The Impact of the Electronic Medical Records (EMRs) on Hospital Pathology Services

This chapter reviews what is currently known about the effect of the Electronic Medical Records (EMRs) on aspects of laboratory test ordering, their impact on laboratory efficiency, and the contribution this makes to the quality of patient care. The EMR can be defined as a functioning electronic database within a given organisation that contains patient information. Although laboratory services are expected to gain from the introduction of the EMRs, the evidence to date has highlighted many challenges associated with the implementation of EMRs, including their potential to cause major shifts in responsibilities, work processes, and practices. The chapter outlines an organisational communication framework that has been derived from empirical evidence. This framework considers the interplay between communication, temporal, and organisational factors, as a way to help health information technology designers, clinicians, and hospital and laboratory professionals meet the important challenges associated with EMR design, implementation, and sustainability.

The Use of Information Systems in a Modern Cytopathology Laboratory

Over the last decade, cytopathology laboratories wishing to achieve an automated and seamless workflow process, to diminish turnaround times, and to improve their diagnostic accuracy have successfully adopted information technologies and automation. New types of cameras and microscopes connected to computers made possible image capture and transmission (telecytology). New innovative information technologies, including e-health and telemedical applications, constitute a valuable tool for interlaboratory collaboration and quality improvement. New applications are expected to enhance the opportunities for improvement in the field of cytological data management and sharing. In this chapter, the authors emphasize quality management concepts applied to cytopathology laboratories and the application of innovative information technologies in a modern cytopathology laboratory wishing to establish an effective quality management system and meet all current requirements concerning all aspects of its routine workflow (personnel, premises, environmental conditions, equipment, information systems and materials, pre-examination processes, examination processes, and the post-examination phase).

Interoperability in Laboratory Management Information Systems

Medical laboratories are the key departments for healthcare. It does not matter if they are independent or part of the health center; they use an information management system. This system has to communicate and exchange data with many different organizations for many different reasons. Interoperability is the ability of two or more systems to exchange data and to use the exchanged data as their own. As always in health information technologies, this is easy to say and hard to perform. It has some challenges. To conquer interoperability, we need standard vocabularies, protocols, nomenclatures, classifications, etc. In this chapter, laboratory management information system-related interoperability issues are examined.

The Role of Total Quality Management Practices on Quality Performance

This chapter introduces the role of Total Quality Management (TQM) practices, thus explaining the introduction of Quality Management (QM) systems, the significance of TQM, the concept of TQM practices, the utilization of QM practices, and the relationship between TQM practices and quality performance. In addition, 17 TQM practices associated with quality performance (i.e., top management commitment, customer focus, training and education, continuous improvement and innovation, supplier quality management, employee involvement, information and analysis, process management, quality systems, benchmarking, quality culture, Human Resource Management [HRM], strategic planning, employee encouragement, teamwork, communication, and product and service design) are explained. This chapter serves as a valuable guideline for both researchers and practitioners to review their TQM programs in order to improve quality performance. Understanding the role of TQM practices on quality performance will significantly enhance the organizational performance and achieve business goals in the global business environments.

An Evaluation of Laboratory Information Systems in Medical Laboratories in Jamaica

This chapter seeks to find out information on the functionalities of the laboratory information systems available in medical laboratories in Jamaica and their ease of use and the overall performance and satisfaction of medical technologists using them. A cross-sectional descriptive survey involving the use of a 48-item questionnaire was conducted among medical laboratories with a LIS. There were a total of 14 completed questionnaires out of 15, giving a response rate of 93.3%. The findings reveal that the majority of the laboratories have a LIS that provides multi-level security, allows password protection at different levels, maintains a patient database, and generates records. The majority of the medical technologists agree or strongly agree that it is easy to use the LIS and experience improved overall performance on the job. The medical technologists clearly understand the existing features and functionality of the LIS. Additional functional features of the LIS should be customized, and adequate funding is needed, especially for hospital-based laboratories.

A Case Study of a Laboratory Information System Developed at the Institute for Cancer Research at Candiolo

Research laboratories produce a huge amount of complex and heterogeneous data typically managed by Laboratory Information Management Systems (LIMSs). Although many LIMSs are available, it is often difficult to identify a product that covers all the requirements and peculiarities of a specific institution. To deal with this lack, the Candido Cancer Institute decided to start a project, named the Laboratory Assistant Suite (LAS), with the aim of developing a new software platform that assists researchers throughout diverse laboratory activities. The proposed system can track laboratory experiments even in problematic environments, support the integration of heterogeneous biomedical data, and help in decision-making tasks. In this chapter, the authors present the current architecture of the system, some real-use cases, as well as statistics about stored data and user feedback in order to provide an overview of the functionalities and show the effectiveness of the platform in supporting research in the molecular oncology field.

Innovative Architecture to Enhance Quality of Service for Laboratory Management Information Systems

Technological improvements have changed the life style in the modern era, where communication has become easier compared with olden days. Technological solutions have been deployed in every sector including business, education, and health services. Although a number of solutions are proposed for improvements in the healthcare sector, the complexity and growing interest in this sector have created new approaches. This chapter proposes an innovative architecture for the laboratory management information system to enhance the quality and management issues. The proposed architecture integrates two major fields, namely wireless technology and data mining. The wireless technology enables the collection of data easily and wirelessly, and data mining ensures meaningful and novel knowledge discovery from the collected data. In particular, the architecture helps management in three different ways: (1) prevention of risks/errors using technological solutions, (2) an environment to respond rapidly to adverse events, and (3) construction of knowledge base for future guidelines.

A Practical Approach for Implementing the Additional Requirements of the ISO 15189:2012 Revision

Medical laboratory services have a critical role as an integral component of patient care. The accreditation standard of ISO 15189, a guidance document, provides validation that a laboratory is competent to deliver accurate and reliable test results. This international standard has been evolving since 2003. Following the second publication (2007), the standard was released as a revised and updated version in 2012 (Medical laboratories – Requirements for quality and competence). The text of ISO 15189:2012 has been approved as EN ISO15189:2012. European Union members and associate countries agreed to accord it the status of a national standard by May 2013. Any conflicting national standards need to be withdrawn by November 2015 at the latest. The purpose of this chapter is to mark the differences between the two versions of the standards and to highlight the changes and additions that have been incorporated into ISO 15189:2012. A practical approach will be helpful for laboratories to make a smooth transition to the updated standard when revising their quality and technical documentation to meet the new requirements.

Quality Management and Quality Assurance in Medical Laboratories

This chapter deals with issues of quality management and quality assurance in medical laboratories. Basic terms and their role in quality assurance in laboratory examinations are analyzed and discussed. Clarifications on certification and accreditation are given with a comprehensive analysis of the procedures they refer to and their implementation for particular tasks. The implementation of the international standard ISO 15189 is presented with reference to some recent developments. The chapter has been prepared to help medical laboratories in an introductory understanding of quality assurance issues and encourage them to proceed with the implementation of the standard ISO 15189 and not as a detailed guide. Some practical considerations rising from the experience of a small country such as Cyprus are also discussed.

Overview of Requirements and Future Perspectives on Current Laboratory Information Management Systems

The chapter argues that a Laboratory Information Management System (LIMS) is the application of computational technology in laboratory medicine. This is an advanced technology that can support the general work in medical laboratories. The LIMS can also be useful in all steps of the laboratory cycle (pre-, intra-, and post-analytical phases). There are many LIMSs at present, and those LIMSs are used worldwide. The present concern is on the standardization of the existing system. In this context, international collaboration to set the standards is required. In addition, the multidisciplinary approach to add up the advantage and application of the technology is promising. With the more advanced computational and wireless information technology, the next step of LIMS will be big wireless LIMS networks that extend from medical laboratories and wards within the hospital to outside units as well as patient homes. The point-of-care LIMSs are the actual future perspectives.