It would be interesting to see how many people are really satisfied with the
computer system(s) they have. When I go into my local bank, the system has
everything (except the money of course) I need to sort the immediate problem
and many others beside. Contrast the commercial way in which large systems
are procured and implemented with the NHS. Having been on both sides of the
fence I think hospitals tend to accept what is provided without too much
questioning and never look at the contract to see they are getting what they
have paid tax-payers money for.
I have strong views on IT - is it really so hard to get an order from a GP
into an electronic form (it would greatly speed up the bottle neck in sample
reception/booking in, the tests don't have to be guessed at, the location is
clear, etc.)?. Why can't the originators track what has happened to the
sample (arrived, being analysed, even notified when the sample is
discarded). The rule bases available now still seem to be very rudimentary.
I work a lot with Windows and 5 years ago I played around with incorporating
full scripting capabilities (MS Script Control) into applications so there
were full procedures etc.available as a programmer would have. This may be
too much for some users but the flexibility it provides is enormous.
Instead, in lab systems I know of, there are line limits, no ability to call
other functions, the calculations available are poor etc. Added on tests are
counted as having been requested at the time of the original request and
received with the original booking-in time so plays havoc with turnaround
times. Why, on the order comms system, can we not automatically page/SMS
text messages to say that results are available e.g. urgent ones in A&E,
ones where the clinician has positively indicated he wants to be notified.
This would save lots of time and trouble. I could go on and on .....
Graham
"Software suppliers are trying to make their software packages more
user-friendly... Their best approach, so far, has been to take all the old
brochures, and stamp the words, 'user-friendly' on the cover." - Bill
Gates.
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of [log in to unmask]
Sent: 22 April 2004 15:42
To: [log in to unmask]
Subject: Add on tests /interpretive comments/
Is part of the problem that we are all trying to make allowance for poor IT
systems? Looking at results gives different information, which if one had a
more useful user friendly IT system might be made a lot easier by allowing
us to choose what should be looked at. Ward ordering is supposed to be the
way forward, so why are summarised clinical details not downloaded with the
request?
All analytes are not the same. For example, I would suggest that for core
Biochemistry adding interpretive comments is a waste of time, unless you are
looking to see which team seem to be overordering, sending you aged samples,
requesting unusual combinations - many of which would alert one to talk to
the team, but would not justify delaying the reporting of the U/E etc.
However, adding comments to endocrinology, toxicology and tumour markers can
be worthwhile. How else would we pick up trends of inappropriate requesting,
treatment reflecting misinterpretation of results etc. However, again a good
IT sytem is required which shows the interretive comment, in a way that is
easy to enter and to read. I never thought I would be saying that Labstar
was superior to APEX (the newer system) for this.I believe if General
Practitioners and others will give the clinical details, if they know
someone is reading them, and who will comment on the report or phone them.
Likewise it is only by looking at Troponin results that you identify the
teams who take samples at the time of chest pain only.
____________________________________________________________
Dr. Helen Grimes, Dept. of Clinical Biochemistry, UCH, Galway, Ireland
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community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
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