Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
IT Department, University Hospitals Leuven, Leuven, Belgium.
J Am Med Inform Assoc. 2020 Aug 1;27(8):1293-1299. doi: 10.1093/jamia/ocaa081.
The study sought to describe the development, implementation, and requirements of laboratory information system (LIS) functionality to manage test ordering, registration, sample flow, and result reporting during the coronavirus disease 2019 (COVID-19) pandemic.
Our large (>12 000 000 tests/y) academic hospital laboratory is the Belgian National Reference Center for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. We have performed a moving total of >25 000 SARS-CoV-2 polymerase chain reaction tests in parallel to standard routine testing since the start of the outbreak. A LIS implementation team dedicated to develop tools to remove the bottlenecks, primarily situated in the pre- and postanalytical phases, was established early in the crisis.
We outline the design, implementation, and requirements of LIS functionality related to managing increased test demand during the COVID-19 crisis, including tools for test ordering, standardized order sets integrated into a computerized provider order entry module, notifications on shipping requirements, automated triaging based on digital metadata forms, and the establishment of databases with contact details of other laboratories and primary care physicians to enable automated reporting. We also describe our approach to data mining and reporting of actionable daily summary statistics to governing bodies and other policymakers.
Rapidly developed, agile extendable LIS functionality and its meaningful use alleviates the administrative burden on laboratory personnel and improves turnaround time of SARS-CoV-2 testing. It will be important to maintain an environment that is conducive for the rapid adoption of meaningful LIS tools after the COVID-19 crisis.
本研究旨在描述实验室信息系统(LIS)功能的开发、实施和要求,以管理 2019 冠状病毒病(COVID-19)大流行期间的检验医嘱、登记、样本流程和结果报告。
我们的大型(每年>1200 万次检测)学术医院实验室是比利时严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)检测的国家参考中心。自疫情爆发以来,我们一直在并行进行超过 25000 次 SARS-CoV-2 聚合酶链反应检测,以进行标准常规检测。一个专门开发工具以消除主要位于分析前和分析后阶段瓶颈的 LIS 实施团队在危机早期成立。
我们概述了 LIS 功能的设计、实施和要求,这些功能与管理 COVID-19 危机期间增加的检测需求有关,包括检验医嘱管理工具、集成到计算机化医嘱输入模块中的标准化医嘱集、关于运输要求的通知、基于数字元数据表单的自动分诊以及建立与其他实验室和初级保健医生的联系方式数据库,以实现自动报告。我们还描述了我们挖掘数据并向管理机构和其他政策制定者报告每日可操作摘要统计数据的方法。
快速开发、灵活可扩展的 LIS 功能及其有效利用减轻了实验室人员的行政负担,并缩短了 SARS-CoV-2 检测的周转时间。在 COVID-19 危机之后,保持有利于快速采用有意义的 LIS 工具的环境将非常重要。