Health Information System for MLS
Release patient results
: The results are added to the LIS, but they are not released to clients outside the laboratory until the results and quality control are reviewed and verified. Alternatively, autoverification can be used. In this case, the computer uses a set of instructions to determine if the results should be released. Because the results are not held up for manual review, autoverification is quicker. To help with verification, reference ranges and panic values can be programmed into the LIS.
Tracking of Goods
- Goods can be easily tracked/traced when they are managed by serial number or batch. Through that, the aging of products can also be monitored based on how long they have been in the warehouse.
Drugs and Consumable Issues and Returns to Patients
30 to 50 % of hospital charges are attributable to diagnostics, drugs, and consumables, and doctors get only between 10 to 20 percent. For both hospitals and patients, medicines and consumables take up the bulk of expenditure. This is why materials management is critical for hospitals to optimize investment in these kinds of consumable assets. While some hospitals have functional inventory databases, the lack of integration does not give them holistic information, and this affects decision-making, both on a managerial level and during day-to-day operations. For instance, some drugs are misplaced or misappropriated, or storages and surpluses may occur as a result of improper inventory controls in a traditional system. This is where materials management systems become advantageous. It provides an overview of the entire institution's purchasing and inventory control process. As a result, decision-makers can have more reliable information and can monitor the bigger picture.
History of the Laboratory Information System
A laboratory information system (LIS) is a computer network of hardware and software for receiving, processing, and storing laboratory data and information. It can interface with laboratory instruments to transfer data into patient records, evaluate quality control data, and store preventive maintenance records. Also, an LIS can interface with an HIS, pathology information system, and other information systems. An LIS is also a computer-based information management system created specifically for laboratories. An LIS is used to support workflows in the laboratory — as well as the repository to store laboratory data — while supporting the laboratory mission. The goal is to deliver correct and complete information to laboratory staff, managers, and customers as efficiently as possible by following four main processes.
Purchase Orders
A purchase order is a legally binding contract, which shows that the seller has already accepted the order issued by the buyer. It should contain information about the buyer and seller (name, address, contact details, etc.); order number and order date; item description (quantity, unit, and total price); shipping information (shipping date and address); billing address; and the authorized signature.
Purchasing
A purchase request marks the beginning of the procurement process. Using this form, the user notifies the purchasing department regarding the needed items and services. It contains the quantity, as well as a timeframe for the items requested. It has the necessary authorization information to proceed with the purchase. The requested items are then confirmed using the purchase order, and a supplier is nominated. Once completed, the order is sent to the supplier for processing. Finally, the items are checked during the receipt of the delivery. The receiver, which is usually the Central Supplies department, uses the purchase order as a basis for accepting the delivered items that should be checked for indents and damages. Afterward, the said items are then released to the requesting department.
Purchase Request
A purchase request or purchase requisition is a document that notifies the purchasing department that certain items or services need to be replenished. The document stipulates a timeframe and required quantities for the requested items. In certain instances, it also contains authorization to acquire assets. For enhanced accountability and documentation purposes, some companies require a purchase requisition for all purchases. Still, others only require them for specific kinds of purchases, such as those that would require greater capital outlay.
Comparison of Quotations and Preferred Vendors Purchase Quotations
A purpose quotation is a document for requesting prices and delivery information from a vendor before the purchase order. It can be created then sent to a vendor. When a response from a vendor is received, with a list of prices and delivery dates, the information can be entered into the purchase quotation. In this way, the complete history of the sourcing process can already be stored in the system. From the quotation, the right vendor of the purchase can be chosen based on the product or service, and increasing on-time delivery. A purchase quotation report allows the comparison of offers to pick the appropriate vendor for the purchase scenario. Afterward, the purchase order an already be created from the selected quotation.
Radiology Reporting
A radiology report is an official medical document that provides the details of the requested radiology examination and the procedure conducted by the radiologist. A qualified physician authorized by the health care institution interprets the report. The main objective of the report is to address the queries in the request. The findings in the report should consider both positive and negative findings, which should be stated, followed by the incidental findings. The basic sections of a radiology report enumerated in the American College of Radiology's practice guideline on communication must include administrative information, patient identification, clinical history, imaging technique, comparison, observations, summary or impression, and signature of the radiologist. The length of the report is dependent on the complexity and cost of the examination.
Areas of focus for the LIS
Adjusting the workflow in the laboratory • Developing management tools such as duty rosters • Improving laboratory record-keeping and management • Ensuring appropriate training of staff • Equipment maintenance procedures
Benefits and Continuous Quality Improvement
An LIS provides laboratories with a tool to aggregate, analyze, and manage laboratory data. Labs can compile information from the LIS and provide timely reports for surveillance, program management, and health policy formulation. As a result, the entire laboratory testing process and data management improve, providing better quality control (QC) and quality assurance (QA).
Analytical (Examination) Functions
An automated analyzer must link each specimen to its specific test request. This is best done automatically through the use of bar codes on the specimen label but can be done manually by the laboratory staff, who can link the sample at the instrument to the specimen number in the computer.
Periodic Physical Stock Taking and Adjustments with Tracking
An inventory count is a process where a business physically counts its entire inventory. A physical inventory may be mandated by financial accounting rules or tax regulations to place an accurate value on the inventory, or the business may need to count inventory so parts or raw materials can be restocked. A business may use the following tactics to minimize the disruption caused by physical inventory: • Inventory services provide labor and automation to count inventory and minimize shutdown time quickly. • Inventory control system software can speed up the physical inventory process. • A perpetual inventory system tracks the receipt and use of inventory and calculates the quantity on hand. • Cycle counting, an alternative to a physical inventory, may be less disruptive. The materials management systems offer all of these in addition to the barcode and RFID capability which are supplementary technologies placed to give the institution more accurate and less burdensome inventory counts.
Invoices
An invoice is also called a bill. It is a commercial document that indicates the product, the ordered quantity, and the agreed price. The supplier issues this to the buyer to show the products and services that were sold or provided to the buyer.
Autoverification
Any results generated must be verified (approved or reviewed) by the laboratory staff before the data are released to the patient report. Autoverification is a process where computer-based algorithms automatically perform actions on a defined subset of laboratory results without the need for manual intervention. Useful data for autoverification can include the display of "flags" signifying results that are outside the reference range values, the presence of critical values or panic values (possible life-threatening values), values out of the technical range for the analyzer, or results that fail other checks and balances built into the system.
Barcoding
Barcoding can facilitate the processing of clinical specimens. The figure above is an example of a bar-coded specimen label. The six-digit specimen number (398291) is bar-coded. The patient number, patient demographics, time/date, and test are written in normal readable letters.
History of the Laboratory Information System
Before 1970, health organizations developed their LIS to make data management and to report more efficiently. These LIS take considerable time and resources to implement. With the advent of technology, some laboratories were able to procure custom-built systems in the 1970s. In the following decade, laboratory instrument makers began to develop commercial LIS solutions designed to increase the efficacy of their particular merchandise. Still, these software-instrument solutions were narrow in focus, industryspecific, and required extensive customization. This resulted in large implementation expenses and long implementation times.
Admission
Before a patient is admitted to a health facility, an admissions counselor will call him or her to gather preliminary information, offer vital information concerning the hospital stay, and answer questions if there are any. Additionally, the physician may also schedule recurring medical exams, such as laboratory tests or X-rays, before hospitalization. Other routine tests can also be carried out on the day of admission. All these can be done more efficiently through the HIS.
Billing
Billing statements show all records on the invoices, payment, and the current balance of a patient's account. HIS is very useful for patients who require frequent health care services because numerous invoices can be combined, and a lump sum payment can be made. It is good practice to generate the billing statement regularly so that the institution could keep its collectible. HIS lists the outstanding balances of the patients. Any overdue payments may be checked easily. Also, balances of patients who only have minimal transactions are kept updated.
BizBox
Bizbox, Inc. was founded 25 years ago. Its very first hospital project was completed in 1994. The goal of the company is to improve work efficiency in health care institutions through software and to produce advanced solutions for better patient care. Today, it is among the top IT companies in the health care industry. Aside from being a certified Microsoft Gold Partner, it has also received the Independent Software Vendor (ISV) of the Year Award. It has fully integrated systems such as electronic health records (EHR) and document management system (DMS) that will streamline tasks and help provide better health services.
Purchase Returns along with Returnable/Non-Returnable Gate Pass
Defective or substandard quality goods, incorrect order delivery, and deteriorated purchased and sold items are usually common in business. These lead to purchase or sales returns. When purchased products are returned, the materials management system updates inventory levels to reflect the decrease in quantity. The movement of inventory is not limited to purchase returns. Supplies and equipment are also sometimes required to be taken out of the department for repairs or consignment. For temporary movement, a returnable gate pass is issued, whereas, for permanent movement, a non-returnable gate pass is given. The system can be configured to track returnable and non-returnable items or equipment. It can also be set to monitor due dates for returnable items and to provide detailed reports about the status of different inventory items.
Laboratory Reporting
Despite differences in presentation and form, all laboratory reports must possess common elements as required by institutional and company policies. They may also contain supplementary items not specifically require, but which the laboratory chooses to report to aid the interpretation of results of medical testing. For identification and filing purposes, some laboratory reports display elements with administrative or clerical information such as the following:
Documents
Documents are statutory requirements used during purchase and sales transactions. These ensure smooth transition and completion of the process.
Implementation and support
During the deployment or upgrade of the HIS, it is imperative that the vendor provides ample training and assistance to the users of the system. Consider vendors that offer 24/7 support through telephone or web services.
System backup
Each day, the data are to be copied to a tape, or other portable storage devices, and removed from the laboratory.
Disaster recovery
Every laboratory needs a plan to restore the system after system disruption by a storm, fire, or other hardware damaging situation.
Relationship of Health Applications and Technologies
Furthermore, to communicate between those applications or health technologies, hospitals should specify communication standards such as Health Level (HL) 7, Digital Imaging and Communications in Medicine (DICOM), and Clinical Context Object Workgroup (CCOW). The figure below shows the relationship between health applications and technologies.
The total cost of the package -
HIS is available on the Internet, which means that authorized personnel providers may reduce upfront and maintenance fees by using a design that requires fewer servers and hardware.
Manual procedures
If the computer system goes down, a contingency plan for manual procedures and forms needs to be in place.
KCCI MedSys
Kaiser-dela Cruz Consulting, Inc. specializes in application development for hospitals, industrial clinics, and medical-related educational institutions in the Philippines. Its products, Visual MEDSYS for hospitals and EDSCHO for schools, provide integrated, comprehensive, and proven solutions for efficient health care practices.
System maintenance
LISs need to be shut down (taken offline) periodically for software upgrades and other maintenance. Occasionally, the system will become nonresponsive (crash).
Types of Laboratory Information System Software
Laboratories choose between commercial off the shelf, custom and open source software based on their needs and budgets.
Manual data entry
Laboratory scientist enters patient results at a client
Scheduling
Managers and employees can access work schedules from anywhere they are and effectively discuss their scheduling preferences through the HIS. Employee scheduling software helps save time and makes employee scheduling less difficult.
System security
Ongoing procedures to ensure the security of patient data and user profiles (usernames and passwords) to prevent unauthorized access must be in place. Users should have access only to the patient information and LIS functions needed to perform their job (minimum necessary use). Antiviral software (e.g., McAfee and Norton) should be installed to protect the system from harmful malware, especially for networks with a Windows operating system.
Orders
The buyer shows the intention to purchase the required item by issuing a purchase order. A purchase order is placed to signify intention to engage in commercial operations for a specific product or service. Upon agreement, the order becomes a contract between the health care institution and the supplier.
Establishing Buying Cycles
The buying cycle (also known as a purchase cycle) is the process a customer goes through when purchasing a product or service. Customers move through a series of purchasing stages in the cycle as they educate themselves and move closer to making a final purchasing decision. Buying cycles should be determined and understood by inventory personnel based on the previous cycles so that inventory ordering becomes manageable through the elimination of shortage and overages. The said cycles determine the trends and adjustments that can be made accordingly.
Postanalytical (Post-examination) Functions Laboratory Report
The end product of the work done by the clinical laboratory consists of the testing results produced by the particular methodology used, which are provided in the laboratory report. It contains all the test information generated by the various laboratories that have performed analyses for a single patient. The data can be electronically transmitted to printers, computer terminals, or handheld pager terminals, giving rapid access to the test information for the user.
Complying with Regulations
The health institution should be responsive to the current trends and needs of the highly regulated health care industry
Help Desk
The help desk becomes more efficient through the HIS because the manual retrieval of information is no longer needed. Clients are provided with information and guidelines associated with a company's or institution's products and services without any hassle.
Introduction to Materials Management Information System
The management function of hospital materials - that is, to ensure that services are rendered successfully from one source to an end-user - covers several areas of the hospital and could drastically affect the expenses of the medical institution. It is executing this function in a manner that lessens costs and ensures adequate cash flow requires effective management of a large amount of information from several sources.
Approval Process
The person who creates the document, either a purchase request or order, is the originator. When the said originator adds document/s to the materials management system, the system checks for any approval requirements. If the documents fail to meet the approval requisites, the originator is notified that the document needs approval. The document is temporarily saved as a draft. When the approval process is launched, an internal request is immediately sent to the first approval stage. This request is received in the Messages/ Alerts Overview window, and the approver can access the document. Approval can be done through a mobile phone if the devices are integrated. An internal notification goes back to the originator with a link to the rejected document when the approver rejects the document. The originator can amend the document, and the approval procedure will continue until the conditions are adequately satisfied.
Inspecting a Shipment
The personnel receiving the items should inspect the goods to ensure that the following minimum conditions are met
Stock and Quarantine Expired Stock/Inventory
When undecided about how to handle defective goods, whether to be sold as scrap, reworked, returned, or used as it is, a quarantine location or warehouse can be used to house them until a final decision is reached temporarily.
Information Provided by a Laboratory Information System
a. Patient demographics b. Worklists c. Data retrieval (inquiry) 1) Generate patient results: Flag critical values, print reports if requested, etc. 2) Perform delta checks: Results of an analyte assay are compared to the most recent previously performed results on the same patient 3) Patient results can be retrieved electronically at a client or via the Internet with a Web browser. Property of and for the exclusive use of SLU. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of SLU, is strictly prohibited. 29 d. Reflex testing: If an initial test result is positive or outside normal parameters, the LIS can automatically order a second appropriate test. e. Current procedural terminology (CPT) codes: The CPT codes describe medical, surgical, and diagnostic services and are designed to communicate information about medical services and procedures among physicians and other healthcare professionals. CPT codes are used for billing purposes and can be programmed into the LIS. f. Quality control: An LIS can analyze quality control specimens and prepare charts and reports (e.g., Westgard rules, Levey-Jennings charts). g. Quality assurance can provide reports on turnaround time, documentation of critical result reporting, and corrected reports. h. Management reports: Cost per billable test calculations, test volume, turnaround time, employee hours, workload data, etc. i. Encoding systems: Systemized Nomenclature of Medicine—Clinical Terms (SNOMED— CT) is a comprehensive database of standardized terminology for healthcare. Once implemented, it will allow automatic data analysis over a wide range of clinical information systems. Logical observation identifiers names and codes (LOINC) is another database of universal standards for healthcare.
Cardiology Reporting
Cardiology reports, like other laboratory reports, contain essential medical information based on the test results of the patient, which are set against past medical records. Doctors can write vascular reports much faster Property of and for the exclusive use of SLU. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of SLU, is strictly prohibited. 16 since access and retrieval of information are made more convenient through computer systems. Using the cardiology information systems, vascular sonography reports are accurately created with only a few clicks. Information on these reports could include ultrasound and diagrams. Nowadays, physicians opt to provide automated reports through the use of information systems. The medical staff can process laboratory reports for the approval of the physician. This means that the results are generated more efficiently, which translates to the improved patient experience.
Ensuring Shipment Accuracy
Checking shipment for accuracy means ensuring that the received items are the ones ordered and the supplies are free from possible damages during transit.
Aligning with Sales Projections
Coming up with an inventory tracking report in comparison with actual sales proves to be a challenge in the field of medicine. However, it is necessary to prevent wastage, identity trend and ensure that there is no excess inventory.
Comlogik
Comlogik Business Systems, Inc. is a Philippine-based software development company thaw was established in 1999, with a vision to be a global technology company. Comlogik led the way in developing innovative applications like online hospital services in which patients can access their billings and examination results. In contrast, administrators can access reports, and doctors can access patients' records anywhere and anytime.
Preferred Vendors
Companies typically maintain a list of preferred vendors, from whom inventory items are usually purchased. They look for a vendor who has on-time performance, offers reasonable costs, provides high-quality products and services, offers fully licensed, bonded, and insured products and services, and has business practices.
Contract Managemen
Contract management is the process of managing contract creation execution and analysis to maximize the operational and financial performance of an organization while reducing financial risk. Organizations regularly encounter pressure to reduce costs and improve company performance. Contract management proves to be a very timeconsuming element of business, which facilitates the need for an effective and automated contract management system. When a contract management strategy is successfully implemented, organizations can expect to see the following: • realization of expected business benefits and financial returns • cooperation and responsiveness of the supplier to the organization's needs • no contract disputes or surprises • satisfactory delivery of services to both parties
Critical Patient Results
Critical patient results must be communicated immediately. The traditional way is by phone contact with the primary care provider. With automated LIS, it is essential to achieve an electronic line of sight from the test order to the receipt and acknowledgment of the critical result to the appropriate health care professional. An automated process that supports critical result reporting with a manual call center backup system error-proofs critical laboratory assay communication and improves the quality of patient care and laboratory staff productivity.
Definition of Laboratory Information System
A laboratory information system (LIS) is a computer network of hardware and software for receiving, processing, and storing laboratory data and information. It can interface with laboratory instruments to transfer data into patient records, evaluate quality control data, and store preventive maintenance records. Also, an LIS can interface with an HIS, pathology information system, and other information systems. An LIS is also a computer-based information management system created specifically for laboratories. An LIS is used to support workflows in the laboratory — as well as the repository to store laboratory data — while supporting the laboratory mission. The goal is to deliver correct and complete information to laboratory staff, managers, and customers as efficiently as possible by following four main processes.
Inventory Control
Inventory is one of the most significant expenses for most medical institutions. Inventory controls play an important part in refining the quality of health care since the lives of people are on the line, and medical costs are increasing.
Issue Methods
Inventory management is a crucial function for any product-oriented business. Common inventory handling methods include:
Interpretative Report Form
If the diagnosis has already been made, the information on the report form can be used for other purposes, such as managing the patient's treatment plan. The physician must know the result of the most recent Property of and for the exclusive use of SLU. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of SLU, is strictly prohibited. 28 laboratory test, what clinically significant changes have occurred since the last test (through the retrieval of current and historical data), whether changes in therapy are indicated, and when the test should be performed next. This information constitutes an interpretive report. An interpretive report form should give information about the range of reference values, flag any abnormal values, and provide these data in a readily accessible format to support laboratories in the interpretation of clinical results in specific diagnostic areas such as cerebrospinal fluid (CSF) testing, urine assessment, and protein profiling. Besides the graphical presentation of patient results and the calculation of formulas, this program provides suggestions for the clinical interpretation of specific protein results.
Reorder Level and Minimum and Maximum Inventory Ordering
In a typical materials management system, reorder level is the minimum quantity of an item that a company has in stock, so when the stock reaches the stated minimum quantity, the item must then be reordered (purchase order/production order). A basic reordering method implemented in many ERPs and other inventory management software is the Min/Max inventory ordering method. The "Min" value is representative of a stock level that prompts a reorder, and the "Max" value is representative of a new targeted stock level that follows the reorder. The main difference between these two - Max and Min - is often interpreted as the economic order quantity (EOQ). Although the Min/Max method is an unpolished method for inventory ordering, its settings could be adjusted to provide better inventory performance.
Consignment Stock Receipt, Consumption, and Regularization
In the process of consignment, the vendor or consignor issues materials to the receiver or consignee, and these materials are stored in the consignee's premises. The vendor maintains legal ownership until such materials are removed from consignment stores. The invoice is due at predetermined material after a certain period.
Overview of the Laboratory Information System
Information is the ultimate product of the laboratory, and the ultimate goal of the laboratory is to provide accurate information promptly to clinicians. To achieve these goals, laboratory information systems have become the foundation in virtually all health care environments. A laboratory information management system (LIMS) represents a more frequently used way of managing a modern clinical laboratory. LIMS are used because of their ability to routinely integrate automation and data handling, provide uniform methodology with complete visibility, and lead to increased productivity and process integrity. The essential requirements of a LIMS include secure login, flexibility to add-ons and software upgrades, and, most importantly, data management. The number of laboratory tests has increased as a result of the development of new diagnostic assays and the increased use of automated, high-volume instruments and handheld devices. Because the number of assays performed in the clinical laboratory and by point-of-care testing has grown so dramatically over the years, and because these assays have produced so much analytical information, the ability to process this information efficiently and accurately has become essential.
Nursing Information Systems
Nursing information systems (NIS) are developed to enhance patient care by providing nurses with accurate information to assist them in their duties more efficiently. An NIS carries out numerous functions, including the handling of personnel schedules, accurate patient charting, and better clinical data integration. Agenda packages help enhance the management of the workforce by assisting managers in handling overtime and absences. They can also be used to obtain cost-effective staffing and show staffing levels. Patient charting applications allow better analysis of critical signs. Nurses could check admission information and care plans, along with applicable nursing notes. Crucial information is kept and can be retrieved when needed. This is also useful in designing the patients' care plan since the medical information integration function allows nurses to collect and examine retrieved medical records.
Pharmacy Information Systems
Pharmacy information systems (PIS) help monitor the utilization of medicines in health institutions; the system also handles information on medication-related complications and drug allergies of patients. It provides information to identify drug interactions, which helps in administering the appropriate drugs by considering the physiological conditions of the patient.
Physician Information Systems
Physician information systems (PIS) are designed to improve the practice of physicians. Electronic medical records (EMRs) and electronic health records (EHRs) are some programs where PIS is deployed and extensively use. Most systems offer support 24/7 to facilitate easier usage of the system by health care professionals.
Point of care testing
Portable laboratory instruments, like handheld analyzers, can connect to an LIS via a wireless connection.
Package Deal Designer
Posting diagnostic medical packages for inpatients, outpatients, and emergencies requires the same process; the difference is that for emergencies, this is called a post-diagnostic package deal. HIS help in accessing information regarding package deals without going through the hassle of paperwork.
Radiology Information Systems
Radiology information systems (RIS) are capable of providing billing services and appointment scheduling aside from reporting and database storage. Technological advances have made the practice of radiology more complicated such that more and more hosp
Request entry
Requests for laboratory tests to be performed can be entered through clients located in the nursing units or remote primary care practitioner's offices. In the case of outpatients, requests can be entered when the patient arrives at the laboratory.
Patient Registration
The HIS patient registration form records the name, age, gender, marital status, and other relevant information regarding the patient. These pieces of information are used for record-keeping and account management purposes. This form is usually filled out during the patient's visit or consultation. Still, if the patient is unable to complete the form due to the need for prompt medical attention, the form can be filled out by a relative or guardian.
Interface
The LIS can be connected to clinical instruments and other information systems through an EDI. An interface is typically bidirectional, meaning information is sent to and from the instruments and the information systems. With a unidirectional interface, analyte results from an instrument are sent to the LIS, but the LIS cannot send requests to the instrument. So that instruments and computers used in healthcare can communicate with each other, the Health Level 7 (HL7) communication standard was adopted. HL7 is an international committee formed in 1987 to formulate data standards, a set of rules that allow healthcare information to be shared and processed in a uniform and consistent way.
User Interface
The LIS software user interface determines how the user will interact with the system. It will have specific screens for entering data, sending reports, reporting results, etc. The software will have features such as security, access control, file maintenance, etc.
materials management information system
The system as mentioned earlier can be used to manage functions like purchasing, accounting, inventory management, and patient supply charges
Web-based system
The system is available on the Internet, which means that authorized personnel can access the information anywhere and anytime. It also allows data sharing between hospitals. A hospital with updated patient history in its system can facilitate access to information from other health facilities upon request.
Transfer
The term 'transfer' means movement (along with the discharge) of an individual outside of the hospital premises at the instruction of any authorized hospital personnel. This, however, does not encompass the movement of an individual who (a) has been declared lifeless, or (b) leaves the facility without the permission of any such authorized person. If a patient is transferred from the emergency room, employees must fulfill the statutory requirements for a proper switch. With the HIS, patient transfer details are easily accessed and processed.
Items Intended and Issues
There are some instances when items are damaged either upon receipt from the supplier or during the move from the source to another location. Some suppliers allow returns of goods that have indents or the like, with a guarantee of replacement without any additional payments. This applies to distribution and retail industries where the products for sale are fast-moving. Typically, damaged items are moved to another warehouse for them to be monitored.
Types of Laboratory Information System
There are two common types of LIS: (1) a module within a hospital information system (HIS) and (2) a stand-alone LIS. An LIS within HIS serves mostly as a means to capture results and a few key elements of data. The second system — a dedicated LIS —shares most of the components listed above and can support all the business processes within a laboratory.
Discharge
Through the HIS, instructions that accompany a patient's discharge or transfer are more efficiently provided. These instructions may include discharge planning, which details services needed to be administered after the hospital stay to ensure the full recovery of the patient.
Management Reporting
Today, management reporting is not limited to data retrieval. It has become a platform for reporting and controlling information valuable to the institution. Recent technological advancements help management reports to provide non-monetary information, which enables the management to have an oversight of its operations. In the same way, these advancements pave the way for the emergence of management reporting systems. These systems capture the necessary data required by the management to operate more efficiently. With this, data redundancy and data quality issues are minimized. Employee headcount, customer account information, funding, and overall performance are some of the data that can be retrieved through the system. Thus, a good management reporting system enhances the capability of an institution to be more responsive, efficient, and effective in decision-making which affects the performance of the institution as a whole. These systems offer a single holistic view which highlights high-value sources and eradicates the lack of visibility in reviewing the performance of the institution.
Preanalytical (Pre-examination) Function
Using handheld technology reduces costs, improves workflow, and eliminates preventable medical errors. If data are collected and printed or transmitted directly, it is more efficient and accurate than manual recording. Identifying and defining the patient in the computer system must take place before any testing is done. Most health care institutions assign a unique identification number to each patient and also enter other demographic information about the patient in the information database (e.g., name, gender, age or birth date, referring or attending physician). These data are known as patient demographics. This information is collected at admission to the facility and entered into the HIS. The information is then transferred electronically from the HIS to the LIS.
Electronic medical records (EMR)/electronic health records (EHR)
refers to the management of patient medical records electronically from a variety of sources dealing with patient treatment, diagnosis, laboratory tests, imaging, history, prescriptions, and allergies.
Installation of Laboratory Information System
a. The installation process is essential and very time-consuming. It is critical to identify any errors early in the process before the system is activated (goes live). b. Vendor representatives will install the server, clients, network connections, and software. Property of and for the exclusive use of SLU. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of SLU, is strictly prohibited. 30 c. Testing: A thorough test of individual components (unit test) and a test of the system (integration-test) are performed. d. Training laboratory personnel and other healthcare providers on the LIS is an expensive process. It is essential to discuss this with the vendor before accepting a proposal. Management needs to know how many people the vendor will train. It will become the responsibility of the laboratory personnel receiving training to teach others. Training will also be needed for healthcare providers outside the laboratory. e. Communication: Before the LIS goes live, it is essential to communicate with all members of the healthcare team about the planning and timeline of the process.
Selecting a Laboratory Information System
a. The process begins with a laboratory needs assessment, where data are collected on the information needs of the laboratory. b. Needs are analyzed to determine the feasibility of a system and what is needed to get the job done. c. Laboratory managers and administrators form a committee and prepare a request for proposal (RFP). The RFP contains information about the laboratory facility, lists specific requirements needed in an LIS, and poses questions about LISs. This information may include interface capabilities to hospital information systems and laboratory instruments, remote user access, system requirements, custom features, hardware and software maintenance contracts, etc. The RFP is distributed to vendors. d. Vendors will respond to the RFP, describing how their systems will meet the needs of the laboratory and the estimated cost of the systems. e. The RFP responses will be reviewed by the committee. To prevent information overload and confusion, only a few of the vendors, those that submitted an RFP response that matches the needs assessment, should be selected to give demonstrations. f. Vendor demonstrations and visits to other laboratories using the systems help narrow the choices. Vendor demonstrations should be scheduled within a short time frame so that information is fresh in everyone's mind. g. Selection is based on the system that can best meet the laboratory's needs at the lowest cost (i.e., the cost does not outweigh the benefit).
System Validation
a. Validation of the laboratory information system is an ongoing process of proving the system performs its intended use initially and over time. b. Validation consists of defining, collecting, maintaining, and reviewing evidence that the system is performing consistently according to specification. It is tedious, challenging, and costly, but it must be done to ensure that the system meets the needs of the laboratory.
Picture archiving and communication system (PACS),
an integral part of comprehensive EMRs, has been recognized as a strategic IT tool for improving a hospital's competitive advantage
Radiofrequency identification (RFID)
can help hospitals and clinics improve their inventory management, patient identification, and the maintenance of patient records and treatments
Electronic data interface (EDI)
connections between an LIS and a clinical instrument allow automatic transfer of patient test results to the LIS.
First In, First Out (FIFO)
inventory items are sold based on the order they are purchased. This is the most common technique
Computerized physician order entry (CPOE)
is an automated clinical decision support intervention that enables healthcare organizations to improve patient safety, clinician workflow processes, and resource utilization.
Telemedicine
is the use of telecommunications for patient care and can involve several electronic delivery mechanisms
Last In, First Out (LIFO)
last items to enter the system are sold first. This is common among non-perishable items like petroleum, minerals, and metals
First Expired, First Out (FEFO)
materials are sold based on the dates they should be consumed, regardless of when they were purchased.
LIS Highlights
mproved laboratory data management • Improved laboratory efficiency • Improved quality • Adoption of international lab standards • Prompt and efficient delivery of accurate and complete information to lab staff and managers • Workflows support • Information tracking during the testing process • Collection, storage, archiving and analysis of data • Reporting of test results for patient care • Reporting of data to MOH and other agencies • Repository to store lab data and system used to support workflows in the laboratory • Improved and appropriately managed data security
Quotations
quotations contain vital information regarding the requirements, which include price, delivery details, payment terms, etc. Companies usually review two to three quotations before selecting the supplier.
Materials management
s primarily concerned with planning, identifying, purchasing, storing, receiving, and distributing materials. Its purpose is to guarantee that the right and sufficient materials in the right location when needed. As such, the automation of an inventory or a materials management system is necessary for a hectic health center to streamline the hospital supply chain. Computerized stock management systems include technologies for tracking inventories and devices used each day in a health care setting. Generally, they utilize barcodes and RFID tags with precise identification numbers assigned for each inventory object to enable accurate tracking and control. Automatic stock management systems also assist health care institutions in figuring out whether the merchandise has been recalled or damaged and should not be given to patients. They enable isolation of drugs and devices that are used regularly and forecasts capacity shortages. Virtually every health care institution has a materials management department that is accountable for receiving materials, retaining central stock, and delivering supplies within the institution. Typically, this is where the responsibility of the materials management department ends as inspection of a nursing unit, suite, or exam floor will reveal a smaller, self-managed inventory in supply closets, nurses' stations, and individual rooms. These inventories are essential in maintain supplies conveniently available for use.
Redundant arrays of independent disks (RAID)
the Food and Drug Administration regulates LISs, and they are required to have mirrored hard drives. Data are stored on two separate hard drives of the LIS server.
Enquiries
the enquiries mark the beginning of the purchasing process. These establish the relationship between the entity and the right supplier. The supplier provides information on the availability and price of the required items.
Record Retention
the packing list should be provided to the receiving department during delivery to ensure that there is proper documentation since it is are taking possession and legal ownership of the delivered items. If no list was provided, the department should request a copy from the supplier. All files should be kept according to the entity. This helps track partial and staggered deliveries.
Signing for Deliveries
the person who receives the delivery should inspect the delivered items before signing the receiving document and the packing list. Then the document should be submitted to the appropriate department for reconciliation.
Refusing delivery
the receiving department should refuse to accept any shipment if the packaging appears to be damaged or if there is any item that does not have a corresponding purchase order.
Partial Deliveries
when items are delivered partially without proper notification from the supplier, the receiving personnel should advise the Purchasing department for approval and further instructions. This should also be typically noted in the packing list or the receiving document.
Laboratory Inventory Management
• The objective of an efficient laboratory is to experience a few shortages in testing reagents, supplies, and materials. • Requisitions for contract and purchase orders to obtain necessary quantities of materials, etc., in suitable time frames • Managers are responsible for purchasing laboratory instruments and service contracts to maintain installments. • Instrument selection includes technical evaluation and cost comparison of instruments from various instrument manufacturers. • Many hospital laboratories contract with outside agencies to provide blood products for patients. • Hospitals contract with outside companies to manage biohazardous waste and hazardous waste disposal.
