It has been estimated that 70% of all medical decisions are based on laboratory results, test results play an integral part in the clinical outcome of a patient and can often mean a life or death decision for the physician. Laboratories increasingly recognize the value of implementing lab informatics and information technologies that allow them to enhance the way in which test results are being handled and reported.
The Power of Automation
As the central reference laboratory for New England, UMass Memorial Medical Center in Worcester, Massachusetts, deals with 4,000 to 5,000 specimens daily and eight and a half million lab tests annually. With lab work volumes of this size coming in and out each day, it would be impossible to deliver results as quickly and accurately as needed without valuable technologies that allow for automation and connectivity among the hospital networks.
Like many hospitals, UMass turned to scripting to automate a variety of tasks and processes, including dictionary synchronization, system conversion, data merge from one system to another and inventory updates. The benefit of scripting lies in the technology's ability to electronically mimic exactly what the user would do manually. This is done by recording the developer's every step as he performs the process as a user would, allowing for any exceptions that may take place and creating the appropriate mechanisms for handling them.
The UMass laboratory department uses Boston Software Systems' scripting and integration technology, Boston WorkStation, to create multiple interfaces that work to automate and streamline the orders, data entry and results reporting processes. The automation interface that is integrated into their Laboratory Information System (LIS) enables specimens to be automatically run through a bar-coded recognition, specimen information uploaded into the LIS, and tests automatically processed and reported out to the appropriate physicians. Additionally, physicians can easily access the lab results from anywhere through the Web-based reporting system, as long as the patient is registered.
Real-time Results
The most important factor when it comes to results reporting is the need to turn the tests around as quickly as possible, particularly if they are critical or life-threatening. In the days before automation and lab informatics, technicians were required to manually enter each order and result into the system and send the test report via courier back to the customer site. Physicians didn't received results until days later. That is unacceptable by today's
hospital standards.
With Boston WorkStation scripting and automation technology implemented in the laboratory, physicians can have results in their hands within an hour from the specimen's arrival in the lab. The ability to report results in real-time not only significantly cuts reporting time from days down to minutes but also reduces the number of employees to half of what was needed at the facility using a manual process. This is a change that is vital to realizing optimal patient care while maintaining costs at a minimal level.
Safety and Quality Improvements
In efforts to improve patient care, The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) established standards for safety and quality assurance. An automated system plays an essential role in ensuring these standards are met in the lab. At UMass Memorial, the reporting of "critical results," or those that are life-threatening, is automated in association with the JCAHO requirements to ensure the highest level of safety and quality. When a "critical result" emerges, the result is automatically reported from the lab to our customer service department, which then notifies the appropriate physician immediately. Using this automated technology, UMass significantly reduces the potential for errors.
Technology: A Valuable Tool in the Lab
As UMass looks back on the drastic improvements lab informatics has brought to test utilization, there is one thing it can be certain of. UMass recognizes the need for employing technology in the laboratory in order to continually improve the quality of care and enable physicians to receive results more rapidly and accurately than ever before.
