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MIPS
Glims

Laboratory Information System

Experts in Healthcare IT
Http://www.mips.be

Glims
General Laboratory
Information Management System

S.A. MIPS N.V.

Industriepark Zwijnaarde 3A
9052 Gent
Belgium

MIPS France S.a.r.l.

15, Place de la Nation
75011 Paris
France

MIPS GmbH
Borsigstrae 22
21465 Reinbek bei Hamburg
Deutschland

MIPS Iberica
Calle Orense 34, 8a Planta
28020 Madrid
Espaa

Glims
Laboratory Information System

Introduction and highlights

Automating your laboratory is an impor-

Internet / Intranet communication

Multiple

tant factor for success in todays competitive world. GLIMS takes advantage

user

interfaces

(Teletype,

Graphical, World Wide Web)

of and inherits many years of experience

from MIPSYS. In the competitive market
of

Laboratory

Information

Systems,

The product's flexibility is truly excep-

GLIMS offers you even more - its graphi-

tional, allowing the user to completely

cal user interface, sample tracking, GLP

define the layout and content of screens

compliance and relational databases, to

and reports. It also incorporates a labo-

name but a few of its advantages.

ratory oriented expert system to implement diagnostic support rules or reflex

From the start, MIPS' policy has been to

develop its products in close cooperation
with key people in the clinical pathology
business. Advice from experts in hospital and ambulatory environments, and

testing. In multilingual sites or distributed networks, each user can log into
the system in his/her own language and
consult the tailor-made generated reports.

also in academic centers has resulted in

a very user-friendly product, offering sig-

Direct access to all functions is imple-

nificant

mented by means of a user-specific tool-

improvements

management

and

in

operational

reduction

in

staff

costs.

bar.

bilities to obtain results for a patient, or

for

The latest technologies are used, including:

A relational Database Management

System, open to external query via
ODBC

An Object-Oriented development approach

Client/Server & Multitier application

partitioning

Users have multiple search possi-

prescribing

stance

physician,

for

in-

Analyzers are bi-directionally

connected, allowing centralized control

Glims
Laboratory Information System

Introduction and highlights

and cost savings.

Dedicated technical

modules are available for all special laboratory departments, including microbiology, transfusion management, pathology.

Billing and accounting modules

are kept up-to-date with fast-changing

legislation.

GLIMS

has

unified

communication

model for external applications improving robustness and increasing GLIMS'

ble at any time to show, monitor and

flexibility for integration into a larger in-

record the various procedures to which

formation Network.

data or laboratory activities have been

for

quality

Support is provided

assurance

functions

(ISO/

subjected from start to finish (of the

GLP).

work).

Users identify themselves when logging

GLIMS also performs audits. For exam-

in. They must provide a log-in name and

ple, all result modifications and status

a password. GLIMS hides the menu op-

changes are automatically logged. The

tions to access those functions prohib-

report of any individual result is also

ited to any user.

logged. All billing operations are logged

and traceable.

GLIMS plays a vital role in implementing

Good Laboratory Practice and is a key
tool for your laboratory in achieving its
goals on quality. An internal audit trail
imposes extra demands on software developments. GLIMS also has Standard
Operation Procedures (SOP) to ensure
the validity and traceability of data on
the internal, routine and daily operation
laboratory procedures. Thus it is possi-

Procedures
GLIMS offers a unified model for the description of all technical laboratory activities, including sampling, preprocessing,

observation

and

derivation.

The

model allows combining basic activity

descriptors into an elegant representation of complex procedures.

Glims
Laboratory Information System

Order entry
The figure above is an example of an

Order entry

action diagram, leading to an assessment of Low Density Lipoproteins in a

clinical laboratory.

Linking orders to patients is effected either with or without communication to

hospital information systems. When a
patient identification code is entered,

GLIMS is highly flexible because it can

GLIMS queries all connected systems,

loosely connect administrative, technical

which support the code format. Patient

and financial configurations. Properties

data input is stored locally to ensure

are attributes of the analyses requested.

availability in the event of a HIS communication problem.

Tests and specimen are requested either

individually or in profiles/panels. GLIMS
uses aliases, or abbreviations, to define
the current set of tests performed in the
They can be assessed through one or
several alternative methods or proce-

dures. System commands available include the selection of specific tests, panels of tests, specific samples of methodologies which can either be explicitly requested at order entry, or automatically
using reflex test triggers.

laboratory.

Sample

lists

can

be

re-

quested to obtain a summary of the

available

tests

configurable

and

profiles.

Different

screen-windowed

order

forms can be displayed graphically on

screen to visually guide the order entry
process. Duplicate requests are automatically detected.

Using its configuration data, GLIMS decides which procedures to use and what
information or specimens are still required to fulfill an order. They are requested

(and,

optionally,

logged

in)

automatically.

GLIMS is able to detect a possible reuse

Glims
Laboratory Information System

Result acquisition
of a specimen or a result, which may

etc.). Consequently, work lists can sum-

have been delivered earlier for the same

marize preprocessing work as well as

patient. If applicable, you can decide

sampling or test requests. Chained ac-

whether or not to reuse the previous re-

tions will automatically be synchronized

sult or specimen, by creating a link with

to wait until all requisites, including ali-

the new order.

quots or

preprocessed

materials, are

available.
If GLIMS determines that some or all of
the required specimen for the requested

Work lists

tests are missing, the specimen records

are kept in a special mode to ensure
scheduling of specimen collection. Subsequently, sample collection lists can be
generated to be taken along during sam-

Work lists can be used for manual result

entry or for review of instrument data.
Special attention

was given

to offer

maximum flexibility and to consider the

user's wishes.

ple collection.

GLIMS will provide printed labels, containing information about the specimen,
the patient and the tests to be performed, as configured by the database
manager. Specimen numbers are assigned using a site-configurable format.

Samples are sequenced, with sorting

controlled by work list specific criteria
such as urgency or test priority.

This

sequencing may also be driven by a

dedicated tray layout, determining the
relative positions of quality control samples among patient samples.

GLIMS enables definition of sample preprocessing

(centrifugation,

aliquoting,

The work list can include user-selected

demographics or test results from the
GLIMS database. Results requiring special attention are highlighted. Different
types can be predefined as templates, to
determine layout, selection and sort criteria, as well as the relative position of
quality control samples among patient
samples. Pop-up menus provide easy

Glims
Laboratory Information System

Result acquisition
The number of work lists is virtually
unlimited.
Successive work list versions are stored
on disk.

Instrument interfacing
GLIMS supports direct communication
with any instrument (supporting host
query if applicable), over either a serial
access to information related to the fo-

or a TCP/IP connection.

cused result.
Among the many benefits are multiple
Work list forms are organized in rows

instrument monitoring from any general-

and columns, corresponding to orders

purpose workstation, standardized pro-

and tests, respectively. Their appearance

cedures for quality control and direct ac-

on screen matches the printed sheet for

cess to historical patient data for valida-

easy result entry by lab technicians.

tion purposes.
Communication via dedicated high prior-

The succession of print-outs and sorting

ity processes, capable of stand-alone

is also parameterized (by department,

operation in the event of server downing

priorities, emergencies, etc.). There is

is also supported.

full control over successive versions,

sorting etc.

Manual result entry

In the absence of an instrument link, results can be typed in a spreadsheet-like
grid interface, with rows corresponding
to specimen and columns corresponding
to properties. The grid size is unlimited,
as it can scroll both horizontally and vertically. The size of the result itself is also
unlimited, as the grid cells can also be

Glims
Laboratory Information System

Quality control
scrolled (the result may be numerical or
free text of unlimited length). From the
result context in the grid cells, any result
method can be activated.

Numerical results can be entered in different units; GLIMS automatically converts to the applicable base unit prior to
performing any checks. Exponential notation is accepted, as are comparatives
(less or greater than).

External quality control (which may be

Quality control

enforced by law) checks whether different laboratories produce comparable re-

One of the prime objectives of laboratories is to ensure that laboratory qualitycontrol practices are adequate to achieve
satisfactory analytical quality.

sults on the same material. In this case,

the control samples may not even be
recognizable as such. IQC is based on
the regular scheduling of analyses on
quality control specimens. This schedul-

GLIMS provides internal and external

quality control.

Internal quality control

ing can be defined by the LIMS, but this

is not mandatory.

(IQC) checks whether test results on

quality control materials are reproducible.

Beside

simple

accuracy

control

and

trend checking, GLIMS supports the QC

algorithms of Westgard and Trigg. Quality control specimen can be scheduled
automatically

at

predefined

among routine specimen.

positions

Alternatively,

unsolicited QC results sent by any connected instrument are also processed. In

any case, quality control results must be
stored to perform the quality control
function. The usual norm validation may

Glims
Laboratory Information System

Result validation
have to be disabled for IQC samples.
Violation of quality control checks puts
the associated result output channel in
Unreliable status, until it is manually
reset. Patient results obtained from an

validation levels: technical and biological. Configuration allows specification of

the result severity level, below which the
respective validation procedures are performed automatically.

unreliable channel are marked as such.

Reporting
Result validation
Method-specific

normal

GLIMS features cumulative reports with

range

checks

according to sex, age, menstrual cycle

and MISPL (see further) rules are available. If so configured at the test level,
each result may have to pass a series of
automated checks: for format, accuracy
and precision, channel trend, range, and
shift (delta checks).

configurable content, layout and conditions for output. Different test types
shown on the reports can be organized
hierarchically. Report models can be set
up for each individual correspondent or
group of correspondents, if required. Reports support

variable

formats:

text, HTML, MS Word reports,

plain
HL7,

HPRIM, LDT, Medidoc, HealthOne, Edifact, Medar messages, etc.

All check definitions allow to specify
how the result must be treated if an
alarm is signaled. Severity levels can be
assigned, comments can be associated
and MISPL trigger code can be launched
to add comments or schedule reflex testing. GLIMS also supports two explicit

At order entry, reports are automatically

scheduled according to the issuers preferences. As results become available,
scheduled

reports

are

automatically

marked for output by dedicated background tasks.

Because of direct contact with the physician prescribing the test, report generation is a particularly important part of
GLIMS. The report generator makes it
possible to build up personalized reports
for each physician. Each physician may

Glims
Laboratory Information System

Reporting
This feature can be used to prevent the
report generator from redundant reporting.

(i.e. by not printing out a report if

all test results are not available).

MISPL
The MIPS Site Programming Language
is an easy to use, object-oriented programming language available to endusers. Site personnel maintain programs
written in MISPL. It is a single configuration language for use throughout the
application.

At application startup time, MISPL reads

the complete scheme information and
hence is able to compile and run sitespecific programs.
obtain reports in the preferred layout, in

Many built-in func-

tions are available.

his/her own language, with one or more

recapitulative result columns, and with
results expressed in units to which he /
she is accustomed. These and other
physician preferences are stored in the
physician database.

Report retrieval is driven by user search

specifications.

Search

keys

are

order

number, an external reference number,

patient name or physician name. For individual tests, GLIMS keeps track of a
result's availability and reporting status.

Applications include filtering, statistics,

calculations, diagnostic support rules,

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Glims
Laboratory Information System

Microbiology
reporting, test method selection, label

storage of any related or intermediate

definition, result derivation

result entered by the analyst. All relevant

data should be stored in a way that permits fast and easy retrieval of result for
daily result operation, previous patient
results, statistical and epidemiological
reports,

A table of antibiotics is present, containing mnemonic, name, reporting order (if

The MISPL builder is a user-friendly tool
which

allows

browsing

through

the

GLIMS database and offers all available

information and functions. While wandering through the database structure,

any), medical comments and result type

(R
Resistant, Intermediate, Sensible or free
text). Antibiotic thresholds assist in the
calculation of the RIS code starting from
a diameter.

the corresponding documentation is updated on the fly in a help window.

Antibiotic panels group antibiotics to be

tested by default, given a certain combination of organism group and sample

Microbiology

material.

One of the main differences here lies in

the fact that frequently the lab is pro-

Results of macroscopic evaluation, mi-

vided with a material and a question

croscopic evaluation, presence of red or

'See what you can find'.

white blood cells, etc. are entered as optional results and treated as output of
the initial. This output can, and probably

Since the procedures to be carried out

and the results to be stored are not
known beforehand, the Microbiology LIS
subsystem should be very flexible in its

will, automatically trigger further test

requests. At any time, the analyst can
decide to add extra tests or results to
the specimen being studied.

data model and user interface.

It should be able to suggest procedures
to be undertaken through evaluating the
current specimen data, but should allow

MISPL expressions allow fine-tuning for

selection criteria such as patient age,
patient location, test requestor, etc. At

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Glims
Laboratory Information System

Microbiology
run time, the analyst can decide to sup-

press or add antibiotics for a specific

User-definable alarms and flags on

isolation, specimen and patient level

specimen. Intermediary reports can be

sent to inform the test requester of the
current status. Such intermediary results
may be "Negative after ... days' incubation", "Suspicion

of...",

etc. The data

model also offers the possibility of easy

database query for statistical or epidemiological purposes.

Highlights

Explicit support for all microbiologyrelated data (isolation, carriers, isolation tests, carrier tests, etc.)

Transfusion Management

Normalized, relational data model

The blood transfusion management has

Seamless

integration

with

other

Glims modules

Multiple specimens per order

User-definable specimen information

(method, location, etc.)

three constituent parts. The first part

handles the determination and storage
of blood groups, rhesus pheno types,
irregular antibody screening, typing and
the specification of antigens and antibodies.

Fast patient history retrieval

Dedicated result entry screens

Expert system support (e.g. for anti-

results, sex, age, previous transfusions,

biogram filtering)

etc. in order to decide whether to pro-

The requests for any of the above mentioned tests can be linked to previous

ceed or discontinue the request.

Based upon the data acquired, additional criteria can be specified.

to derive a valid result from sub-tests

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Glims
Laboratory Information System

Transfusion management

to check consistency of independ-

ties like blood group, rhesus and

ently obtained results as e.g. the

pheno

blood group which can be derived

types or even the authology and the

from the serum part and the erythro-

corresponding

cytes part;

There is provision for self-transfusion

to

effect

conditional

specified.

blood

bags

or

of

(urgent)

marking blood bags as discontinued

or expired, so that these blood bags

group, rhesus, phenotype, etc.

if

blood

blood product requests;

to check the reusability of previous

results with respect to the blood

person

for

queries for an up-to-date overview of

stored

result;

antigens

product data storage.

to check consistency of the current

result with respect to the previous

types,

will no longer be used in further

request

transfusions;

(avoiding unnecessary requests by

taking into account sex, age, etc.)

continued to indicate that those par-

to store the blood group, rhesus and

ticular requests need to be cancelled;

screening information in a person

oriented table;

to store absence or presence of antigens and antibodies like duffy, lewis,

etc.

blood requests can be marked as dis-

generation of order advice lists at

any time to obtain an up-to-date
overview

of

the

total

number

of

transfusion-ready blood bags;

Finally, the third part offers a complete
trace on blood bags during transfusion.

The second part is the management of

The transfusion trace includes the re-

the blood bag database, which allows

quest of blood products, the selection of

obtaining an overview of the current

blood bag supply with respect to the
different

manipulations

to

which

the

blood bags are submitted during the

transfusion

process. These manipula-

tions include:

data entry for new blood bags is performed manually or via barcodes.
This allows storing data on proper-

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Glims
Laboratory Information System

Anatomic pathology
Most of the results in a material examination are textual descriptions, but can
be more structured as well. E.g. for the
conclusion,

simple

text

might

do,

whereas the body contains more specific

and varied text results. All these results
are gathered in the material examination
on which the pathologist is working. For
each material exam GLIMS offers a compact overview of its results, the possibilblood bags based on a predefined com-

ity to manipulate the examination until a

patibility system, the physical or elec-

finished state and to produce reports for

tronic (Type and Screen) compatibility

it.

check, the checkout of blood bags, generation of a transfusion form and the
completion of a blood bag trace by the
transfusion data and a possible transfusion reaction. In some exceptional cases,
during the life cycle of the blood bag, it
may be returned to stock, or discarded
because of accident or expiry.

The anatomic pathology module also

supports image results which can contain both microscopic and macroscopic
images.

With the appropriate

editing

software installed, these images can be

edited and stored from the GLIMS application. Thanks to the MS Word reporting functionality in GLIMS, the anatomic

These situations are also supported in

pathology module also allows to include

GLIMS. Finally, this module allows re-

both macroscopic and microscopic im-

porting with respect to the transfused

ages on reports. These reports can also

blood bags.

contain very long texts as for example

an autopsy report.
The anatomic pathology module also

Anatomic pathology

offers support for different coding stan-

The anatomic pathology module is fully

dards, like SNOMED, ADICAP, ICD-9/10

integrated in GLIMS and supports the

etc.

processing

examinations.

module in GLIMS provides access to all

The module is suited for biopsy, cytol-

related chemical and microbiological in-

ogy as well as autopsy.

formation.

of

material

The

seamless integration of this

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Glims
Laboratory Information System

Billing
duced, etc. Private clinical labs typically
have to deal with invoicing for patients,
physicians

and

insurance

companies,

while hospital labs usually send billing

information to the hospital information
system which performs the actual invoicing. Industrial or commercial labs
should be able to create invoices for isThe

anatomic

pathology

module

of

suers,

object

suppliers,

veterinarians,

GLIMS is highly flexible thanks to its

animal owners, etc. In these cases spe-

possibility

personalized

cific negotiated price lists are used in-

schemes for material examinations and

stead of official price lists. Billing might

the

reusable

also be different for orders where a labo-

texts and information blocks. In the

ratory is operating as a sub-contractor.

mean time, you have an overview of

In Germany, Laborgemeinschaften per-

each material examination, you can eas-

form routine tests for physicians: these

ily fill in the results and you can follow

tests are billed directly to the physician.

up the evolution of the material exami-

In France, pharmacies interfere in the

nation. This module will give you both a

billing process. The VAT regime is also

detailed and compact solution for anat-

country and environment depending.

to

configure

possibility

to

configure

omic pathology.

From the outset, the GLIMS billing mod-

Billing

ule was designed to cope simultaneGLIMS

provides

an

extensive

billing

module. Since GLIMS is an international

product, it needs to cope with the billing
peculiarities in all supported environments.

ously with all these different requirements. The result is a general-purpose

billing engine that sets new standards in
flexibility.

Billing involves two major

steps: tariffication and invoicing. Tariffication is the actual price and debt calcu-

Clinical lab billing is usually highly regulated and consequently country dependant.

Local

legislation

specifies

billing

rules, price levels, documents to be pro-

lation while invoicing includes everything from generating electronic and paper invoices to payment follow-up.

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Glims
Laboratory Information System

Billing
The GLIMS billing engine supports the
tariffication for all the various lab services (both sampling and testing; as
well as microbiology and blood transfusion activities). It can be configured for
both individual or grouped billing.
Payment agreements, policies and price
lists as concepts, laboratories have great
flexibility in configuring which parties
(e.g. test requester, veterinarian, health
care insurance company or specimen
supplier) are involved in the billing proc-

additional charges (for urgent samples

or those analyzed at night, etc.).

ess, which billing codes to use, and at

which price. Several payers can be involved in a single order and customer
specific price lists can be established.
The billing engine also takes care of
multi-firm/multi-lab

environments

and

Calculation is the responsibility of the

billing engine. The results of the tariffication can be communicated to a hospital
information system using standard protocols like HL7.

sub-contracting. The definition of billing

rules supports the implementation of
test combination prohibited by specific

The GLIMS invoicing sub-module cre-

national reimbursement schemes. VAT,

ates the billing documents sent to the

different paying organizations. GLIMS
keeps track of invoices and credit notes.
Invoices are grouped in invoice summaries, if required, allowing for easier invoicing to large accounts. The layout of
all billing documents (e.g. certificates,
invoices, invoice summaries) is totally
user-definable. GLIMS keeps track of the
documents produced. GLIMS allows invoices to be communicated to a separate
accounting system.

16

Glims
Laboratory Information System

Statistics

Variable document layouts (e.g. Certificates, Invoices, Invoice summaries)

Communication with hospital information and external accounting systems

Statistics
Highlights
GLIMS comes with an extensive statis-

Support for medical and industrial

tics module covering production, micro-

laboratories

biology, blood transfusion and finance.

Multiple internal accounts

Individual or grouped billing of lab

All modules have a uniform look and

services (both sampling and testing;

feel, though differ in some detailed as-

including

blood

pects typical to the kind of statistics re-

transfusion activities) by means of

quired. Guidance by the GLIMS statistics

internal billing codes.

wizard makes the collection and display

microbiology

and

Payment agreements allow definition

of different payer categories (e.g. the

of the statistical data now easier than

ever.

prescribing Doctor, Patient, Veterinarian, Health Care Insurance Com-

The user can choose from a wide variety

pany, Sample supplier,etc.)

of selection and classification options.

Multiple payers per order

The statistical results can be consulted

Customer specific price lists

Configurable cummulation and exception rules

VAT calculation

Supplementary

calculation

(administrative procedures, emergencies, ...)

17

Glims
Laboratory Information System

Urgency monitor
and

edited

through

different

output

channels.

gent orders that have not been entirely

completed. Depending on the time since
order creation, the order is shown in a
The data can be printed, directly be dis-

different color.

played on screen in different formats,

saved into a file for use with third party
applications like MS Excel, MS Access
or any web browser and even emailed to
one or more contact persons.

The user can choose from a wide range

of selection options for the orders as e.g.
the minimal urgency, maximal result
status, the issuer, the department In
addition, the display setting (colors, re-

Highlights

fresh period) of the urgency monitor

can easily be customized.

Fully integrated in GLIMS

Guidance by GLIMS statistics wizard

Uniform look and feel of all statistics

Communication
modules.

MIPS places a very high priority in its

products ability to communicate with

Extremely flexible selection and classification options

many peripheral applications, including

analyzer control software, hospital infor-

Open-ended: results can very easily

mation systems (HIS), general practitio-

be loaded into 3rd-party software

ners systems, insurance systems and

web browsers.

Urgency monitor
The standards supported include HL7,
The urgency monitor program shows a
continuously updated overview of ur-

HPRIM, LDT, ASTM and Edifact.

18

Glims
Laboratory Information System

Communication
The complete list is much longer since
we have a lot of connections based on
local or national standards and connections with legacy systems. GLIMS is
able to communicate with several hospital information systems simultaneously
to support laboratories servicing several
hospitals. Each hospital may have its
own identification system and an unlimited number of patient identifiers can be
stored.

Available platforms
The flexibility of the MIPS products is
one of their main features and allows us
to deploy them on many different hardware platforms. MIPS has no preferred
relationship whatsoever with any hardware supplier and strives to maintain
this independence. Most of the server
systems sold run on Windows 2000 or
Unix (HP, Sun Solaris, IBM, etc). GLIMS
clients typically run on Windows NT or
Windows 2000 PC's. Host-based configurations without clients are also possible, using terminal servers (MS Terminal Server Client, Citrix, etc.) or the
GLIMS TTY interface.