Diagnosis: Medical INFORMATICS: MIDDLEWARE
• Middleware is a bundle of software that is layered between laboratory instruments and the laboratory information system (LIS). Generally, middleware allows interfacing of multiple instruments and information systems using different communication protocols.
• Middleware can meet the needs of the laboratory by applying rule-based algorithms (e.g., if-then statements) for quality control rules, autoverification, delta checks, critical value flags, reflex test ordering, and specimen archiving. These rule-based algorithms are also known as “expert-systems.”
• Total laboratory automation requires middleware to operate as the controller of specimen routing, load balance, and specimen archiving and retrieval.
• Just as all LIS are different; middleware products are also different, middleware products are also different. Selection of the appropriate middleware products will depend on the functions of the laboratory information systems and the types of enhancements that are needed.
