Azzato Elizabeth M, Morrissette Jennifer J D, Halbiger Regina D, Bagg Adam, Daber Robert D
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
J Pathol Inform. 2014 Aug 28;5(1):29. doi: 10.4103/2153-3539.139709. eCollection 2014.
At some institutions, including ours, bone marrow aspirate specimen triage is complex, with hematopathology triage decisions that need to be communicated to downstream ancillary testing laboratories and many specimen aliquot transfers that are handled outside of the laboratory information system (LIS). We developed a custom integrated database with dashboards to facilitate and streamline this workflow.
We developed user-specific dashboards that allow entry of specimen information by technologists in the hematology laboratory, have custom scripting to present relevant information for the hematopathology service and ancillary laboratories and allow communication of triage decisions from the hematopathology service to other laboratories. These dashboards are web-accessible on the local intranet and accessible from behind the hospital firewall on a computer or tablet. Secure user access and group rights ensure that relevant users can edit or access appropriate records.
After database and dashboard design, two-stage beta-testing and user education was performed, with the first focusing on technologist specimen entry and the second on downstream users. Commonly encountered issues and user functionality requests were resolved with database and dashboard redesign. Final implementation occurred within 6 months of initial design; users report improved triage efficiency and reduced need for interlaboratory communications.
We successfully developed and implemented a custom database with dashboards that facilitates and streamlines our hematopathology bone marrow aspirate triage. This provides an example of a possible solution to specimen communications and traffic that are outside the purview of a standard LIS.
在包括我们机构在内的一些机构中,骨髓穿刺标本分类工作很复杂,血液病理学分类决策需要传达给下游辅助检测实验室,并且许多标本分装转移是在实验室信息系统(LIS)之外处理的。我们开发了一个带有仪表盘的定制集成数据库,以促进和简化这一工作流程。
我们开发了用户特定的仪表盘,允许血液学实验室的技术人员输入标本信息,具有定制脚本以向血液病理学服务部门和辅助实验室呈现相关信息,并允许将血液病理学服务部门的分类决策传达给其他实验室。这些仪表盘可通过本地内联网进行网络访问,并且可以在计算机或平板电脑上从医院防火墙后面访问。安全的用户访问和组权限确保相关用户可以编辑或访问适当的记录。
在数据库和仪表盘设计完成后,进行了两阶段的测试和用户培训,第一阶段侧重于技术人员的标本录入,第二阶段侧重于下游用户。通过数据库和仪表盘重新设计解决了常见问题和用户功能请求。最终实施在初始设计后的6个月内完成;用户报告称分类效率提高,实验室间沟通需求减少。
我们成功开发并实施了一个带有仪表盘的定制数据库,该数据库促进并简化了我们血液病理学骨髓穿刺分类工作。这为标准LIS范围之外的标本通信和流转问题提供了一个可能的解决方案示例。