This email is directed at labs which send their results to PROTON a
renal information system used by 50% of Renal Units in the UK. We are under
immense pressure to release non clinically validated results directly into
this system, so that patients can be discharged promptly.
We do pick up quite a few errors at clinical approval for example
discrepant Creatinine and Urea results that can be seen on the cumulative
view of serial results that usually turn out to be mislabelled samples or
other mix ups. But we also pick up problems that are not immediately obvious
when the samples are technically validated, for example poorly clotted
samples that cause partial probe blocks etc. Ok its not true clinical
validation as such, but it is a reality check that generally picks up 2 or 3
errors a week
Our renal physicians tell us we are the only laboratory in the UK
who continue to clinically validate renal unit patient results and delay
them going into PROTON, ? is this true.
I am always interested in how remote systems handle path data, so
I duly spent a morning reviewing our results on it, the experience was
worrying.
I sent a text message as a specimen comment saying "PLEASE IGNORE
THESE RESULTS THEY ARE RUBBISH" on a test patient where I generated
Potassium of 7.9 mmol/L. It appears that PROTON has no way of conveying
specimen related information to you when you are reviewing results which is
a significant omission from the system. Also I noted that if an amended
result is sent from Pathology the change is made in PROTON but there is no
way the change can be alerted to anyone using the system. So any clinical
action taken on the first set of results will almost certainly not be
questioned. Possible the worst feature of PROTON that I noticed was the lack
of showing any normal ranges. Given that PROTON is aggregating results
produced from different laboratories using different normal ranges; trends
in the data that probably don't exist appear to the reviewer.
Anyhow thoughts and experiences that relate to this system would be
welcome
Thanks
John
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