TY - JOUR
T1 - Implementation of a Laboratory Information Management System (LIMS) for microbiology in Timor-Leste
T2 - challenges, mitigation strategies, and end-user experiences
AU - Oakley, Tessa
AU - Vaz, Juliao
AU - da Silva, Fausto
AU - Allan, Raikos
AU - Almeida, Deonisia
AU - Champlin, Karen
AU - da Silva, Endang Soares
AU - Tilman, Ari Jayanti
AU - Marr, Ian
AU - Smith-Vaughan, Heidi
AU - Yan, Jennifer
AU - Francis, Joshua R.
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Effective diagnostic capacity is crucial for clinical decision-making, with up to 70% of decisions in high-resource settings based on laboratory test results. However, in low- and middle-income countries (LMIC) access to diagnostic services is often limited due to the absence of Laboratory Information Management Systems (LIMS). LIMS streamline laboratory operations by automating sample handling, analysis, and reporting, leading to improved quality and faster results. Despite these benefits, sustainably implementing LIMS in LMIC is challenging due to high costs, inadequate infrastructure, and limited technical expertise. Methods: This study evaluated the implementation of a customised microbiology LIMS at the National Health Laboratory (NHL) in Timor-Leste. The LIMS was deployed in November 2020, with an accompanying online results portal introduced in early 2021. The implementation was assessed via a checklist based on key challenges and requirements for LIMS in LMIC, alongside a post-implementation survey of scientists and clinicians. RESULTS: The assessment revealed significant improvements in laboratory processes, including enhanced sample throughput, data management, and result reporting. The LIMS reduced transcription errors and standardised reporting of antimicrobial susceptibility testing (AST), improving data quality and accessibility. However, challenges such as unreliable internet connectivity and the need for ongoing funding and technical support persist. The user satisfaction survey, with responses from 19 laboratory scientists and 15 clinicians, revealed positive feedback on workflow improvements and result accessibility, although concerns about internet speed, sustainability, and the need for further training were noted.Conclusion: This study highlights the importance of careful planning, customisation, and stakeholder engagement in LIMS implementation in LMIC. The success in Timor-Leste demonstrates the potential for improved laboratory quality and patient outcomes, but also underscores the need for ongoing investment in infrastructure, technical expertise, and sustainability planning.
AB - Background: Effective diagnostic capacity is crucial for clinical decision-making, with up to 70% of decisions in high-resource settings based on laboratory test results. However, in low- and middle-income countries (LMIC) access to diagnostic services is often limited due to the absence of Laboratory Information Management Systems (LIMS). LIMS streamline laboratory operations by automating sample handling, analysis, and reporting, leading to improved quality and faster results. Despite these benefits, sustainably implementing LIMS in LMIC is challenging due to high costs, inadequate infrastructure, and limited technical expertise. Methods: This study evaluated the implementation of a customised microbiology LIMS at the National Health Laboratory (NHL) in Timor-Leste. The LIMS was deployed in November 2020, with an accompanying online results portal introduced in early 2021. The implementation was assessed via a checklist based on key challenges and requirements for LIMS in LMIC, alongside a post-implementation survey of scientists and clinicians. RESULTS: The assessment revealed significant improvements in laboratory processes, including enhanced sample throughput, data management, and result reporting. The LIMS reduced transcription errors and standardised reporting of antimicrobial susceptibility testing (AST), improving data quality and accessibility. However, challenges such as unreliable internet connectivity and the need for ongoing funding and technical support persist. The user satisfaction survey, with responses from 19 laboratory scientists and 15 clinicians, revealed positive feedback on workflow improvements and result accessibility, although concerns about internet speed, sustainability, and the need for further training were noted.Conclusion: This study highlights the importance of careful planning, customisation, and stakeholder engagement in LIMS implementation in LMIC. The success in Timor-Leste demonstrates the potential for improved laboratory quality and patient outcomes, but also underscores the need for ongoing investment in infrastructure, technical expertise, and sustainability planning.
KW - Health infrastructure
KW - Implementation
KW - Laboratory Information Management System (LIMS)
KW - Low- and middle-income countries (LMIC)
KW - Microbiology
KW - Sustainability
KW - Timor-Leste
UR - http://www.scopus.com/inward/record.url?scp=85216181146&partnerID=8YFLogxK
U2 - 10.1186/s12911-024-02831-6
DO - 10.1186/s12911-024-02831-6
M3 - Article
C2 - 39825312
AN - SCOPUS:85216181146
SN - 1472-6947
VL - 25
SP - 32
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 32
ER -
