Template:The Comprehensive Guide to Physician Office Laboratory Setup and Operation/Data management/Other workflow requirements
3.4 Other workflow requirements
For the most part, data management systems such as the LIS and EHR/EMR are designed to handle core workflow functions; the LIS manages specimen receiving, processing, and analysis, while the EHR excels at organizing and presenting patient data. However, technological innovation and demand for more comprehensive tools has driven software developers to add additional functionality beyond the main workflow track, including environmental monitoring, customer management, and billing and revenue management. As such, it's worth taking a brief look at any additional workflow requirements in the POL and how data management tools may or may not address them.
1. Quality management: In their 2011 manual on quality management systems, the World Health Organization (WHO) states the following about the importance of laboratory quality:
Laboratory quality can be defined as accuracy, reliability and timeliness of reported test results. The laboratory results must be as accurate as possible, all aspects of the laboratory operations must be reliable, and reporting must be timely in order to be useful in a clinical or public health setting.[1]
Given how vital reliably accurate and prompt test results are to the clinical environment, quality management is a necessary ancillary component to the POL's primary workflow. For CLIA-waived POLs, quality management procedures may be relatively simple, focusing on proper sample collection, test procedures, and result documentation. For moderate- and complex-level POLs, quality management procedures and documentation may be much more rigorous. For the POL not using an information management system, quality management comes down to developing standard operating procedures (SOPs) and a means to train staff and evaluate the SOPs' effectiveness. However, an LIS often includes functionality that promotes quality control beyond in-house SOP development and implementation. Quality control tasks can be scheduled and Westgard rules—"[r]ules that are used in conjunction with each other to provide a high level of error detection while reducing the incidence of false rejection"[2]—can be implemented in the LIS' quality control tools. POL staff benefit from receiving alerts on out-of-range values of test results and viewing Levey-Jennings plots which provide a better visual indication of whether or not a laboratory test is working as expected.[3] It can also house corrective action plans and QC task history.[4] Again, however, the need for software-based quality management tools in the POL is going to largely depend on the POL's specimen and test types, as well as the CLIA certificate type the POL holds.
2. Reporting: Reporting represents another ancillary task that comes out of processing patient specimens. And like quality management, the breadth of reporting in a POL is primarily determined by the volume and difficulty of lab testing. Like so many other tasks, the POL that is dealing with low-volume CLIA-waived testing may simply opt to document test result directly to the patient file. However, opportunities exist for even the smallest of POLs to integrate a variety of reporting functions into their workflow, even if it's through a third-party reporting platform. Aside from specimen reports and test results, inventory, billing, workload, profitability, quality control, regulatory, compliance, and epidemiology can all be documented in text, tables, charts, etc. in a variety of digital, printable formats. The reports can then be automatically faxed, e-mailed, or printed, or delivered via an affiliated provider or patient portal.
3. Other laboratory management tasks: Of course, other POL tasks may originate from the main workflow or simply fall under the category of "general laboratory management." Some of those tasks—often able to be managed via an information management system like an LIS, EHR, or practice management suite—include:
- task assignment and management
- demographic management of customers, suppliers, and other outside entities
- inventory management
- creation, modification, and maintenance of training records and materials
- incident and performance tracking
- billing and revenue management
- ↑ World Health Organization (2011) (PDF). Laboratory Quality Management System Handbook (1.1 ed.). Geneva, Switzerland: World Health Organization. ISBN 9789241548274. https://apps.who.int/iris/bitstream/handle/10665/44665/9789241548274_eng.pdf. Retrieved 17 May 2022.
- ↑ Dawson, Sarah (16 February 2005). "Westgard Rules: The Nitty Gritty of Quality Control" (PDF). HPTN Central Lab. Archived from the original on 10 October 2015. https://web.archive.org/web/20151010050214/http://www.hptn.org/Web%20Documents/HPTNMeeting2005/WestgardPresentation02_16_05.pdf. Retrieved 17 May 2022.
- ↑ Moumtzoglou, Anastasius; Kastania, Anastasia; Archondakis, Stavros (2014). Laboratory Management Information Systems: Current Requirements and Future Perspectives. Hershey, PA: IGI Global. p. 285. ISBN 9781466663213. https://books.google.com/books?id=lhqXBQAAQBAJ&pg=PA285.
- ↑ Laughlin, Sandra; Feldman, Deb (22 October 2015). "The LIS, the healthcare market, and the POL". Medical Laboratory Observer. MLO – NP Communications, LLC. https://www.mlo-online.com/information-technology/lis/article/13008470/the-lis-the-healthcare-market-and-the-pol. Retrieved 17 May 2022.
