How to Choose a Laboratory Information System in 2026

Choosing a laboratory information system comes down to four things: whether it was built for your testing mix, how many interfaces it must support, whether billing belongs inside it, and how much validation and migration work your team can absorb. A pathology lab, a physician office lab and a hospital outreach lab need very different systems, so start with the work, not the vendor list.

Define your lab type and testing mix

LIS vendors tend to specialize, even when their websites list every discipline. Before any demo, write down your main volume by discipline and the share of revenue each brings in. That short list rules out half the market.

• Anatomic pathology, cytology and histology: you need case accessioning, gross and microscopic workflows, block and slide tracking, case routing to pathologists by subspecialty, and synoptic reporting based on CAP cancer protocols.
• Clinical chemistry, hematology and microbiology: analyzer interfaces, autoverification rules, QC tracking and fast result release matter most.
• Molecular and genetics: look for batch and plate handling, reflex and add-on testing, and reports that carry complex interpretive text.
• Physician office labs: simple order entry, a handful of analyzers, CLIA paperwork and results that flow straight into the practice EHR.
• Hospital labs: if the hospital already runs Epic, the lab module inside that EHR may make more sense than any standalone LIS.

NovoPath, for example, is built around pathology and specialty workflows, while CGM LABDAQ targets physician office and small reference labs. Both are good systems, but each would be a poor fit in the other’s lab.

Think three to five years ahead, too. A lab planning to add molecular testing, open a second site or build an outreach business needs a system that handles multiple locations, client billing and new disciplines without a second LIS. Ask vendors how existing customers have grown on the platform, and what the license cost looked like when they added a site or a discipline. Replacing an LIS twice in five years is far more expensive than buying a bit more capacity than you need today.

Must-have features for daily lab work

Once the system matches your disciplines, judge how it handles the work your staff repeat hundreds of times a day.

• Specimen tracking from collection through accessioning, processing, storage and disposal, with barcode labels at every step.
• Order entry from client EHRs and a web portal for clients without an interface.
• Rules for specimen requirements, so a wrong tube or missing source is caught at accessioning rather than after testing.
• Autoverification and delta checks for clinical results, and workload-based case distribution for pathology.
• Turnaround time dashboards by test, client and pathologist.
• Report templates your own staff can change without a vendor ticket.
• Audit trails for every result change, amended report and user action.

That last point about configuration deserves weight. Labs add tests, clients and report formats constantly. NovoPath lets lab staff change workflows and report templates themselves, which saves weeks compared with waiting on a vendor’s queue. Ask every vendor which changes you can make on your own and which require their team, and what they charge for the second kind.

Count every interface before you compare prices

Interfaces drive much of an LIS project’s cost and timeline. List every connection the system must support:

1. Each analyzer and middleware connection, with model numbers.
2. Client EHRs that send orders and receive results, usually through HL7 v2 order and result messages.
3. Reference labs you send tests out to.
4. Billing systems or clearinghouses.
5. Public health reporting for notifiable conditions.
6. Digital pathology scanners and image management systems, if you use them.

Then ask each vendor how many of those interfaces already exist, who builds new ones and how they are priced. Some vendors charge per interface. Others do not: LigoLab prices by testing volume rather than per user, module or interface. NovoPath says it offers more than 100 prebuilt connections to EHRs, instruments and other tools. Also ask whether the system uses LOINC codes for results, since clients and public health agencies increasingly expect standard coding.

Middleware is the other variable. Many labs run instrument middleware between analyzers and the LIS for autoverification and QC rules. Find out whether the new LIS can take over that work, or whether you will keep paying for middleware alongside it. Either answer is fine, as long as you know it before you sign.

Decide where billing lives

Lab billing is unusually complex. Claims depend on CPT codes, medical necessity, ABNs for Medicare patients and, for many molecular tests, MolDX requirements such as DEX Z-Codes. Missing data at accessioning becomes a denied claim weeks later.

You have two options. An LIS with built-in revenue cycle management, such as LigoLab, keeps results and billing in the same data, so missing diagnosis codes or insurance details can be flagged before the specimen is even tested. A separate billing system or outsourced billing company can work well too, but only if the interface passes complete, clean data. Ask to see a full order flow from requisition to claim, including how the system handles a missing ICD-10 code.

Check compliance, security and deployment

An LIS sits at the center of your regulatory obligations. CLIA requires documented procedures, quality control and result reporting, and CAP-accredited labs must validate their LIS and keep records of that validation. Ask vendors for validation templates and evidence that their releases are tested before they reach you.

On security, you need a signed business associate agreement under HIPAA, role-based access and complete audit logs. For cloud systems, ask for independent assurance such as a SOC 2 Type II report, which NovoPath holds. Also review the 21st Century Cures Act information blocking rules with your clients, since results now often reach patient portals quickly and report wording matters.

Deployment is the last piece. Cloud systems remove server maintenance and simplify remote sign-out. Server-based options suit labs with strict hospital IT policies. LigoLab offers both. Whichever you choose, get uptime commitments, backup terms and data export rights in the contract, including what format you receive if you leave.

Budget for the real total cost

Most LIS vendors quote prices after a discovery call, based on test volume, users, modules and interfaces. A few reference points help set expectations:

• CrelioHealth publishes pricing: its Pure POL plan for low-volume physician office labs is $300 a month plus $2,500 onboarding, and its Smart plan starts at $600 a month for one user and two analyzers, billed annually.
• LigoLab says labs with software budgets under $2,000 a month may not be a fit, which gives a sense of where full-featured platforms begin.
• Enterprise systems typically involve multi-year contracts, implementation fees and annual support.

Add interfaces, validation labor, data migration, training and any hardware such as label printers and scanners. Then weigh the total against current costs: overtime spent on manual entry, denied claims and slow turnaround that costs you clients. For prices and ratings on all six systems we track, see our ranked list of the best laboratory information systems.

Plan validation, migration and go-live

An LIS go-live is a project, not an install. Ask each vendor for a written implementation plan that covers:

1. Building the test compendium, reference ranges and report templates.
2. Interface development and testing with every analyzer and client.
3. Migrating historical results or archiving them in a searchable form.
4. Validation scripts and parallel testing before cutover.
5. Training for accessioners, techs, pathologists and client services.
6. Support coverage during the first weeks after go-live.

Timelines vary widely. CrelioHealth quotes about two weeks for self-service Smart setup and eight weeks for its assisted Optimized plan, while larger pathology and hospital projects take several months. During demos, run your own cases: a frozen section, an add-on test, a corrected report or a specimen that arrives mislabeled. Then call reference labs of your size and ask what went wrong at go-live and how quickly the vendor fixed it.

Questions to ask in every demo

• Which of our disciplines is your system built for first?
• How many of our analyzers and EHR clients already have working interfaces?
• How are new interfaces priced and built?
• Which workflow and report changes can our staff make without you?
• Does billing run inside the LIS or through an interface?
• What validation documents do you provide for CLIA and CAP?
• What is the implementation timeline and staff time required?
• In what format do we get our data back if we leave?

Frequently asked questions