An information system for improving clinical laboratory outcomes.
(9/223)
Laboratories performing clinical molecular diagnostic and cytogenetic testing require improved information systems to address their specialized data processing needs. We developed an application that automates result reporting, documents quality assurance information, and tracks specimens. While similar functionality was implemented in both the molecular diagnostic and cytogenetic modules, we present an outcome assessment of the cytogenetic laboratory's use of the system since it maintained a relatively constant number of personnel, test procedures, and samples over a three-year period. Upon implementation, significant reductions occurred in the time taken from receipt of sample to the release of the final report by 44% (P < 0.001) and 48% (P < 0.001) for peripheral blood and bone marrow samples, respectively. The number of cases processed per technologist increased by 26% (P = 0.017). We attribute these gains in quality improvement to the automation of clerical tasks and decision support provided by the information system. (+info)
Enrolling patients into clinical trials faster using RealTime Recuiting.
(10/223)
Previous work has been done on both optimizing the clinical trials process, and on sending critical laboratory results and decision support through paging systems. We report the first integration of both these solution, focusing on improving the clinical trial recruitment process. We describe a clinical trial needing a real-time method of recruiting patients in an unbiased manner, quickly enough that study tests can be obtained before patients leave or samples discarded. The report describes how the ten currently recruited patients were found and how diagnoses of potentially life-threatening disorders are being made. (+info)
Requirements of a Web-based experiment management system.
(11/223)
Recent advances in tools for scientific data acquisition, visualization, and analysis have lead to growing information management problems for medical research laboratories. An exponential increase in the volume of data, combined with a proliferation of heterogeneous formats and autonomous systems, has driven the need for flexible and powerful Experiment Management Systems (EMS). This paper provides a detailed analysis of the informatics requirements of an EMS, and proposes a new type of middleware called an EMS-Building Environment (EMSBE), which enables the rapid development of web-based systems for managing laboratory data and workflow. We describe the Web-Interfacing Respository Manager (WIRM), an open-source application server for building customizable experiment management systems. WIRM is being used to manage several ongoing experiments, including a natural language processor of radiological findings, and an interdisciplinary project for studying brain function. (+info)
A method for the automated mapping of laboratory results to LOINC.
(12/223)
LOINC is emerging as the standard for laboratory result names, and there is great interest in mapping legacy terms from laboratory systems to it. However, the mapping task is non-trivial, requiring significant resource commitment and a good understanding of the LOINC identifying attributes for the laboratory result names. Because the number of results in a laboratory system may range from around 500 to 2000 or more, manual, one-by-one matching, even with the aid of the RELMA matching tool provided by LOINC, is time consuming and laborious. Moreover, human variation may introduce mapping inconsistencies or errors. Through our experience mapping the results from a variety of laboratory systems to LOINC, an automated mapping method has been developed and is described in this paper. This method allows for data from the laboratory information system to be provided in a manner familiar to the submitting technician, and makes use of parsing and logic rules, combined with synonyms, attribute relationships and mapping frequency data, to perform automated matching to LOINC. (+info)
Coverage of neonatal screening: failure of coverage or failure of information system.
(13/223)
OBJECTIVES: To evaluate neonatal screening coverage using data routinely collected on the laboratory computer. SUBJECTS: 90 850 births in 14 North East Thames community provider districts over a 21 month period. METHODS: Births notified to local child health computers are electronically copied to the neonatal laboratory computer system, and incoming Guthrie cards are matched against these birth records before testing. The computer records for the study period were processed to estimate the coverage of the screening programme. RESULTS: Out of an estimated 90 850 births notified to child health computers, all but 746 (0.82%) appeared to have been screened or could be otherwise accounted for (0.14% in non-metropolitan districts, 0.39% in suburban districts, and 1.68% in inner city districts). A further 893 resident infants had been tested, but could not be matched to the list of notified resident births. The calculated programme coverage already exceeds the 99.5% National Audit Programme standard in 7/14 districts. Elsewhere it is not clear whether it is coverage or recording of coverage that is low. CONCLUSION: Previous reports of low coverage may have been exaggerated. High coverage can be shown using routine information systems. Design of information systems that deliver accurate measures of coverage would be more useful than comparison of inadequately measured coverage with a national standard. The new NHS number project will create an opportunity to achieve this. (+info)
Automation and high through-put for a DNA database laboratory: development of a laboratory information management system.
(14/223)
Automation and high through-put production of DNA profiles has become a necessity in every DNA database unit. In our laboratory we developed a Laboratory Information Management System (LIMS) controlled workflow architecture, which comprises a robotic DNA extraction- and pipetting-system and a capillary electrophoresis unit. This allows a through-put of 4,000 samples per person per year. Improved sample handling and data management, full sample- and batch-histories, and software-aided supervision of result data, with a consequent average turn-around time of 8 days, are the main features of our new system. (+info)
An integrated system for high throughput TaqMan based SNP genotyping.
(15/223)
We have developed an integrated laboratory information system that allows the flexible handling of pedigree, phenotype and genotype information. Specifically, it includes client applications for an integrated data import from TaqMan typing files, Mendel checking, data export, handling of pedigree and phenotype information and analysis features. AVAILABILITY: The SQL source code, sources and binaries of the client applications (NT and Windows95/98 platforms) and additional documentation are available at http://www.mucosa.de/. (+info)
The total laboratory solution: a new laboratory E-business model based on a vertical laboratory meta-network.
(16/223)
Major forces are now reshaping all businesses on a global basis, including the healthcare and clinical laboratory industries. One of the major forces at work is information technology (IT), which now provides the opportunity to create a new economic and business model for the clinical laboratory industry based on the creation of an integrated vertical meta-network, referred to here as the "total laboratory solution" (TLS). Participants at the most basic level of such a network would include a hospital-based laboratory, a reference laboratory, a laboratory information system/application service provider/laboratory portal vendor, an in vitro diagnostic manufacturer, and a pharmaceutical/biotechnology manufacturer. It is suggested that each of these participants would add value to the network primarily in its area of core competency. Subvariants of such a network have evolved over recent years, but a TLS comprising all or most of these participants does not exist at this time. Although the TLS, enabled by IT and closely akin to the various e-businesses that are now taking shape, offers many advantages from a theoretical perspective over the current laboratory business model, its success will depend largely on (a) market forces, (b) how the collaborative networks are organized and managed, and (c) whether the network can offer healthcare organizations higher quality testing services at lower cost. If the concept is successful, new demands will be placed on hospital-based laboratory professionals to shift the range of professional services that they offer toward clinical consulting, integration of laboratory information from multiple sources, and laboratory information management. These information management and integration tasks can only increase in complexity in the future as new genomic and proteomics testing modalities are developed and come on-line in clinical laboratories. (+info)