P-007 Laboratory medicine Oral communication

A next-generation integrated laboratory information system: experience from the first Epic-Beaker implementation in Switzerland

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Authors

H. Nilius presenting

Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern

#0
M. Stickel

Medical Directorate, Inselspital, Bern University Hospital, University of Bern, Bern

#1
K. Volken

Center for Laboratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern

#2
A. Tolkmitt

Directorate of Technology and Innovation, Inselspital, Bern University Hospital, University of Bern, Bern

#3
M. Nagler

Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern

#4

Abstract

Introduction: Traditional laboratory information systems (LIS) operate largely as stand-alone solutions, with information flowing mainly from the laboratory to the electronic health record. This one-way architecture limits the laboratory’s ability to use clinical context, monitor processes in real time, and contribute to digital care pathways.

Methods: In March 2024, Inselspital, Insel Gruppe AG, implemented the Epic electronic health record. In parallel, the Center for Laboratory Medicine introduced Epic Beaker as its integrated LIS. Beaker is embedded in the EHR and uses a unified database. We report insights from the first implementation in a German-speaking university hospital group.

Results: During two years of preparation, we built an interdisciplinary team combining IT specialists, Epic experts, clinical stakeholders, and diverse laboratory professionals. Key success factors were a shared vision, empowered teams, analysts with laboratory expertise, end-to-end testing, and deliberate workflow redesign within the laboratory and at the interface with clinical care. Four implemented capabilities illustrate the transition. First, Epic enabled closed-loop sample tracking from blood draw to storage, documenting time, user, and location, and supported container sharing across laboratory sections. This improved traceability, reduced identification errors, and eliminated manual sample searches. Second, clinical information became accessible within the laboratory interface, supporting safer validation, interpretation, and communication with care teams. Third, the unified database linked laboratory results with clinical data, enabling real-time monitoring of device performance, turnaround times, and test utilization, while supporting quality improvement and research. Fourth, the system’s configurability enabled integration of an in-house diagnostic decision-support machine learning model. Challenges included changes in professional routines and differences between Swiss laboratory traditions and a US-designed system, e.g., limited custom PDF reporting capabilities.

Conclusion: The first Epic Beaker implementation in Switzerland shows that an integrated LIS can do more than replace a conventional LIS. Combined with workflow redesign, empowered teams, and integration into clinical care pathways, it can transform the laboratory into an active partner for patient safety, operational excellence, and diagnostic innovation.