Design and implementation of a clinical laboratory information system in a low-resource setting.
Malawi
informatics interventions
laboratory information system
laboratory testing
low-resource setting
Journal
African journal of laboratory medicine
ISSN: 2225-2002
Titre abrégé: Afr J Lab Med
Pays: South Africa
ID NLM: 101603205
Informations de publication
Date de publication:
2019
2019
Historique:
received:
30
05
2018
accepted:
28
06
2019
entrez:
21
11
2019
pubmed:
21
11
2019
medline:
21
11
2019
Statut:
epublish
Résumé
Reducing laboratory errors presents a significant opportunity for both cost reduction and healthcare quality improvement. This is particularly true in low-resource settings where laboratory errors are further exacerbated by poor infrastructure and shortages in a trained workforce. Informatics interventions can be used to address some of the sources of laboratory errors. This article describes the development process for a clinical laboratory information system (LIS) that leverages informatics interventions to address problems in the laboratory testing process at a hospital in a low-resource setting. We designed interventions using informatics methods for previously identified problems in the laboratory testing process at a clinical laboratory in a low-resource setting. First, we reviewed a pre-existing LIS functionality assessment toolkit and consulted with laboratory personnel. This provided requirements that were developed into a LIS with interventions designed to address the problems that had been identified. We piloted the LIS at the Kamuzu Central Hospital in Lilongwe, Malawi. We implemented a series of informatics interventions in the form of a LIS to address sources of laboratory errors and support the entire laboratory testing process. Custom hardware was built to support the ordering of laboratory tests and review of laboratory test results. Our experience highlights the potential of using informatics interventions to address systemic problems in the laboratory testing process in low-resource settings. Implementing these interventions may require innovation of new hardware to address various contextual issues. We strongly encourage thorough testing of such innovations to reduce the risk of failure when implemented.
Sections du résumé
BACKGROUND
BACKGROUND
Reducing laboratory errors presents a significant opportunity for both cost reduction and healthcare quality improvement. This is particularly true in low-resource settings where laboratory errors are further exacerbated by poor infrastructure and shortages in a trained workforce. Informatics interventions can be used to address some of the sources of laboratory errors.
OBJECTIVES
OBJECTIVE
This article describes the development process for a clinical laboratory information system (LIS) that leverages informatics interventions to address problems in the laboratory testing process at a hospital in a low-resource setting.
METHODS
METHODS
We designed interventions using informatics methods for previously identified problems in the laboratory testing process at a clinical laboratory in a low-resource setting. First, we reviewed a pre-existing LIS functionality assessment toolkit and consulted with laboratory personnel. This provided requirements that were developed into a LIS with interventions designed to address the problems that had been identified. We piloted the LIS at the Kamuzu Central Hospital in Lilongwe, Malawi.
RESULTS
RESULTS
We implemented a series of informatics interventions in the form of a LIS to address sources of laboratory errors and support the entire laboratory testing process. Custom hardware was built to support the ordering of laboratory tests and review of laboratory test results.
CONCLUSION
CONCLUSIONS
Our experience highlights the potential of using informatics interventions to address systemic problems in the laboratory testing process in low-resource settings. Implementing these interventions may require innovation of new hardware to address various contextual issues. We strongly encourage thorough testing of such innovations to reduce the risk of failure when implemented.
Identifiants
pubmed: 31745456
doi: 10.4102/ajlm.v8i1.841
pii: AJLM-8-841
pmc: PMC6852617
doi:
Types de publication
Journal Article
Langues
eng
Pagination
841Informations de copyright
© 2019. The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Références
Clin Chim Acta. 2016 Nov 1;462:183-186
pubmed: 27649855
Clin Leadersh Manag Rev. 2000 Nov-Dec;14(6):296-300
pubmed: 11210218
J Pathol Inform. 2011;2:35
pubmed: 21886891
J Pathol Inform. 2014 Feb 25;5(1):7
pubmed: 24741466
Lancet. 2018 May 12;391(10133):1927-1938
pubmed: 29550029
Clin Chim Acta. 2009 Jun;404(1):16-23
pubmed: 19302995
Ann Clin Biochem. 2011 Nov;48(Pt 6):487-8
pubmed: 22045648
Am J Trop Med Hyg. 2016 Jun 1;94(6):1426-32
pubmed: 27022150
PLoS Med. 2010 Aug 10;7(8):null
pubmed: 20711476
Clin Chem Lab Med. 2006;44(6):750-9
pubmed: 16729864
Afr J Lab Med. 2015 Nov 18;4(1):
pubmed: 27213139