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Application of advanced informatics and Telematics for Optimisation of clinical laboratory services

Objective

The project is developing a common architecture and facilities for data exchange among the clinical laboratories throughout Europe.
The research concerns the development of a common architecture and fac data exchange among the clinical laboratories throughout Europe.

A system which on test selection and feedback on tests requested is under development. A protot an expert system shell and rule base is now available.

Data and process modelli Dynamic Test Rescheduling (DTR) product have been completed and a method for the of multiple algorithms towards the solution of clinical problems has been design for the improvement of the utilization of laboratory services have been identifi corresponding prototypes as follows have been developed and documented.

In the Facilities Management area, tools are being developed for real time simulation o resources in the laboratory.

In the Advanced Instrument Workstation area, inter the integration of new instruments with the Laboratory Information Systems (LIS) for local and remote fault diagnosis and maintenance of instruments, real-time q automated patient results validation are under development.

Data and process mo advanced instrument workstations and advanced laboratory workstations functional developed. Preliminary prototypes have been developed for real time quality cont diagnosis and corrective maintenance, patient result validation and statistical control.

Under the heading Essential Methodologies, tools are under development application areas.

A first version hierarchical cooperative knowledge bases sys architecture has been developed and used in one of the application prototypes.

work in the areas of semantics, syntax and telematics have been implemented in s countries.
Motivation & Aims

Over the past two decades there has been rapid technological progress in Clinical Laboratories. Doctors have become increasingly dependent on an ever widening range of diagnostic services. The latter are often provided through the use of multi-channel and other automated analytical instruments, which generate increasing numbers of test results which are becoming available more and more rapidly. Laboratory workloads have been growing by 5-10% per annum. Physicians receive increasing amounts of data out of which information must be sifted. It has been shown that a considerable proportion (up to 60%) of tests ordered are unnecessary and that only a small proportion (10%) of the test results actually influence medical decisions. Knowledge based systems are being developed in OpenLabs to aid in the selection of tests and to provide feed-back on test requesting behaviour.

Highly specialised tests are available not only in central laboratories but also at the bedside in large hospitals and in small remote laboratories. The interpretation of laboratory test results is becoming increasingly refined; factors such as age, sex, sampling procedure, concurrent drug therapy and so forth need to be taken into account. Thus, the expertise to interpret test results is frequently lacking where required. This is particularly true for general practitioners, as the delivery of health services moves from hospitals to ambulatory and primary care. To answer the need for expertise in the area of test result interpretation, knowledge based decision support systems are being developed in OpenLabs.

A number of surveys have shown that the hospital service which is in greatest demand by remote users (GP's, health centres, smaller hospitals) is the transmission of laboratory test results. This is further evidenced by the proliferation of proprietary test result message formats such as EDIFACT in Europe. The suppliers of GP and Laboratory Information Systems (LIS) do not have the resources to support such a variety of solutions. A standard for EDI of laboratory information is required. The work of the AIM exploratory phase project EUCLIDES continues in OpenLabs. Test codes and the semantics & syntax of messages for the exchange of laboratory information are being developed in co-operation with CEN TC-251.

Most of today's LISs are dedicated laboratory databases which are neither modular nor open. It is difficult to build new interfaces to them for the purposes of telecommunications or the addition of advanced features. An Open Architecture for a LIS incorporating advanced features is being specified within OpenLabs and will be demonstrated in the project.

Coordinator

IRISH MEDICAL SYSTEMS
Address
Clara House, Glenageary Park, Glenageary Co. Dublin
Dublin
Ireland

Participants (13)

Bayer Diagnostics
France
Address
49 Chemin De Vieux Chêne
38242 Meylan
CRI A/S - Computer Resources Intl.
Denmark
Address
Bregneroedvej 144
3460 Birkeroed
HVIDOVRE HOSPITAL
Denmark
Address
Kettegaards Alle 30
2650 Hvidovre
Informed Software
United Kingdom
Address
2 The Square University Avenue
G12 8QQ Glasgow
Katholieke Univ. Leuven
Belgium
Address
Oude Markt 13
3000 Leuven
METHODE NOUVELLE
Belgium
Address
Excelsiorlaan 4A
1930 Zaventem
RAMIT STATE UNIVERSITY GHENT
Belgium
Address
De Pintelaan 186
9000 Gent
Selly Oak Hospital
United Kingdom
Address
Selly Oak
B29 6JD Birmingham
Sistemi Organizazzione e Gestione Servizi Sociali e Sanitari Srl
Italy
Address
Via De Amicis 53
20123 Milano
UNIVERSITY OF LIMBURG
Netherlands
Address
Annalaan 60
6217 KC Maastricht
UNIVERSITY OF UPPSALA
Sweden
Address
P.o. Box 174 - Academic Hospital Entrance 17,5
75114 Uppsala
University of Birmingham
United Kingdom
Address
Wolfson Research Laboratories Queen Elizabeth Medical Centre Edgbaston
B15 2TT Birmingham
VTT
Finland
Address
Kanslerinkatu 8
33101 Tampere