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FEATURE LABORATORY MANAGEMENT


interfaces which can limit and dumb down functionality on both sides. It ensures the accuracy and timeliness of results and a streamlined workflow across departments. By grouping results into clinical panels such as Haematology, Chemistry, Immunology etc., the EMR makes clinical sense to physicians. Graphing of current and historical clinical results allows physicians to make an intuitive interpretation of results. By illustration, one of the ways that the


Blood Bank Unit would integrate with the EMR can be seen in the case of transfusion data. Information regarding blood samples and patient data is shared between the two systems in real time. Electronic cross-matching saves critical testing time by checking for incompatibility between a patient’s blood and a unit of blood or blood product, prior to transfusion. All data relevant to transfusions, such as patient vital signs and transfusion reactions, is available in the EMR. Furthermore, the function of bedside verification allows nursing staff to use bar code readers to scan and match products, such as checking blood product expiration dates. A fully integrated LIS, not only tightly


integrates with the EMR, but also with various other ancillary systems, belonging to order management solutions, care rooms, emergency departments, pharmacy solutions and administrative modules providing patient census and demographic information. Thus, integration simply means that all these applications share the same database. For example, the laboratory is able to alert the pharmacist to critical care situations, such as when a patient is resistant to an antibiotic prescribed by a physician.


INTEROPERABILITY The trend towards community health networks demands that the LIS caters for greater interoperability and information sharing. Interoperability eliminates silos of information from within the walls of the hospital, by allowing disparate systems to interact with each other across on increasingly larger geographic area. Thus, the LIS needs to operate as an


information hub enabling the optimization of data. For example, the LIS should enable the seamless exchange of electronic orders and results with external reference laboratories. This reduces the manual keying in of results and the associated


“The laboratory is able to alert the pharmacist to critical care situations, such as when a patient is resistant to an antibiotic prescribed by a physician”


human error, which in turn promotes an accurate patient record in the EMR. It should also include a platform where non-affiliated clinicians can quickly and securely place and view electronic orders. An LIS that functions inter-operably enables all the results of point of care testing to be automatically transmitted from the patient’s bedside to the laboratory, thus eliminating retrospective resulting and reducing prolonged


turnaround times and data capture errors. The LIS should also have the capability


to capture and connect external data to the EMR, such as insurance cards, consent forms or any other externally generated data. It is common for this non-clinical data to fall through the cracks. This creation of a unified and managed infrastructure for content capture, archive and retrieval, enhances decision making capabilities and moves healthcare organizations toward powerful EMR systems.


NOTIFICATIONS According to the Joint Commission of Accreditation of Healthcare Organizations (JCAHO), the clinical laboratory produces nearly 80% of the information that physicians use for medical decision making. However, what use are these results


if they are not received in real time by clinicians? An effective LIS should automatically notify the physician of 


MedLab Issue 2 2011 23


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