An Evaluation of Laboratory Information Systems in Medical Laboratories in Jamaica

Introduction

Laboratory medicine is the foundation on which the structure of scientific medicine is erected and is an integral component of the clinical diagnosis and management process. The clinical laboratory is increasingly integrated with patient care, assisting diagnosis, monitoring therapies and predicting clinical outcomes. Laboratories also provide essential public health information and disease surveillance (Dacombe et al., 2006). Due to this wide-ranging role, laboratories are an important part of many disease control programmes. Therefore, laboratory-based disciplines such as clinical chemistry, haematology, histology, immunology and microbiology contribute significantly in effectively controlling infectious and non-infectious diseases.

Laboratory medicine has undergone marked changes during the 20^th century and is likely to develop even more rapidly in the 21^st century (Guidi & Lippi, 2006). Ongoing technological developments have considerably improved the productivity and efficiency of clinical laboratories, and there have been significant improvements in the provision and quality of diagnostic tests. Significant developments such as automation, commercially produced reagents and more powerful computers provide clinicians with an ever-increasing list of rapid and cost-effective tests. Furthermore, more efficient patient result verification has greatly improved laboratory test throughput while decreasing turn-around-times, enabling critical results to reach clinicians rapidly for better clinical outcomes. Advances in laboratory medicine have occurred in conjunction with analytical developments that measure many different analytes with specificity for pathological conditions and ever-increasing sensitivity. Such tests revolutionized clinical diagnosis in ways that were unimaginable even a decade ago (Herzlinger, 2006).

Information systems in pathology provide opportunities for clinical laboratory scientists and pathologists to impact both clinical care and research agendas adding value to the health care system, both at local and international levels. Pathology information systems can provide major databases for research in health services and new informatics-based approaches to database research. Databases are created through the archiving and organization of laboratory data through the laboratory information system (LIS), hospital information systems (HIS) or peripheral programs (Connelly, 1997). Databases of quantitative laboratory data can be used for data mining, rule discovery, retrospective analysis and other clinical research applications. Maintaining the integrity of databases is an important function of the laboratory diagnostician or information technology scientist (Friedman, 1990). Database support encompasses acquisition, coding, data classification, design, display, reporting standards, management, and query methods (Connelly, 1997; Friedman, 1990).

The last two decades have brought major advances in processing power and software engineering, many of which have had a direct impact in clinical laboratories. Laboratory information systems have revolutionized the storage and retrieval of information. They are used for assessing and improving quality in clinical laboratories, and patient management using decision support (Bates et al., 1999). The purchase and installation of a modern LIS module in clinical laboratories have significantly increased laboratory productivity in terms of quality and cost reductions, and improved turn-around-time as test results are produced faster (Pelegri et al., 1996).