In business for nearly 40 years, Fletcher-Flora entered the health care field in the 1970s and created its first LIS in 1983. Today, the company produces LabPak as well as a suite of Web-based solutions for laboratory information management. CLP spoke with Neal P. Flora, CEO and cofounder, about the LIS revolution and other changes in the industry.

Q: How did the LIS revolution begin?

A: I think you have to look at the LIS revolution as a combination of four factors: If you think about it as a circle made up of need, solutions, technology, and cost, that circle is essentially closed. If you begin to look at the progress of LISes starting back in the ’70s, you find that, as the solutions became available to fulfill the need, technology had to catch up, and cost had to come down to make the technology available. The instrument manufacturers needed to make improvements on their analyzers so that the data could be available to computers. At the same time, you had the PC revolution, which was a huge leap in technology and also a significant drop in cost. What used to cost $50,000 for a computer in the ’70s, cost $5,000 in the ’80s, and is now a few hundred dollars. So the technology, the cost, the other players in the industry all had to fall into place for the LIS revolution to continue.

Q: Are most of your customers upgrading at this point, or are there still a lot of first-time buyers?

A: Surprisingly enough, there is still a plethora of first-time buyers of LIS —to the tune of 30% or 35% of overall sales. I would have to say there isn’t a major hospital institution that doesn’t have some form of LIS. But there’s certainly a tremendous number of physicians’ offices and small hospitals that, because of the solutions available and their cost, have not been in a position to acquire anything that they can afford.

Q: Is your company trying to bring a solution to those small practices?

A: Our Flex eLink is a software product that will run on any PC, and its purpose is to provide that connectivity from instrumentation directly into EMRs. It’s not designed to be an LIS; it’s designed to help very small facilities move their data and information to their EMRs. We have an entire suite of products with the Flex name in them. The Flex eSuite is essentially the next-generation LabPak. It’s a Web-based client server solution that is flexible and extendable. For the very small to the 1,000-workstation institution, the same core product spans the entire range of customers.

Another thing I think you’re going to see is a tremendous upswing in application service provider (ASP) solutions. ASP solutions for the LIS would allow a user to pay a subscription fee for a service that gives them the LIS functionality, but they don’t have to buy it. We still give them the connectivity to their instruments, and to the EMRs, but the quality control, the data, and all of the information is controlled by our central computer, so they don’t have to burden themselves with that cost.

Q: Given that roughly 65% of the market is upgrading or replacing their LISes, how do you attract new users?

A: From a practical standpoint, our mainstay as a company has been the ease of use, connectivity, expandability, and functionality we provide for the cost. These attributes have provided us with all the ingredients for success. One of the unique things with Fletcher-Flora is our approach to presale support. The value we bring as a company has always been the consultative approach we take to understanding what the customer’s needs really are so that when we ultimately put together the package it’s not a cookie-cutter unit. Taking that consultative approach is how we’ve become successful.

Q: With the government’s urging of EMR adoption, how do you keep up with the variety that hospitals may be choosing?

A: We started out almost 8 years ago putting into place connectivity as a main thrust of our company because we could see the handwriting on the wall. EMR, practice management, electronic billing system vendors—we’ve already worked with well over 60 of them successfully. We have over 500 successful deployments of connectivity to these various systems to date. We have a tremendous amount of knowledge of how all these pieces fit together. It all relates to the growing need for delivery of information. That’s all an EMR system is: It’s a mechanism to deliver information to the clinician. By taking a proactive look at the way things are going, by drawing upon our core knowledge, all of the connectivity we have done in the last 5 or 6 years puts us in a pretty good place to respond to the direction of the industry. From a practical standpoint, the ability of clinicians to obtain fast, efficient, accurate information on their patients anywhere they are is going to be a very important driving force for the future.

Q: What changes will labs need to make in the coming years?

A: In the next 5 years, or even less, the Internet will be used for delivery of lab results, whether it will be delivery to a doctor or to a patient. Imagine if you as a patient can log into your clinic and get access to your information. From a health care perspective, the only way we’re going to control cost and still deliver quality service is for individuals to become more involved in their own health care. In order to take responsibility, they need to be educated, and they need to have access to the information. What is changing is the delivery of information. Whether that delivery is to the end patient or to the clinician, it still needs to get there, and it needs to get there quickly. We’ve realized that even the smaller institutions need to have information delivery over the Internet, so we’ve provided that as a core piece in the Flex eSuite product line.

Q: Is there anything else you would like to let readers know?

For more information, search for “LIS” in our online archives.

A: At the end of the day, we as a company are in this for the long haul. We intend to be around for a long time. We’ll continue upgrading technology and responding to the changing needs of the industry, and we will try to come up with solutions to new problems created by the new technology. The circle comes into play again; as technology becomes more readily available, needs are going to change, and responding to those needs in a timely fashion is extremely important for our customers.

Zac Dillon is associate editor for  CLP. For more information about Fletcher-Flora, go to [removed][/removed].