How to Automate Laborie

A urodynamics study is the evidence a pelvic health clinic argues from

Laborie is a medical device company working in pelvic health, gastroenterology and maternal and child health. In urology and urogynecology it makes the urodynamics systems themselves, the NXT family alongside the Goby, Solar Blue and Aquarius ranges, and the NXT Synergy software that records and stores each study.

Synergy is where the study lives: vesical, urethral and abdominal pressures, urine flow and volume, and pelvic floor EMG, captured during the test and kept afterwards. It runs on the workstation beside the equipment, with report layouts you configure and HL7 and DICOM connectivity to send the finished study into the record system.

That trace is the most consequential hour in the whole pathway. A midurethral sling, a course of pelvic floor physiotherapy, sacral neuromodulation, intradetrusor Botox: each is argued for out of what the study showed, and a payer will ask to see it.

The test lasts an hour and its consequences last months

The study itself is the straightforward part. Everything it sets in motion happens elsewhere, and slowly.

The patient has to arrive having kept a three-day bladder diary, and diaries do not fill themselves in. The slot has to be booked against both a machine and a trained technician, so when somebody cancels on Monday that hour is worth finding another patient for. The report has to reach the referring clinician while the decision is still live.

Then the paperwork the study exists to support. A prior authorisation for sacral neuromodulation needing the urodynamic findings attached. A bladder Botox request needing the diagnosis on file. A pelvic floor physiotherapy referral needing the findings summarised and the first appointment confirmed. A post-operative voiding trial to be read against the baseline the study established.

Each of those sits in a different system, belonging to a different organisation, and each of them stalls quietly.

Laborie

Test days not lost to missing intake Upcoming studies checked against whether the three-day bladder diary and the pre-test questionnaire actually came back, days before the appointment.

A cancelled slot offered to somebody Monday's dropped appointment matched against the people waiting for testing, with an offer drafted for a member of staff to read and send.

Authorisations that stopped moving Neuromodulation and bladder Botox requests checked on the payer's site each morning, so a stalled one is chased in week one.

Synergy records the study and stops at the study

The software does its own job well, and none of what follows is a complaint about it.

NXT Synergy offers customisable workflows and reports, configurable channel visibility and control panels, automatic artifact detection, auto flow detection with auto-start, automatic post-void residual measurement, and event markers placed and edited during the recording. Report configurations can be saved and reused, and EMR and networking connectivity over HL7 and DICOM is offered so a finished study reaches the record system instead of staying on the machine.

That is a diagnostic instrument doing what a diagnostic instrument should: capture the trace faithfully, present it clearly, hand it on.

What it was never built to do is watch what happens next. The payer's authorisation portal, the record system where the referral was written, the scheduling calendar, the physiotherapy clinic's booking software, the laboratory holding a urine culture: all of those belong to other organisations, and a urodynamics workstation sits in a procedure room with no view of any of them.

A pressure trace gets consulted long after the catheter comes out

The study finishes within the hour. The clinic keeps referring back to it for months, and that referring back is work somebody currently does by hand.

Pending authorisations for neuromodulation and bladder Botox checked on the payer's portal every morning, so a request that stopped moving is chased in week one rather than discovered on the morning of the procedure.

Upcoming studies checked against whether the bladder diary and the pre-test questionnaire have actually come back, so a test day is not spent on missing intake. A cancelled slot matched against the people waiting for one, with an offer drafted for staff to send.

Post-operative voiding trials and post-void residuals gathered and set beside the baseline the study established, so a failed trial reaches a nurse the same day. Urine culture results read from the laboratory's site and checked against who is booked for testing this week, since a positive result changes the plan. Physiotherapy referrals followed on the receiving clinic's system, so an appointment that was never made is visible while it still matters.

In a urodynamics service that division is permanent. Reading screens and assembling lists can run unattended. Every alteration to a record, and every contact with a patient, is written up first and stops with a person qualified to send it.

The study record ends up where a browser can reach it

Almost none of that follow-up happens on the urodynamics workstation. It happens in the record system, the payer portal, the scheduling calendar and the referring practice's software, and every one of those opens in a browser.

WebRun is an AI agent that drives a real Chrome browser, signed in the way your staff sign in. It opens the record system, the payer site, the laboratory and the physiotherapy clinic's booking software, reads what each shows, and brings back a worked list with the dates attached.

It runs on your schedule in your own private environment. A workflow can be locked to a named list of domains, sessions are not shared between workflows, and a run can be watched and stopped. The judgement stays with the clinician; only the fetching moves.

Each workflow below names the systems it opens.