for every configuration, module, upgrade, user, you name it. The cost can quickly add up, making it difficult for labs to maintain a balance between budget, constraint, and the need for advanced technologies. These challenges paint a picture of the current state of many labs, a state that calls for urgent attention and action.

Let's explore how we can move beyond this unfortunate status quo and embrace more efficient, effective, and scalable solutions for laboratories. Unfortunately, many IT teams end up building a monster in the lab, and this is typically out of necessity, with each body part here representing different laboratory software systems and data silos in your laboratory.

This is a current challenge many labs face due to legacy LIS systems that lack the modern features required for today's operations. So let's dive into this metaphor a bit more. Each part of this monster symbolizes a distinct system or a data repository. Some might represent your technical department systems, others for financial operations, data warehouse, outreach, and tracking. You name it.

What's the problem? These body parts don't communicate effectively with each other. This is the Frankenstein scenario. They operate in isolation, create data silos and hinder your laboratory's ability to function cohesively and efficiently. And this creates lots of synchronization issues. All these systems need to be working in synchrony, and most of the time they don't. They have very simple integrations, which are having two rooms and communicating through the door keyhole, right? That's your integration from one system to another whereas in a modern LIS system that's designed from the ground up.

You should look for laboratory information systems that have all of these walls opened up, so it's all in one solution, one system, one visible source of truth. So these siloed systems lead to a labyrinth of complexities. Data transfers become cumbersome and error-prone. Reporting is delayed. Getting a comprehensive view of the lab's operation feels nearly impossible.

This fragmentation not only slows down processes but also impacts the accuracy and reliability of the data, which is critical in today's health care and laboratory field. Moreover, the effort and resources spent in managing these disparate systems are substantial. It requires more manpower to input, extract, and interpret data across multiple platforms, often leading to increased operational costs and lots of potential for human error, unfortunately.

So the irony here is that technology that is supposed to streamline our work ends up complicating it.

So with that to set up the stage here for Dennis, who has been an independent consultant for over 30 years with a lot of experience, specifically in lab informatics. He'll dive deeper into the reasons and justification for digital transformation.

With his expertise, we'll explore how unifying these disparate systems through digital transformation cannot only tame this multi-headed monster, but turn it into an ally, enabling your laboratory to function more effectively, reduce errors, and ultimately provide better patient care and revenues. So with that let’s pass it over to you, Dennis.

^{Dennis Winsten}: Happy holidays and thank you for taking time out of your Christmas shopping to attend this webinar. As a matter of fact, after the webinar, I'm going out shopping myself.

So as Suren noted roughly two-thirds of the labs are using LIS systems that are over 10 years old. Just because they're old doesn't necessarily mean that they have to be replaced, however, there are a large number of reasons and they're not in any particular order here, that justify replacing your LIS system. One of them is not having a cloud-based operating platform. I look up to see if I can see the cloud, but I know it's there. That's an important consideration if your LIS system is not cloud-based.

Sometimes the LIS systems that you have aren't sufficient and they don't provide the opportunities for your lab volume growth, or they limit your ability to add new clients, which is going to limit and affect the growth potential in revenue for your lab. Another factor to consider for replacement is the LIS system is very expensive.

It's expensive to operate. It's expensive to maintain. And the pricing model. How you're paying for your LIS system. Are you paying for it on a per-seat basis? Are you paying for it with a fixed license? Or are you paying for it on a transaction basis? Whatever it is, the LIS system pricing model doesn't fit your current lab's cash flow or your financial situation.

Another factor for replacement is whether the LIS system is well integrated with your laboratory billing and lab revenue cycle management systems or other institutional systems. If you're in a hospital, how does it interact with your EMR, for example? The LIS system might be based on LIS software that's not mainstream or consistent with the national or industry standards or incompatible with other existing laboratory software systems.

So those are four, and there are more reasons.

Support services for your LIS system are poor. I did a survey several years ago, and asked various people around the lab, the lab director, the pathologist, the lab techs, and the LIS manager. What are the things that are most important to you about your LIS system and your LIS system supplier? And you’d think that function and functionality would be number one, but you know, it wasn't. The number one factor that people thought was important to them was the support they get in maintaining and keeping their LIS system operating and fixing problems quickly, or ideally avoiding problems, preventing problems from happening,

Functionality and functions are important. A lot of LIS systems today, going back historically, don't have the current applications that are prevalent and necessary in today's laboratory. Molecular diagnostics, digital pathology, very flexible reporting, providing portals to the consumer, and more importantly, the application of artificial intelligence to the entire laboratory LIS system operation.

Not having these functions clearly will place your lab at a competitive disadvantage. Another criterion for replacement is a slowdown. You know, you can have the greatest functionality in the world in your LIS system, but if your response time on your LIS system is taking multiple seconds, obviously the throughput is going to be significantly affected by that, and your lab turnaround times are going to deteriorate.

The lab needs to have in-house experience, and very often this is not provided and supported by LIS system vendors. Also, federal and state regulations are constantly changing. Your laboratory information system needs to be constantly updated and quickly updated to maintain compatibility with various regulations.

Security. As you know, security has become a tremendously important issue these days. You need to ensure that your LIS system, your existing LIS system (and many older ones are not set up for that and are subject to penetration) is compliant with HIPAA. I think most of the LIS systems today, if they're operating, obviously are, but they need to be constantly upgraded to maintain security and to maintain consistency with HIPAA.

This is not true so much anymore that your LIS company is no longer in business. However, as you know, many LIS companies have been bought out by larger LIS companies. Smaller LIS companies have been bought by larger companies, and the extent to which the larger company is going to support the company that's acquired is very questionable and historically has not been a good sign for LIS companies that have been successful, that have been acquired by a larger entity.

The original LIS company that you bought, we see some of this today as well, has been replaced with a more modern version, and is discontinuing the LIS system version that you have, so you will not be getting enhancements and support for your LIS system going forward in time.

Another factor to consider for replacement is your original LIS company has been acquired by a larger company with a competing LIS system, which is very similar to the LIS company replacing your system. So now you've got a competing LIS software product and you don't have contractual assurances that you're going to get continuing support.

Although even if you do have assurances that you're going to get continuing support, if there's a competing product, which is the main focus of the LIS company, the new company, you can be assured that the kind of support you're going to be getting isn't what you expected in the past.

So if you're thinking about replacing your laboratory information system, it's not an easy thing to do. Budgets are very tight. There's a lot of competition for the available funds, either within your independent lab or in a hospital setting, and how do you go about justifying a new LIS system to get budget approval?

You have to develop a very rigorous financial spreadsheet analysis, which shows the benefits, the financial benefits, and the operational benefits that you will acquire and you will achieve by going to a new lab information system. For example, going to a pathology lab software as a service model, particularly when your capital budgets are limited, and you want to avoid upfront costs for the LIS system and replace it with monthly costs that vary with your workload. So to the extent that you've done a rigorous and definitive analysis and a cost-benefit projection, I usually like to look at five years. What's the total cost of ownership of the LIS system over five years? If you do a rigorous analysis and present it to your management that says Here's a good financial, a good operational, and a good regulatory rationale for replacing the LIS system,” the chances are a lot stronger that you'll be given the go-ahead for a much-needed replacement LIS system.

_{Suren Avunjian}: Thank you, Dennis. By the way, with Dennis, we also bring him on as a consultant to help understand The ROI and the benefits you've gained as a customer and also he can help get the metrics that are in place today and potentially do estimates on how you could benefit in the future from the LIS system too.

So I think this is also another important exercise that could be done to justify a replacement LIS system.

^{Dennis Winsten}: that's very important. It's, it's surprising how many labs don't look at the metrics. When they put in a new LIS system to see how and be able to measure the benefits of the system throughout using it for six months or a year and all the key performance indicators can be measured before and after. That’s tremendous, tremendous feedback to your administration that you did the right thing. 

_{Suren Avunjian}: And a lot of it could be due to that monster we saw earlier because of all the silos, it becomes really hard to get this information. And so let's explore what the benefits are of a digital transformation for your organization. 

So these advantages are not just about keeping up with the latest trends, right? They're about fundamentally enhancing the way our laboratories are operating and how we serve our communities. Firstly, digital transformation allows us to standardize and reduce complexity, right? How do we do that?

By having a unified LIS system, we can ensure consistency across all operations, making it easier to manage, maintain, and train staff. Standardization also plays a crucial role in error reduction and turnaround times.

Next, we could streamline and automate processes. These automations transform time-consuming manual tasks into efficient technology-driven processes. This not only speeds up our overall operations but also frees up staff to focus on more critical and value-added tasks. We see many laboratories scale with us, and they're able to scale two, three, or four times more volume with the same amount of staff or maybe 10 percent more that's added, so it's much more important to, especially with these limited staff people, allow them to be doing more relevant tasks in the laboratory and let the LIS system do a lot of the redundant and boring tasks. For example, optimizing compliance, right?

To reduce the risk is another significant benefit. Digital transformation and advanced tools help us stay compliant. With the ever-changing regulations and healthcare automation compliance can be done by automating compliance-related tasks. We minimize the risk of errors, and penalties, and ensure we adhere to industry standards and best practices.

Gaining a competitive advantage is crucial in today's healthcare landscape, especially in our local markets, right? These advanced digital tools allow labs to make their offer, and bring their offer to a wider community with better services, and innovative testing options that set the lab apart from others.

Typically, the LIS system is a really important differentiator for laboratories. It allows you to serve the community, the doctors and the ordering providers, exactly the way they want to be served. And you can build all of this into the back end of the LIS system and let the system take care of this. So by improving our efficiency and capabilities, we can attract new business, and retain the current ones we have. And provide them with superior service.

Digital transformation also makes it easier to scale your operation, whether it's by increasing the testing capacity, directory of services, or expanding our services and offerings to the customers. So unifying and gaining operational visibility is about having a clear, comprehensive view of the entire operation.

This visibility allows us to make more informed decisions, identify areas for improvement, and monitor the impact of changes we implement. Lastly, solving for today and the future means the digital transformation is not just a one-time upgrade, it's an ongoing process that prepares us for future challenges and opportunities.

As technology evolves, so do our capabilities, enabling us to continuously adapt and stay ahead of our field. So in conclusion, digital transformation is an essential step in modernizing the laboratory. It's about more than just technology. It's about improving our services, efficiently and with the ability to adapt in a rapidly evolving healthcare environment.

With that, I will ask Michael to go over a case study that recently implemented laboratory gains by moving to more modern systems. 

^{Michael Kalinowski}: Thanks for that, Suren. A very compelling argument from both of you. 

Suren brought this term up just the other day. I think it's pretty fitting here. If there is another software partner that you're contemplating working with, look at that LIS company not necessarily as a software company, but as a lab scaling company. I think that's a really good mindset because, as we all know, no two laboratories are alike. And as we all know, laboratory environments are constantly changing. So having a LIS laboratory information system and a laboratory software partner that is there and interested not only in where you are today, but where you're going to get and how quickly you're going to get there in the future, I think are two very important considerations.

Everybody likes to hear about success stories. Here's a a laboratory that was doing what a lot of laboratories do, using outdated manual processes and fragmented software solutions, running into common problems of inefficiency errors, and delayed reporting. This was turning into bottlenecks and hurting the business.

So the lab recognized the bottlenecks, recognized that it was time to make a change, and then partnered with  LigoLab for modernization. This resulted in a 31 percent increase in lab productivity, a reduction in errors, improved turnaround times, and better relations with your clients.

All of these things are offshoots of this increased efficiency and productivity within the lab, and then most importantly, revenue was boosted by 18 percent in the subsequent year thanks to the enhanced LIS laboratory information system that was operating within this laboratory. Really impressive numbers in just one case study. An increase in productivity and efficiency will ultimately mean more in net collections. And less time in accounts receivable for your laboratory. 

_{Suren Avunjian}: Thank you, Michael. We've also prepared some self-assessment questions that you could be asking internally.

These will help determine if your laboratory has outgrown its informatics platform, and assess whether consideration to switch or upgrade the LIS system might be needed.

If your laboratory information system LIS can't integrate well with other equipment, EHRs, or laboratory software systems, it might force you to use multiple platforms.

And this approach leads to data silos and synchronization issues impacting efficiency and accuracy. For example, if you're workload has grown and the current LIS system is struggling with data processing, slow response times, or frequent crashes, it might be time to upgrade the LIS system.

The laboratory information system should provide in-depth reporting and analytics. If your current system falls short of generating reports or adhering to regulatory requirements, it may no longer be adequate. Assess if your LIS model can adapt to future growth or technological advancements. A medical LIS system that isn't flexible or easily upgradable can hinder your lab's potential to evolve and stay competitive and relevant. 

^{Dennis Winsten}: I think the issue of silos is a very significant one because in many cases you don't know for sure which is the source of truth. If you have different systems that are not well integrated, interfacing can be done, but there are several issues associated with interfacing in terms of keeping the data coordinated and consistent with each other.

_{Suren Avunjian}: Thank you, Dennis. Some more things to consider, right? If the LIS medical is not user-friendly, this leads to inefficiencies, errors, frustrations, and major drawbacks. The user needs to evolve and LIS systems that once seemed adequate can become outdated. Medical LIS should meet an evolving need. 

^{Dennis Winsten}: I want to comment again on support maintenance. Very often overlooked. I think people sometimes look at the function and feature and they say, wow, look at this, isn't this great? And maybe it is, but the important thing is are they a good partner with their pathology LIS systems?

Does your LIS company understand your particular laboratory operation and what's unique about it? Because as Suren said, labs are different. I used to have a saying that labs are all the same. And then people go, Oh, and then I go on and say, except for the differences. Labs are all the same, except for the differences, and you folks out there in the lab, you know that that's the case.

_{Suren Avunjian}: Thank you, Dennis. It's a really good key point there. And we need to also consider compliance, right? Should they keep up with the regulatory requirements and securities, function, features, and maintenance? If the laboratory information system software vendor charges excessively for every small change and cannot deliver the robust functionality needed to stay competitive in your market, that's a significant red flag. Frequent disruption and maintenance or slow support responses also indicate it's time for a change. So operational costs and efficiencies. Consider the total cost of operating your lab information system, including indirect costs like downtime, staffing, and efficiencies. You know, a LIS system that requires additional software or staff to fill the gaps can lead to increased operational costs.

So in summary, when evaluating your laboratory information system LIS in terms of scalability, integration, capabilities, reporting and analytics, user interface, compliance, and vendor support, so much to consider here, right? It's become financially burdensome for the laboratory without delivering these necessary functions.

If you're answering even up to half of the questions it's time to look for a more suitable and advanced lab organization software solution. 

So with that, I want to bring us toward our final slide and discuss, for example, how a LIS company like LigoLab can can be a transformative step for your laboratory to position itself for success in a competitive environment.

LigoLab stands out with this best-in-class white glove service, ensuring that your experience is seamless. and supported at every stage. We offer a unified platform that includes not just an LIS software solution, but really all the supporting modules the laboratory needs to be successful, paired with a lab revenue cycle management system that has full visibility into the operational and technical operations and can help with coding.

And all the compliance that comes with a direct-to-consumer lab testing solution called TestDirectly. This unified approach eliminates the need for multiple disjointed systems, thereby reducing data silos and synchronization issues. One of the key reasons why  LigoLab was founded is the desire to take full ownership of all of your informatic needs. That way if there is an issue you only have one laboratory information system vendor that takes full responsibility for all the informatics needs rather than the finger-pointing that is commonplace, unfortunately.

We align with the laboratory and its growth. Our LIS system is designed to grow with your laboratory. It understands that as your laboratory expands, your needs evolve, and the LIS system is built to adapt and scale, providing flexibility, and functionality requirements to support your lab's growth along with changes in the industry.

We're continuously improving the lab information system. Every day we roll out new features. With LigoLab, you're not just getting a static LIS system, you're investing in a LIS software solution that's continuously improving. LigoLab stays ahead of the industry trends and technological advancements, ensuring that your laboratory has access to the latest features, modules, and tools to be successful.

^{Dennis Winsten}: Well, in addition to helping you win Suren, I believe I'm correct that the LIS system will help you justify if you have situations which we described, where it makes sense to replace your system, but you have to convince someone to do it. And you know, the biggest factor is always money.

So, I believe that if you look at The cost of ownership over several years that will help you look at the financial trade-offs and the financial difference between, for example, upgrading versus continuing to operate your existing LIS system in terms of what your current cost model is.

_{Suren Avunjian}: Thank you, Dennis. And, you know, it's not just about LIS software. It's really about the service. It provides best-in-class, unparalleled support and assistance to the lab. So this includes personalized training, responsive customer service, and expert guidance to ensure maximum benefit out of the system.

We're continuously helping the laboratory evolve and implement new features to keep up with the dynamic nature of this industry. In a competitive market, having a robust, efficient, forward-thinking LIS company as a partner can be a game changer.

You're partnering with a team of dedicated laboratorians, software engineers, and people who will continuously help and improve your lab workflow and provide the best processes that we've learned from different organizations so that the laboratory can have a lot of different choices in how the laboratory information system LIS is working for them.

Because as Dennis mentioned, every lab is quite different, even though, you know, it sounds like it should be the same. Every lab loves to do things a little bit differently, and that's why it's important to build an LIS laboratory information system that has this level of flexibility to tailor to your needs without necessarily needing to go and write new software for it.

It's more on the back end, super configurable, and in your hands to be able to make this change without ever being nickel and dimed for all these configuration needs. You know, that's what laboratories that are customers with us love to have, this kind of capability at their fingertips. Not only does it not cost them a couple of thousand dollars every time they need to make a change, it only costs them a few minutes to go and make that change themselves.

So with this unified platform, we align with your growth. That's our pricing model, our licensing model, and just in general, our philosophy. That's why we provide best-in-class service. We commit to continuous improvements and make it an invaluable asset in achieving and maintaining a leading edge in your field.

So I want to thank you all for your time and attention and wish you all happy holidays. Michael, I'll turn it over to you. 

^{Michael Kalinowski}: Perfect. I think the summary you gave was fantastic. We bet on the lab's future success which is a big part of our success. too.

And so that is one of the core beliefs with is. We want to have a partnership and we believe in your lab's growth, be it anatomic pathology, molecular diagnostics, or reference laboratory work. We have the tools to help you. 

Now we still have a minute or two, so we can slip in a question or two from the audience. Go ahead and use the chat option at the bottom of your Zoom screen to ask your questions.

Also, one thing that came out of this discussion for me, and Dennis, I'll let you weigh in here first, how many lab managers and lab directors out there are familiar with today's innovative laboratory information system solutions?

^{Dennis Winsten}: It's very interesting because if you're a user of a certain LIS system software, your mindset is sort of related to that particular system. Sometimes it's very hard for someone to understand that they can leapfrog ahead because their experience has been limited to one particular healthcare LIS. Very often it's that they are sort of constrained by the system they're using and sometimes it's really difficult to to have them understand, for example, what does it mean if you're on the cloud? Or what does it mean if you have this type of flexibility in your laboratory report software? And what does it mean if you're integrated versus interfaced? So I think there's a lot of educational needs out there, and that's why I'm pleased to see that LIS companies like LigoLab are offering informational webinars like this one.

^{Michael Kalinowski}: Anything that you’d like to add, Suren? 

_{Suren Avunjian}: Yeah, we're seeing more and more prospects coming to us that are well-educated on the exact issues that are having, and that's been enlightening. I think there's a lot more awareness of what to look out for and where the constraints are. A lot of new customers do their homework and do massive due diligence.

The sales cycles are long and they should be because this is a really important decision. It’s mission-critical software, and we're seeing people pay a lot more attention and make the right decisions.

^{Michael Kalinowski}: I do have a question from the audience. What size lab is your LIS system designed to scale and support with a transition? Are you looking at a lab with 30 clients hoping to grow to 100 for instance? Are you trying to disrupt the real big national laboratories that exist within our country?

_{Suren Avunjian}: That's a great question. The LIS system software is designed for laboratories of all sizes, but our real target audience is medium-to-large-sized laboratories already having hundreds of clients and scaling to thousands of clients. If not tens of thousands of clients. We have a lot of laboratories like this that we support. So we're covering enabling over 200 different laboratory facilities to scale currently.

A lot of these labs can vary because we cover lots of different disciplines. So, for example, for pathology labs, I'd say a good level where the pain point is high enough to need an advanced LIS software system like the labs with over four or five pathologists.

A lot of the groups that we serve are the ones with 20-plus pathologists. That's a typical customer. But then we have groups that have almost 100 pathologists in them, so really on the pathology side, it varies. On the molecular or clinical side, it's typically a couple of 100 tests per day, but more often a couple of 1000 tests per day and they're looking to scale two, three, four, or five times more. We have laboratories that have grown 10 times more, but obviously, this takes much longer periods because it doesn't happen overnight unless it's COVID. And even in those instances during COVID, we had many laboratories that we're processing around a thousand or a few thousand cases per day.

Some of the fastest-growing laboratories in the country were our customers, and I don't think it was a coincidence. Typically these customers use the entire platform. We call it the trifecta, and that is the direct-to-consumer lab testing solution in the front, the laboratory information system solution in the middle running all the technical operations, and then the lab revenue cycle management solution in the back, automating all of the laboratory billing on the back end. 

The main job of LIS systems is to remove the bottleneck of growth and the artificial ceilings that the laboratory ends up kind of being trapped in. This is what the LIS system and the laboratory information system vendor's job is, to remove this.

So if it's a small customer growing from 30 clients to 100, it has completely different problems that need to be solved. But then from a hundred to 500, 500 to a few thousand, and then to processing on average between 20 to 30,000 orders per day and then some of them reaching 50, 000 per day. So these are completely different scaling problems, but the beauty is you don't need to keep changing LIS systems to be able to solve these. The laboratory information system has been built foundationally from the ground up to be able to solve all of these different artificial barriers as the lab breaches them.

So that's why with our aligned pricing model, we're very much in line with the growth appetite of the laboratory. So whether you're just the startup lab trying to take over a little bit of a marketplace or trying to disrupt Quest or Labcorp, we're there to support you.

Sonic Healthcare has been a customer for over 10 years, so I think they're on their way to making some disruptions on a larger scale as well. So thank you for that question. 

^{Michael Kalinowski}: Another question. Can you give me an example of automation and how it would turn a complex process into a simple one? 

_{Suren Avunjian}: So typically automation and the rule engine can help bring all of this standardization into the lab workflow to make sure nothing is dropped through the cracks. For example, with women's health where you might have different testing platforms like a Panther or a Roche for your molecular needs, you might have some customers that have a preference for these testing platforms.

So based on the combination of the specimen, the preference of the customer, and the availability of the instrument, the LIS system can help make these routing decisions on where the specimen should go and put human readable data on the specimen level. Of course, the platform has all this information in it.

So when you scan the specimen, it tells you where it's been, what kind of derivatives it might have, and where it's going. So this is just a very small, simple automation that could be built to help with these kinds of preferences. Another example is if you're not carrying a certain type of insurance the lab information system can route to a different laboratory for testing.

And all of this, instead of, you know, Betsy in the laboratory remembering all these preferences, these are programmed by your team with our team's help in the beginning, but once you do the same thing a few times, it becomes pretty simple for someone to replicate and maintain these rules and automation.

The laboratory can build as many of these as they wish. We've seen some laboratories build 30-plus different nodes of decision-making like a decision support tree. To model the realities and the needs of customers or the laboratory into the LIS system so that the LIS system can help you improve these and make sure nothing slips through the cracks.

^{Dennis Winsten}: I'd like to underscore what Suren said. In a complex situation, there are a lot of decisions that have to be made, and if the decisions are being presented to the user all the time, you can simplify the process by building in rules or AI that says, “I understand where you need to go with this,” and not require someone to do all the manual entries in a complex process.

^{Michael Kalinowski}: All right, well, we'll respect everybody's time and go to final thoughts from Dennis and Suren

^{Dennis Winsten}: There are a lot of people out there who probably are operating LIS systems that should be replaced. And I think it falls very often on the laboratory information system vendors to be able to provide the tools and the information to these people so that they get the needed help. And I think it behooves any LIS vendor who's looking at helping a lab to be able to say, “Hey, we can give you some tools to help you do what you need to do to convince the people to release the money to let you do what you need to do.”

_{Suren Avunjian}: I would add this. Today with with all of the different pressures from reimbursement rates being cut, staffing shortages, and more expensive labor costs, it's really important to make the right investment into the laboratory's future and ensure growth, efficiency, and success.