Most laboratories have needs and concerns that are unique and often-changing.  Though most “off-the-shelf” Laboratory Information Management Systems are widely marketable, they are generally an approximate fit, at best, for any particular environment.  The exact functionality needed by users suffers due to the constraints of the LIS's architecture.  What is present and applicable is generally awkward to use, with work-arounds and inconveniences for the laboratory staff.     Laboratories often find that a large percentage of their software cost is, in fact, for tag-along capabilities which have no utility in their environment.  And, more than likely, there is some needed functionality which would really help smooth out the workflow, but it is typically unavailable.  If it can be provided by customization, it will be at exorbitant cost.   ·       Labs grow in size under their own power. Labs also frequently acquire, or are acquired by, other laboratories. Typically, acquisitions mean coping with non-compatible system(s), and also differently formatted legacy data. ·       Acquired labs and/or independent divisions within a single institution need different software applications to process their specific tests.   ·       Test offerings change over time.   Protocols change over time.   Healthcare regulations and requirements change.    As a result many systems are quickly outdated and a laboratory can easily become shipwrecked, both functionally and economically.      On the positive side, the good that you as a laboratory may receive with many vendors is a rapid installation.  Also, you may be motivated by the security of basic utility based on a track record of a certain number of years in the business, and perhaps the thought that the vendor will still be around tomorrow if you need them to honor any guarantees.  The truth remains, however, that your efficiency, accuracy, and competitiveness will suffer as long as the system that you are using demonstrates poor performance and can not keep up with all the changes.                                                                                                                                 Why ALIS?