As the world of pathology and laboratory medicine has increasingly headed in the direction of automation, implementation of Clinical Decision Support Systems are becoming a vital part of the process. The advances in technology and costs of human resources are factors pushing for automation. This chapter addresses the advantages and issues encountered during the installation of the new automated system Roche Cobas 8000 and Middleware IT3000 for the Clinical Chemistry Laboratory of one of the major teaching hospitals in Australia. The input and cooperation of Laboratory staff, Clinicians, Roche Diagnostics and LEAN processes has resulted in a fine example of how automation and clinical decision support systems play a major role in Improving Health Management.
TopBackground
The major teaching hospital currently provides pathology services to the following health facilities:
It also operates a successful private enterprise in the community and supports several other major public hospitals. The Pathology Department provides a range of services including Anatomical Pathology, Biochemistry, Hematology and Microbiology. It also provides specimen collection services (including blood collection).
The pathology specimen reception receives and processes 1500 to 1700 patients’ specimen test requests on a daily basis and the Clinical Chemistry department performs approximately 16,000 tests.
The Pathology Core Laboratory has had a recent upgrade and restructure to accommodate the increased demands for pathology services and also to respond to the challenge of dwindling resources from the government to operate its health services.
Why Automate?
There are many reasons for automating a process, which can be narrowed down to:
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Economic reasons - Businesses or organizations need to be sustainable so operating costs are usually an area that is investigated.
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Reducing errors – Many factors cause errors and so eliminating or reducing these is highly regarded especially in the health industry.
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Improved quality.
Automation derives from the replacement of manual, potentially dangerous, error-prone steps with automated processes requiring minimal operator intervention (Melanson, Lindeman & Jarolim, 2007). This results in improved turnaround times and tracking of specimens, and prevention of errors in specimen aliquoting; the end result provides an efficient and quality service to health workers and patients.
The expectations from an Automated System are different because each single laboratory will have different specific needs. However, the common theme of automation is to increase efficiency by meeting Key Performance Indicators, benchmarking, reducing operational costs and improving performance, thereby improving quality of care.