CHAPTER 2
3. LITERATURE REVIEW
To help understanding the most recent development and
achievement on the capability of a laboratory test management information
systemto improve patient communication within the health facilities, the
communication of medical practitioners within the clinical setting, and the
efficiency and the health care quality, we will conduct the review onthe use of
automatedlaboratory data management within an EMR, on the benefits of improving
laboratory data management on the patient safety in care delivery, on the
importance of laboratory data for public health monitoring of diseases and
epidemics, on the benefits of the Electronic Health Record (EHR) and their
implementation problems, and then on the mobile health (mHealth). The review on
the common categories of CPOE and a particular focus on the laboratory order
and lab result management automation will be also be done, then we will
conclude with the review on some cases on the design and implementation of
health information system (HIS)that involve the automation of management of
the laboratory data.
3.1. The useof automated laboratory data management with an
EMR
Laboratory, radiology results serveclinicians in healthcare
for screening, diagnosis of the disease and medication management.In the study
conducted by Nancy Elderand others in 2010, focused on «the documentation
of results management steps in patients charts at eight primary care offices in
the southwest Ohio region» (Elder et al., 2010)in USA.The research team
assessed whether results managed by an Electronic Medical Record (EMR)or by a
specialized lab management system improve the lab test documentation comparing
to manual and paper based practices. Observations, interviews with clinical
staff, and chart audits of twenty five (25) patient in each offices as been
used to assess the efficiency of the two systems. In this study, the clinicians
have expressed concern that EMR for managing test results just as part of
patient medical record are not satisfactoryeven if they have recognized a
significance improvement, compared to in-build system focus on laboratory data
management. (Elder et al., 2010)
Since, there are multiple steps involved in the management of
test results, beginning with offices tracking their orders and the return of
results to the clinician's office,one of the concern expressed is related to
the breakdown of communication process between clinician, lab technician and
nurses.The lost to follow up of laboratory test result by the practitioner
involved in patient care is also cited as a major problem in lab result
management. The research team has found that 64% of results managed with the
laboratory data management system had a follow-up plan documented compared to
only 40% of paper managed results. They find also thathaving two or more
standardized results management steps did not significantly improve
documentation of any stepsince there are not take into account in the standard
EMR. Instead all offices fall short in notifying patients and in documenting
interpretation of the laboratory result. (Elder et al., 2010)
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