- 26th Jun '26
- Sell SaaS
- 9 minutes read
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SHAREHow to Choose a Laboratory Information System: A Guide for Pathology Lab Directors
Picking a laboratory information system is one of the bigger calls a pathology lab director has to make. The platform shapes how your staff work, how fast cases move, how clean your data ends up, and how well your lab plugs into the rest of the healthcare system. Pick wrong and you live with the friction for years. Pick right and the system fades into the background, letting your team focus on the diagnostic work.
Here's what to think about, what to ask, and what to watch for as you go through the process.
Start With Your Workflow, Not the Software
The first mistake most labs make is starting with vendor demos. A demo shows you a platform at its best, in a controlled scenario, with a salesperson driving. What you actually need to know is how the platform handles your work, on a busy Tuesday, with your case mix and your staffing.
Before you talk to any vendor, write down how your lab really runs. Map the workflow from accessioning through sign-out. Pin down the spots where your current system gets in the way. Talk to your histotechs, your pathologists, your billing folks, and your IT staff about what slows them down and what they wish worked better.
That documentation becomes the lens you use to look at every platform. Instead of asking whether a system has a feature, you ask whether it solves a problem you actually have. Instead of getting impressed by capabilities you'll never use, you stay focused on the ones that will change how your lab works.
Match the Platform to Your Subspecialty Mix
Not every LIS handles every kind of pathology equally well. Anatomic and clinical pathology have different workflow needs, and inside anatomic pathology, dermpath, hemepath, molecular, and cytology all pull in different directions.
If you do a lot of dermpath, you need a system that handles high case volumes, supports the quick sign-out cycle derm cases run on, and works with the imaging and reporting the specialty depends on. If molecular is a big piece of your work, you need a platform that can manage molecular orders, track specimens through long testing timelines, and pull molecular results into the final report. If you handle cytology, you need cytology-specific screening workflows, ThinPrep integration, and the rapid case turnover the work demands.
Ask vendors how their platform handles your subspecialty mix specifically. Get references from labs doing similar work, not just labs that happen to use the same platform.
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Look Hard at Integration Capabilities
Modern pathology runs on connections. Your LIS needs to talk to your EHR, your billing system, your digital scanners, your reference labs, your molecular platforms, and increasingly to AI tools and tumor board systems. The quality of those connections drives everything from turnaround times to clinician satisfaction to your bottom line.
When you look at integration, get past the marketing materials and ask the questions that actually matter:
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Which EHR platforms does the vendor have live integrations with, and at what depth
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Are the integrations bidirectional, or do orders flow one way and results flow back another
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Do reports land in the EHR as structured data or as static documents
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What does the integration roadmap look like for the technologies you plan to bring in over the next three to five years
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How are integrations maintained, and what happens when one breaks
Talk to current customers about how integrations work in practice. The gap between what a vendor promises and what labs actually experience is often wider than it should be.
Look at the Numbers Honestly
LIS pricing swings widely, and the headline number rarely tells the full story. A platform with a low subscription fee might come with high implementation costs, pricey interface fees, charges for every change request, and steep penalties for adding users. A platform with a higher subscription cost might include implementation, interfaces, and ongoing configuration in the base price.
Build a five-year total cost of ownership model that covers:
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Implementation and initial configuration
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Interface development and ongoing maintenance
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Training for current and future staff
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Subscription or licensing fees
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Charges for change requests, custom work, and new modules
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Hardware costs for on-premise setups
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IT staff time for system administration and support
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Data migration and any parallel running during the transition
Compare platforms on the full picture, not just the monthly fee. The cheapest option on paper often turns expensive over the life of the contract.
Test the Vendor, Not Just the Product
The platform matters, but the company behind it matters too. A great product from a struggling vendor is a risk. A solid product from a steady partner is a foundation.
Ask about the vendor's financial health, customer retention, and acquisition history. A vendor that's been bought and sold three times in five years is probably not the partner you want for the next ten years. A vendor with high churn is telling you something about how customers experience the relationship over time.
Look at the support model. Who answers the phone when something breaks at 2 AM? How fast do tickets get resolved? Is there a dedicated account manager, or does every interaction start with explaining your setup to a stranger? Ask reference customers about their support experience specifically, because that's where the long-term relationship really plays out.
Dig into the product roadmap. Where is the platform going over the next two to three years? Is the vendor investing in the areas you care about, or in markets and features that don't apply to you? A platform that's stagnant today probably won't keep up with the changes coming to pathology over the next five years.
Take Security Seriously
Pathology data is some of the most sensitive information in healthcare, and the regulatory pressure around it keeps getting tighter. Your LIS vendor needs to take security as seriously as you do.
Ask for current third-party audit reports. SOC 2 Type II is the baseline for healthcare software. HITRUST certification is a stronger signal. Read the reports, don't just confirm they exist. Look at the scope, the testing period, and any exceptions.
Ask about encryption, access controls, audit logging, vulnerability management, and incident response. Find out how the vendor has handled past security incidents and what they told customers when it happened. A vendor with a track record of transparent, well-handled incidents is often a safer bet than one that claims they've never had a problem.
Get clear contract terms on data ownership, breach notification, and exit provisions. Your data needs to be yours, the vendor needs to tell you quickly if something goes wrong, and you need to be able to get your data back in a usable format if you decide to leave.
Plan for Implementation Realistically
Even the best LIS won't help you if the implementation goes badly. Most failed LIS projects fail at implementation, not at platform selection. Going in with realistic expectations and a solid plan makes all the difference.
Expect implementation to take longer than the vendor's initial estimate. Twelve to eighteen months is common for a mid-sized anatomic pathology lab, and complex deployments can run longer. Build in time for workflow analysis, configuration, interface development, training, parallel running, and post-go-live stabilization.
Find a strong internal project lead who understands both the lab's operations and the technology. This person becomes the bridge between the vendor's implementation team and your staff, and the quality of this role often decides whether the project succeeds.
Be honest about the disruption to operations during implementation. Staff will get pulled into meetings, training sessions, and testing. Turnaround times may take a hit during the transition. Plan for it, communicate about it, and don't pretend it won't happen.
Get Real Input From Your Team
The people who will use the system every day need to be part of the evaluation. A platform that looks great in a director's meeting can be a nightmare for the pathologists, technologists, and accessioning staff who actually live in it.
Bring pathologists into demos and ask them to walk through a typical sign-out. Have histotechs evaluate the specimen tracking and ancillary order workflows. Let your billing team look at charge capture and coding. Take their feedback seriously, especially when it conflicts with what the vendor is telling you.
Reference visits to similar labs are worth the time. Send a small team that includes a pathologist and a lab manager, and let them spend a day watching how the platform actually gets used. The conversations that happen in the hallway between sessions are often more useful than the formal presentations.
Build the Right Contract
The contract is where the relationship gets defined for the next five to ten years. Get experienced legal counsel involved, ideally counsel that knows healthcare software contracts, and don't accept the vendor's standard terms without negotiating.
Watch for:
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Pricing escalation clauses and what triggers them
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Service level commitments with real penalties for missing them
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Data ownership and portability terms
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Termination rights and exit assistance obligations
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Indemnification for security incidents and intellectual property issues
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Limits on the vendor's ability to change terms unilaterally during the contract
A well-negotiated contract won't save a bad relationship, but a bad one can trap you in a relationship that's gone wrong with no way out.
Make the Call and Commit
After the demos, the reference calls, the security reviews, and the contract negotiations, you'll need to make a decision. No LIS software will be perfect. Every option will have tradeoffs. The goal isn't to find the ideal system, it's to find the one that fits your lab's work, your team's strengths, and where you want to go.
Once you've decided, commit fully. Halfhearted implementations get halfhearted results. Bring your team along, put real effort into the training and configuration the platform deserves, and give it the time it needs to settle in.
The right LIS, picked carefully and implemented well, becomes invisible. It supports the work without getting in the way. It scales with your lab as you grow. It connects you to the rest of the healthcare system in ways that benefit your patients. That's the standard worth holding out for, and the one worth doing the work to reach.
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