Jones Richard G, Johnson Owen A, Batstone Gifford
Deputy Director, Yorkshire Centre Health Informatics, University of Leeds, Leeds, UK;
School of Computing, University of Leeds, Leeds, UK;
Clin Biochem Rev. 2014 Aug;35(3):177-92.
The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, 'Informatics' - the art and science of turning data into useful information - is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology - whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients - which requires critical assessment of the ever-increasing volume of information available - can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a need to rethink the architecture of pathology systems and in particular to address the changed environment in which electronic patient record systems are maturing rapidly. The opportunity for laboratory-based informaticians to work collaboratively with clinical systems developers to embed clinically intelligent decision support systems should not be missed.
在工作量增加、成本限制和技术进步的综合压力下，病理服务的性质正在发生变化。面对这种情况，实验室系统需要满足与临床电子记录系统进行数据交换以进行检验申请和结果报告的新需求。随着这些需求的发展，新的挑战也在出现，特别是在正在交换的数据集的格式和内容方面。如果要在这两个领域实现智能系统的潜力，临床医生和实验室信息专家之间持续的对话至关重要。病理学中信息技术（IT）的要求现在远远超出了提供纯粹分析数据的范畴。为了实现实验室数据与整个临床路径的无缝集成，“信息学”——将数据转化为有用信息的艺术和科学——在检验医学中变得越来越重要。信息学在病理学中是一个强大的工具——无论是在实施病理学现代化流程、引入新的诊断方式（如蛋白质组学、基因组学）、提供及时且基于证据的疾病管理，还是在实现对有限且通常成本高昂的资源的最佳利用方面。向有能力且感兴趣的患者提供适当信息——这需要对不断增加的可用信息量进行批判性评估——也能从信息学在增强慢性病自我管理方面的适当应用中大大受益。本综述探讨了在医疗保健服务更广泛的发展变化背景下对病理信息系统日益增长的需求。医学信息学的总体趋势反映在检验医学当前的优先事项中，包括对统一电子记录、计算机化医嘱录入、数据安全与恢复以及审计的需求。我们得出结论，有必要重新思考病理系统的架构，特别是要应对电子病历系统迅速成熟的变化环境。不应错过基于实验室的信息专家与临床系统开发者合作嵌入临床智能决策支持系统的机会。
