NEW CHALLENGES IN LABORATORY INFORMATION SYSTEMS DR. MILIND M. BHIDE

AIM OF EVERY LAB Consistently accurate result in the quickest possible time at the most reasonable rate

LIS REQUIREMENT §Laboratory Information system. §Has evolved from a glorified typewriter to complex software with intelligence. §Most labs have a main lab and few collection centers l Remote registration and printing of reports l SMS to clinicians and patients l of reports

What can LIS do for you? §Help in specimen labeling. §Automatic selection of tests on analyzers. §Sample tracking §Sample retrieval §Multi QC rules. §Inventory management §Superior data management by minimizing errors.

LABELLING ERROR ELIMINATION §Use barcodes §Tube should be barcoded before addition of sample §Aliquots should also have barcodes §Proper staff training required for placement of barcodes

WHAT ARE BARCODES §Numeric or Characters coded as lines §Different formats §Code 39 §Code 128 §Sample ID coded as Barcode §Barcode read by readers on instrument

Bar code printers

CODE 39 §The Code 39 specification defines 43 characters, consisting of uppercase letters (A through Z), numeric digits (0 through 9) and a handful of special characters (-,., $, /, +, %, and space)..

CODE 128 §High density barcode that can encode more information into lesser space. CODE 39 EXAMPLE CODE 128 EXAMPLE

2 D BARCODES

ATTACHING BARCODES



CONTAINER SPECIFIC BARCODES §Blood sugar fasting and pp for the same patient

LABEL REPRINTING §Reprints required when aliquots are made. §Reprints are required when original barcode is spoilt or unreadable. §Every reprinted label is a potential source of mistake and label reprinting requires to be audited.

BARCODING REMOTE SAMPLE COLLECTION ? §Barcode printing at collection center §Home collection §Bedside collection §Is the barcode attached after the sample reaches the lab ?

BARCODE ERROR RATE §Check digit §Barcode density (Higher density Error rate) §Size of sample ID. l Smaller ID requires low density §Size of Label l Restricted to 50 x 25 mm. §Printing technology

INSTRUMENTS AND BARCODES §Does the analyzer accept primary tubes ? §Does your analyzer have barcode to read sample tubes. §Hematology analyzers : Auto loader §Can a sample be added after the batch is started

Instrument Interfacing

USING QUERY MODE §Re testing should not get ordered if sample re-loaded §Facility to order test re-runs §If test menu is divided across 2 instruments then test ordering should be correct

Remote printing §Convert to PDF and it to remote site §Use of PDF printer §Google drive §Remote network printer §Windows terminal services

PDF PRINTER §Several free tools available §Virtual printer §Anything sent to the printer gets converted to PDF 

Google Drive §Cloud computing. §Attached to your gmail account §Two centers can share files using this utility

Using network printer to print reports at collection center LAB COMPUTER MTNL ROUTER IN THE LAB MTNL ROUTER IN THE COLLECTION CENTER NETWORK PRINTER IN THE COLLECTION CENTER Network printer is a special printer which has RS232 connector (Network )

Windows Terminal Services §Server l Win server 2000 onwards §Client l In built from Win XP onwards (RDP)

Windows Terminal Services §Remote client connects to a server running Windows Terminal Server software §Video, Keyboard and mouse commands are transmitted over the network §Printing command given at the remote client gets processed at the server but prints on the client printer (Printer Redirection) §Cytrix a special tool that speeds up Terminal services

INVENTORY MANAGEMENT

Inventory management §Record as the supplies come §Record reagents used as testing is done §The difference is inventory §Check it against average usage and order if necessary

INVENTORY MANAGEMENT §Use 2D barcode provided by the manufacturer. §Scan reagents as they arrive §LIS tells about lot and bottle use §Define re-order level §Reagent lot and bottle (Date and time of first use)

Quality management §We are expected to run 2 levels control for common tests §30 X 2 ie. 60 values obtained §Print, feed the values §Plot charts §If the day starts at 9:30 when to take corrective action and when does the work begin ?

APPI – VISION DOCUMENT §To increase the member by active membership drive §To conduct continual medical education to advance the knowledge and imbibe the good practices §To represent the interests of the practising pathologists §To start medico-legal cell to support pathologists §To create awareness amongst medical practitioners and general public with regards the quackery in diagnostic practices §To facilitate and improve quality and effectiveness in laboratory

THANK YOU