Over the next 5 years the Diagnostics Directorate will manage a significant change in the cornerstone clinical systems that support the ongoing operational delivery of the service. This will include the implementation of a new Laboratory Information Management System (LIMS), a change to the Managed Service Contract (MSC) responsible for all laboratory analysis and the Re-Provisioning of the National Picture Archiving Communication System (PACS). 

Successes

A significant number of developments were undertaken during the COVID-19 pandemic within the Laboratory Service and the digital systems including LIMS. This was essential in order to provide scale up of testing capacity for staff and the public and to support the complex data flows required for testing, infection control measures and reporting of data from both local and national laboratory. 

Work was also completed on the development of a Microbiology Reporting System specifically to enable improved reporting and tracking of complex testing. 

In 2019 the Diagnostics IT Support Teams aligned under the management of eHealth. This allowed us to review current IT requirements and processes within Diagnostics and align with established eHealth processes and procedures, adopting best practices for IT Security and implementation. This has enabled improved operational resilience and security. 

Opportunities

Laboratory Information Management System (LIMS)

LIMS is crucial to the function of Laboratory Medicine as it is used to result and report all primary, secondary and tertiary laboratory requests received by Laboratory Medicine. It also enables automation of workflows, integration of instruments, and management of samples and their associated information. LIMS systems interface with several key local and national healthcare systems including Patient Administration Systems, the Electronic Patient Record, Analytical Middleware and Regional and National Systems. 

During 2021/22 a new LIMS was procured by a consortium of 12 Health Boards. The new LIMS offers considerable opportunities to improve operational efficiencies, new diagnostic pathways and sustainability as a number of existing LIMS systems need to be replaced. The system will continue to underpin current laboratory services and enable services to transform and standardise to allow them to better meet evolving and changing service demands. 

We are working in a consortium of 12 Health Boards. This provides significant opportunities for service transformation locally, regionally and nationally. 

In addition to the core LIMS there is opportunity to develop a new genetics module. eHealth is an essential stakeholder in delivering Scottish Government's soon-to-be-published Genomics Strategy (anticipated summer 2023). Working closely with the local Laboratory Genetics department and the NSD Genomics Transformation Team, eHealth will help lead the delivery of the digital requirements for this strategy. 

This has some overlap with the ‘National’ LIMS but also includes the strategy for the analysis, storage and sharing of genomic data for direct healthcare, clinical trials and research. This strategy will likely be delivered in collaboration with the National Digital Strategy team but also with chosen 3rd party commercial providers. 

Aims

  • To deliver a modern LIMS that will enable delivery of Laboratory Medicine 
  • To ensure that no matter where health care is delivered, patients will have equitable access to efficient, effective, sustainable and affordable laboratory services 
  • To implement standardised processes, data sets and common coding that can enable transformation of diagnostic services in Boards, regionally and nationally 
  • Develop a Genetics Module within the LIMS supported by sustainable storage and infrastructure for genomics data 
  • To realise the aims of NHS Scotland’s eHealth Strategies. “Scotland's Digital Health and Care Strategy” 
  • To aid partnership working to deliver services in a radically different way, including the need for collaboration, innovation and flexibility 

Clinical value

A modern LIMS is a key enabler to altering care pathways with benefits to both patient experience and operational efficiencies. LIMS will enable multidisciplinary team working including the production of diagnostic pathways and cascading of tests to support optimal use of resources. It will support improved productivity and efficiency across laboratory medicine by streamlining key processes and improving turnaround times. 

Sustainability

Demand across services is increasing, requiring Laboratory Medicine to utilise the same, or fewer, resources to maintain services. A modern LIMS will help ensure service sustainability and reduce the reliance on “bolt-on” solutions. 

Demand optimisation

A modern LIMS is a key enabler to reducing unnecessary testing across primary and secondary care. This will release capacity to address rising demand and deliver testing that positively affects the patient pathway. 

Implementation

We will work collaboratively with other NHS Boards’ Laboratory Medicine Services to design, configure and implement a LIMS fit for a modern laboratory medicine service. There will be a 24-month NHSGGC LIMS implementation project that will see the replacement of the current NHSGGC LIMS solution. 

Strategic goals

There are a number of key programmes to be delivered within the 2023-2028 strategy period. 

  • Implement the new Laboratory Information Management System (LIMS) in NHSGGC replacing the old, legacy system. Develop a comprehensive benefits plan 
  • Develop and implement a new Genetics module within the new LIMS 
  • Complete the PACS Re-Provisioning programme 
  • Support the implementation of the new Laboratory Medicine Managed Service Contract 
  • National Digital Cytology Transformation 
  • PET Service Review and Transformation 
  • Digital Image Management System Review and Transformation 
  • Implement new Secure Clinical Image Transfer (SCIT) app with Medical Illustration Services