Thanks for including the section on monitoring.
Here's how monitoring looks different from some other applications of
Laboratory Medicine:
* It should be automatically triggered by another event: eg diagnosis,
prescription...
* There is no need for the responsible clinician to retrieve and
interpret individual reports: it 's pretty simple to make this
rule-based.
* Because of both of these it is much easier to automate than
"diagnostic testing"
* It's inherently boring, until an exception is triggered. (This is
more important than it sounds: one of the reasons for non-adoption of
medical expert systems was that they might take interesting tasks
away... )
Typical areas:
* Monitoring of thyroxine replacement in adult hypothyroid patients
(including nGMS contract); driven by diagnosis/ registration
* Looking for albumin in urine in known diabetic patients (including
nGMS contract): driven by diagnosis/ registration
* Monitoring plasma lithium concentration (including nGMS contract):
driven by prescription/ diagnosis/ registration
* Measuring INR in patients on warfarin (and lots of us have partially
automated systems for this); driven by prescription
Background information;
* Paul's papers in eg BMJ
* James Falconer Smith's thyroid and lithium registers
* The Tayside DARTS project (but this doesn't have outputs in clinical
actions, more like audit and research)
Jonathan
On 14 Jun 2005, at 10:27, Rick Jones wrote:
> Muir,
> I enclose the completed draft of the Position Paper on the needs of
> Laboratory Medicine from the CfH Programme. I feel this is now ready
> for circulation within CfH and hope that it can open up a constructive
> dialogue with the programme.
> Best wishes,
>
>
> Rick Jones
>
>
> Dr Rick Jones
> Clinical Biochemistry & Immunology
> Leeds Teaching Hospitals Trust
> Leeds General Infirmary
> Great George St
> Leeds
> [log in to unmask]
> [log in to unmask]
> Tel: 0113 392 2340
> Fax: 0113 392 5174
> LS1 3EX
>
> http://www.ychi.leeds.ac.uk
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