Vol. 23 • Issue 8 • Page 24
Laboratories have been touting the time-and-labor saving benefits of autoverification for years-and countless organizations rely on the value it brings. Yet in a world driven by large healthcare organizations and multi-site lab networks, many administrators are now realizing that today’s advanced middleware solutions can deliver benefits extending far beyond autoverification and even beyond the walls of the lab itself.
In fact, innovative middleware can help the entire healthcare system by centralizing data, standardizing decision rules and combining dictionaries from multiple testing platforms-even multiple lab locations-on the same networked server. This powerful resource puts labs in the driver’s seat and offers tremendous value to the larger healthcare ecosystem.
From Data Manager to Workflow Manager
In the past, people typically viewed middleware as just a “final gateway” for results being autoverified from one instrument and delivered to the LIS. Today, that mentality is changing.
When paired with automation, advanced middleware solutions can consolidate and manage data from a wide range of clinical lab disciplines-including chemistry, immunoassay, hematology, coagulation and urinalysis. Not only can it autoverify all the results-a huge help in and of itself-it can also leverage information from one instrument and instantly pass it along to another, thus preventing other testing bottlenecks.
Within hematology, for example, middleware can automatically transmit test results from a primary analyzer to an automated differential analyzer, for a complete start-to-finish workflow process that requires no technologist attention.
Because results can continually transfer between various instruments on an as-needed basis, today’s middleware is gaining recognition for being the powerful, integrated workflow manager it is. And the more it controls, the better the workflow process becomes. In fact, this higher level of interaction is exactly what enables middleware to deliver so much for organizations systemwide.
1. Combining Multiple Rules Dictionaries Across Platforms
Years ago, labs dreamed of middleware solutions that could manage results from both chemistry and hematology platforms at once. Over time, this wish was granted. New products were introduced that could manage information for multiple testing disciplines on the same server-all from a single system. These solutions helped to automate decision-making by applying unbiased evaluation to specify whether a test warranted a rerun, a reflex test or even the human expertise of technologist review.
With today’s middleware solutions, decision rules are no longer dependent on specific instruments, disciplines or worker preferences. Rules dictionaries from multiple testing platforms can now be centralized, with one set of rules covering the entire laboratory.
Instead of running separate local networks-one for chemistry, one for hematology and one for coagulation-labs can create a single database containing all of the rules and results, accessible from anywhere in the lab space. This offers tremendous advantages for busy lab workers who often struggle to keep pace with increasingly heavy workloads. Instead of physically traveling between various departments, the technologist can view results from multiple disciplines from a single viewing station.
2. Centralizing Data Across an Entire Lab Network
Today’s advanced middleware solutions can take this same idea even further. Not only can middleware consolidate data from ðmultiple platforms within a single lab, it can also consolidate data from multiple locations within an entire lab network.
Consider a hospital network that ðmanages 20 different lab locations across a specific state or region. Advanced middleware can drive decisions and manage all the data from all those branches from a single networked server, thereby standardizing care, decreasing variance and reducing the risk of reporting errors across the entire healthcare system. Organizations no longer need to worry that a sick patient may be diagnosed differently based on test results from different locations. The decision rules will be consistent everywhere, with full visibility for all users, too.
3. Improving Consistency and Quality of Care
Being able to view a wider body of information-from multiple instruments and multiple testing locations-can have a tremendous benefit on patient care. To review archived patient results in the past, a laboratory worker could only access data from the specific testing discipline’s database. Using the advanced middleware, however, a lab worker can now view patient results in a single, consolidated database and view any test that was run on a specific patient. If the middleware system is connected to a larger network of labs using the same database, the worker can also see if the patient was tested at another hospital location and view those results, as well.
Essentially, middleware helps drive better consistency across the entire paradigm of lab care. Doctors and clinician teams that rely on lab results can be assured that the quality of care will remain consistent and accurate because lab decisions aren’t dependent solely on people, but rather a proven IT process.
4. Optimizing Labor Resources
Of course, the far-reaching benefits of autoverification across an organization shouldn’t be minimized either. By providing an automated and standardized rules engine for decision-making, middleware can remove up to 90% of the manual review work from a lab’s workload, enabling skilled technologists to focus on the 10% of test results that require expert attention and review.
Having standardized decision rules also ensures testing quality in labs who use contingent labor or part-time technologists who work at more than one lab. Autoverification and standardized rules engines eliminate variances in interpretation and also minimize the risk of a technologist applying the incorrect rule during manual review.
Pulling It All Together
Having a strategic partnership with your middleware manufacturer is always wise, too. Look for a partner who offers the proven expertise to implement a middleware solution that brings efficiency, precision and value across your entire healthcare ecosystem.
Stefanie L. McFadden is informatics technical support engineer, and Chris Barnes is product manager, Workflow & IT Solutions, Beckman Coulter.