Choosing an anatomic pathology LIS is a decision your lab will live with for many years, and it touches every specimen, every pathologist and every report. This guide is for lab directors, managers, hospital IT and procurement teams who need a structured way to compare systems and avoid expensive surprises.
Anatomic pathology has different needs from a general clinical laboratory system. Cases branch into parts, blocks and slides, reports are narrative and often long, and the workflow loops back for recuts and ancillary tests. A system designed mainly for chemistry and hematology tends to handle these poorly.
Start with your workflow, not a feature list
Vendor feature lists look similar. What separates systems is how well they fit the way work actually moves through your lab. Before talking to vendors, map your current workflow and decide what you want it to become.
Document, at minimum:
- Case types and approximate volumes: biopsies, resections, cytology, frozen sections, consultations
- Each workstation: accessioning, grossing, processing, embedding, microtomy, staining, sign-out
- Where identifiers are printed, scanned or typed
- How reports are structured, approved, amended and delivered
- Which external systems need data: hospital information system, electronic medical record, billing, cancer registry
This map becomes the backbone of your requirements and your demo script.
Core capabilities for an anatomic pathology LIS
Case and specimen tracking
The system should model the full hierarchy of case, part, block and slide, and support barcode printing and scanning at each station. Ask how it handles add-on blocks, recuts and items sent out for consultation. Specimen tracking with barcodes explains why scanning at every handoff matters.
Pathologist workspace and reporting
Pathologists spend most of their system time here, so involve them early. Look at how cases are assigned and prioritized, how templates and synoptic checklists work, whether voice dictation is supported, and how preliminary, final and amended reports are handled. Full-text search across past reports is valuable for correlation and teaching.
Histology and ancillary testing
Check how special stains and immunohistochemistry are ordered, tracked and billed, and whether pending work is visible to both histology and the pathologist.
Archive and inventory
Blocks and slides are stored for years and borrowed often. The system should record locations, loans and returns. Reagent and consumable tracking is a useful addition.
Digital pathology readiness
Even if you are not scanning slides today, ask how the system links to whole slide images and image viewers, and whether it can share cases with remote pathologists.
Security, privacy and compliance
Pathology reports contain sensitive health data, so security is a core requirement rather than an IT afterthought. Ask vendors to explain, concretely:
- How access is controlled by role, and how roles are configured
- Whether multi-factor authentication is supported for all users
- What actions are written to the audit log, and who can review it
- How data is encrypted in transit and at rest
- Where data is hosted, and how backups and disaster recovery are tested
- Which security frameworks their practices are aligned with or certified against, with evidence
For cloud-hosted systems, a lab manager's checklist for cloud security gives a fuller set of questions. In Thailand, the Personal Data Protection Act treats health data as sensitive personal data; see Thailand's PDPA and patient data in the laboratory for what that means in practice.
Integration and data ownership
An anatomic pathology LIS rarely works alone. It usually needs orders from the hospital system, results sent to the medical record, and data shared with billing and registries. Ask which interface standards the vendor supports, who builds and maintains each interface, and what happens when the hospital system is upgraded.
Data ownership deserves its own conversation. Confirm in the contract that your lab owns its data, that you can export it in a usable format at any time, and what the vendor will provide if you leave. Migrating years of reports out of a closed system is painful without this.
Cloud or on-premises
Both models can work. On-premises systems give you direct control of hardware but require local IT staff for servers, backups, patches and security monitoring. Cloud systems shift that work to the vendor and make multi-site access easier, but depend on reliable internet connectivity and on the vendor's security practices.
Ask about uptime commitments, planned maintenance windows and what the lab can do during an outage. A documented downtime procedure, with the ability to print labels and continue critical work, is important for either model.
Running demos and reference checks
Generic vendor demos show the best paths. Write a demo script based on your workflow map and ask each vendor to follow it with realistic cases, including awkward ones: a resection with many blocks, an amended report, a recut after sign-out, a consultation sent out and returned.
Include a pathologist, a histotechnologist and an accessioning clerk on the evaluation team, and score each step separately. Then ask for reference sites with a similar case mix and talk to the people who use the system daily, not only to the lab director.
Questions worth asking
- How long does a typical implementation take, and what does the lab need to provide?
- How is training delivered, and what happens when staff change?
- How are new features and fixes released, and can we test them first?
- What does support look like at night and on weekends?
- How is pricing structured as volumes or user numbers grow?
Common mistakes
- Choosing on feature checklists without a workflow-based demo.
- Leaving pathologists and histology staff out of the evaluation.
- Underestimating data migration from the old system.
- Ignoring total cost: interfaces, hardware, training and support.
- Not confirming data export rights in the contract.
Key takeaways
- An anatomic pathology LIS must model cases, parts, blocks and slides, not just test results.
- Map your workflow first and use it to write a realistic demo script.
- Treat security, privacy and audit logging as core requirements.
- Confirm integration responsibilities and data ownership in writing.
- Involve the people who will use the system every day.
If PATHOLOGY+ is on your shortlist, we are happy to follow your demo script with your own case types. Book a demo or see plans to compare options.