For most pathology programs, the Laboratory Information System (LIS) is the operational center of gravity. Everything flows through it, and every new integration can either strengthen that foundation or quietly undermine it.
This isn't news to us or to the labs we work with. When we surveyed our customers and broader network on Image Management System (IMS) selection criteria, LIS integration capability ranked third overall - outranking scanner compatibility, viewer features, and many other key factors.
Figure 1. LIS integration ranked third among IMS vendor selection criteria.
But capability isn't the same as readiness. A separate PathAI survey this year asked pathology leaders what actually held them back from going digital. The barriers weren't what they'd cited when asked about upfront concerns. Legacy LIS integration topped the list - existing systems that simply aren't designed for modern workflows. Close behind were fears of go-live disruption and the reality that most labs lack the IT bandwidth or vendor support to manage the complexity. Timeline uncertainty rounded out the picture.
The message from labs is consistent: get the integration right, or don't bother investing the time and resources.
For institutions running Epic Beaker as their LIS, the stakes are even higher. Epic Beaker deployments are rarely out-of-the-box—organizations build their operational workflows around years of institutional configuration, and any new platform needs to fit into that reality, not replace it. It's why PathAI has made LIS integration a core part of how we deploy AISight Dx, and why Epic Beaker has become the most common integration across our customer base.
Here's how we approach it - and what it looks like in practice.
What PathAI Is Doing Differently
PathAI's approach is to meet labs where their workflows already are. For customers that want to preserve their existing LIS-centric experience, AISight Dx can launch directly from Epic Beaker, fitting into the workflow pathologists are already comfortable with. For those looking to transition more responsibilities to their IMS such as case assignment, prioritization, reporting, AISight Dx can take on that role as well. Rather than prescribing a single model, AISight Dx supports the full range of workflows:
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LIS-Driven Launch: Pathologists prioritize cases from their Beaker worklist and launch directly into AISight Dx through a punchout link, with real-time digital case statuses indicating digital slide availability.
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IMS-Driven Launch: Pathologists work from the AISight Dx Case Assignment Dashboard, using filtering and sorting tools to manage their workload.
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Hybrid: Both workflows are available to pathologists to choose the approach that suits their preferences.
AISight Link: Building for Configurability
This flexibility is made possible by AISight Link, PathAI's middleware engine that manages bi-directional HL7 message exchange between AISight Dx and a lab's LIS. The full message stack - orders, case statuses, events, and diagnostic results - is configurable: PathAI works with you and your LIS vendor to define which messages are in scope at go-live, with the ability to phase in additional capabilities over time without interruptions. After each new interface is delivered, our team works directly with the LIS vendor's technical team to confirm which components of their build are transferable to future customers and align on a standardized timeline for enabling future interfaces of a similar scope. This ensures that every lab that follows benefits from the strong technical foundation already built.
Figure 2. LIS integration
Epic Beaker: The Proof is in the Pipeline
For institutions using Epic Beaker, our process was no different. PathAI onboarded our first Epic Beaker customer in 2024, conforming to Epic's integration specifications and configuring the AISight Link message stack defined during the project scope phase.
The day-to-day workflow is straightforward by design: Once an order is placed in Beaker, case metadata flows to AISight Dx so the platform is ready to receive and process slides as they are scanned and uploaded. As slides are ready for review, an external link is automatically populated back in the pathologist's Beaker worklist with a digitization status. From there, pathologists can see the digital status of a case at a glance - how many slides are available, whether the case is ready for review- without leaving their existing environment. When they're ready, launching into the AISight Dx viewer is a single click from within Beaker, opening directly to the case they're working on. No toggling between systems, no manual lookup, no disruption to the prioritization workflow they already know.
For labs that prefer to keep case management in AISight Dx, that option exists too. But for Epic Beaker customers, the LIS-driven workflow has consistently been the preferred path - and it shows. Epic Beaker is the most common LIS integration across our customer base, and the pathologists using it every day are the best measure of whether it actually works.
Supported Integrations
PathAI's Supported LIS Integrations program is designed to drive repeatability for platforms where we have already done the work to integrate with an LIS. For each supported LIS, PathAI and the vendor jointly define the full interface scope, confirm the build is transferable to future customers, agree on a fixed timeline, and document everything in a co-approved scope.
The practical result: LIS integrations in as little as four to eight weeks from kickoff to technical go-live for several systems, with the requirements-gathering phase largely eliminated and late-breaking issues significantly reduced by using interfaces that have been stress tested and are being used by peers at scale within their clinical use cases.
For Epic Beaker, that foundation is already in place - the interface has been built, tested with Epic's technical team, and validated in live production. Our implementation teams are not starting from a blank page.
FIgure 2. Autoresearch experiments for stain prediction.
Curious if your LIS is a supported vendor? Connect with our team to see the full list and find out what an implementation with your LIS could look like or learn more about becoming a supported vendor yourself. Contact our team: digitaldx@pathai.com
AISight® Dx is FDA-cleared for primary diagnosis in the US and CE-IVD marked for primary diagnosis in the EEA, UK, and Switzerland.
