Legal Research

Technological Changes in the Medical Laboratory

The California Healthcare Foundation recently released a report entitled Under the Microscope:  Trends in Laboratory Medicine which was prepared for them by the Lewin Group.  Having spent 16 years as a Medical Technologist in a hospital laboratory, I found this report quite interesting, especially seeing how much the lab has changed since I left to go to graduate school in 1987.   The report is very comprehensive regarding current trends in  laboratory medicine as well as anticipated future trends that will affect the lab.

To point out what an important player the laboratory is in patient healthcare, the report’s introduction states that an estimated 70 percent of medical decisions regarding prevention of disease, patient diagnosis and subsequent patient treatment involve laboratory tests.  As healthcare stakeholders increasingly demand more “scientific evidence for clinical decision making”, the lab becomes more and more important.

What I found most interesting about the report was the discussion of  three electronic tools (which obviously were not around when I worked in the lab!) which have the capacity to improve the quality, safety, and efficiency of patient healthcare and also the cost-effectiveness of patient treatment - the electronic health record (EHR), computerized physician order entry capability (CPOE), and a computerized decision support system (CDSS).  The EHR can decrease orders for overused tests and increase orders for underused tests by providing laboratory test guidelines on the computer screen as a physician accesses his patient’s EHR.  A CPOE tool which connects the ordering physician with the laboratory information system (LIS) increases accuracy and efficiency in laboratory workflow and also decreases turnaround time for lab tests.  This can result in higher quality healthcare because a patient can receive medical treatment sooner, as his physician is alerted to any abnormal lab tests more quickly.  A CDSS  flags abnormal test results, reminds the physician to order preventive tests, and minimizes redundant test orders, thus contributing to better patient care and increased cost-effectiveness.

The report points out that the major problem, at present, with these 3 electronic tools is that the data standards may differ from one LIS to another.  This requires special software, “middleware”,  to allow data exchange between clinicians, hospitals, laboratories, etc.   This is one of the issues that must be fixed, if the  National Health IT agenda is to succeed.

When I left the lab some 21 years ago, discussion had just started about how computers could be used in the lab.  It was interesting to me to see how far the lab has come and what the future holds for those working in the laboratory medicine field.  And how crucial solving the data exchange problem is before the lab can become an efficient and cost-effective part of our future National IT Program.

The full report can be accessed from this webpage.

Full post as published by Jenkins Webblits on April 20, 2009 (boomark / email).