Features and Properties of ‘MediLab’

The features and properties of the ‘MediLab’ Laboratory software are extensive. They cover all the functions of clinical laboratories in multiple ways and methods. Through its properties, the laboratory system “MediLab LIS’ has a particularly strong adaptability. It is parametrically adapted to the way each laboratory operates.

Laboratory types

MediLab LIS, manages the diverse needs across of all types of private medical laboratories. These include BioChemistry, Hematology, Coagulation, Virology, Immunology, Serology, Toxicology, Urinalysis, Microbiology, Molecular Biology, Cytogenetics, Flow Cytometry, Anatomic Pathology, Cytology and others. Flexible workflow tools of ‘MediLab LIS‘ automate clinical test order processing through the entire order life cycle.

Management of daily work

•  Ordering tests
•  Distribution to laboratories
•  Scheduling of tasks
•  Connection to analyzers with barcode and/or with work lists)
•  Management, control, distribution of results.
•  Communications and data exchanges

The Software exchanges data with other systems of the Health Unit’s Information System. These data include the transfer of patient demographic data, possible health data and ordered tests and results that will update the medical record.

The system connects the existing analyzers of the laboratory. It fully exploits all communication capabilities. It supports both, one-way or two-way communication, use of barcode, quality control, communication checks like digit control, etc.

Patient manager

The Patient Manager module provides convenient access to all available laboratory test/result data. It encounters details, charges and billing information, attached documents and files, clinical history, and demographic detail. It also includes family relationships.

Test Orders

The management of incoming orders (test orders) is done in a unified manner. The LIS allows the definition of test orders for all categories of tests. It offers many different ways depending on the conditions of the Diagnostic Center. The definition method can be centralized (central secretariat) or multiple ordering points.

Decentralized test ordering is done through the system. This feature concerns the online ordering of laboratory tests from any point. It can be e.g. the secretariat of the Radiology laboratory or the secretary or the doctor of a specific specialty. In case for any reason it is not possible to temporarily register the order through the ordering system, then the system implements the process through the central secretariat.

Order numbering

Each order has a unique order number. The Laboratory Software MediLabregisters all the necessary demographic or other data for the full execution of the order. It is automatically updated via the patient’s social number, by data obtained from the National database. In case that communication is not possible, the system is able to operate autonomously.

In order to make this functionality possible, the laboratory system can use any different code the patient has. At the same time, it provides a search for previous laboratory results with multiple criteria.

Barcode labels

The software MediLabprints the sample labels (plain or with barcode) if they have not already been printed by the order issuance system. It is possible that an order has more than one type and number of samples. The sample number in combination with the type of sample (e.g. Blood, urine, etc.) create a unique order.

Order registration

A configurable order management, specimen collection, and accessioning tools, address a variety of situations. Among these are manual order entry, CPOE via interface with HIS or EMR, interface with another LIS, and import of batch order file. Other integrated features include sample collection/phlebotomy, built-in tools to capture ICD10 codes with medical necessity checking, recurring orders, cloning and merging orders, double data entry, question forms, and label printing.

The LIS System offers a number of software features for managing Phlebotomy/sample collection activities. The features can be set-up to suit the needs of different order processing scenarios. For instance, routine ward collection rounds and the relatively ad-hoc phlebotomy operations at an outpatient clinic.

Order registration ensures the following rules:

•  The patient’s registration number is common to all samplew and orders, so all the tests can be grouped by patient.
•  Each patient can have more than one sample ID code within a day.
•  The laboratory software provides security during registration in terms of data accuracy.
•  Identity errors are avoided both in the test order and in the identification of samples.
•  Ability for authorized persons to transfer test orders and results from patient to patient in cases of duplicate registrations (merging of patients).
•  Each order is accompanied by the details of the ordering physician, as well as the details of the user who registered it (user code, date, time).
•  The origin of the examinee (e.g. referring physician) is recorded and follows the registration details.
•  There is a special label for urgent examinations.
•  Upon validation of the registration, the system distributes the examination orders to the processing areas and the corresponding medical devices, while providing the necessary information for the movement of the samples.
•  After the preparation of the samples, the system determines which samples are excluded from further processing and for what reason. 

Phlebotomy operation

There is a flexible presentation and grouping of phlebotomy activities, e.g. by Nurse, Phlebotomist, Practitioner etc. Seamless integration of phlebotomy operations with Order processing. Comprehensive information about sample types, sample volumes, specimen collection tubes, storage conditions etc. exist in the original test order.

There is a positive patient and order identification prior to sample collection. There is also a capability to schedule phlebotomy operations according to priority and pre-defined, hospital specific collection plans. Additionally there is an automatic printing of specimen labels and collection sheets in batch or at the point of collection.

Barcodes printing – handling

The software supports any Windows compatible barcode scanner or printing device. It prints on the barcode label in human-readable font the necessary data, available in the data base.

Analyzer Connection

MediLabis interfaced to the analyzers with full exploitation of all features:

•  Two-way communication and communication in query mode where this is supported.
•  In one-way communication, the system takes the necessary measures for the identification of the sample – examinee and the general ecurity of the system.
•  Recording of results that do not correspond to system orders in a special log file per analyzer.
•  All features offered by the respective communication protocol with the analytical device are exploited.
•  The user controls both the communication status and the progress of the analyses.

Test Controls

Test controls include a wide range of different processes that culminate in their validation. The most important tasks are:

•  Flagging incomplete tests.
•  Calculation of the result (in case of calculated tests).
•  Unacceptable values, outside normal limits or outside panic limits.
•  Checking batch control values.
•  Test anomalies (via parametric control file).
•  Checking average values per test in previous days – comparison with current results to check the reliability of the machines and reagents.
•  Group intervention possibilities on results after recording the intervention in the database (audit trail). The modification is made based on the deviations due to the analyzer – reagent. Such corrections are made in exceptional cases and only by an authorized user.
•  Final validation of the results and forwarding for printing – distribution. The validation of urgent examinations is followed by a special audio or visual signal to the ordering physician or the registration workstation.

Results management

•  When managing results, i.e. when entering, correcting, changing status (approval, re-examination, etc.), the user simultaneously sees on the screen the previous values of the results of all the sample tests.
•  Approval and release of results of part of the order up to the test level and not necessarily of the entire sample or order. The result is that it is not necessary to execute the entire order, or all the tests of the sample in order to print an already ready and approved result of the sample or order.
•  Possibility of entering both quantitative and qualitative results or both simultaneously in the tests in distinct positions.
•  Unified coding of sample type (blood, urine, etc.).

Result automation

User-configurable algorithms for evaluating the quantitative result and its automatic conversion (or addition) to a qualitative result. The algorithms are configured for each analyzer separately. Consequently, the laboratory software allows, through appropriate parameterization, the definition of algorithms. These convert the quantitative result of a test into the corresponding qualitative one (characterization e.g. NEGATIVE).

The diagnostic laboratory software MediLaboffers unified test coding. This concerns all tests ordered such as individual, complex, calculated and groups of tests (e.g. Checkup). It synchronizes and correlates the codes of the information systems (e.g. by maintaining multiple test codes in the laboratory system). In addition, it has the ability to automatically extract findings based on the evaluation of one or more related tests.

Culture stages

The laboratory software, specifically for the Microbiology Laboratory, monitors the intermediate stages of the cultures. The workflow for each examination is parametrically defined by the laboratory physician. Consequently, it allows the definition and monitoring of the distinct steps for the completion of the culture processes. During this process takes into account any specificities and differences that exist in the existing flow of Microbiology Laboratories.

Profiles

The MediLab Laboratory Software allows the organization of tests into groups (profiles), so that many can be selected in one go. These profiles are defined by an authorized user only. An analytical exam can belong to more than one profile.

Test characteristics

The basic characteristics of analytical tests (beyond the obvious, such as description, unit of measurement, etc.) are:

•  Result type: Numeric, Alphabetical, Date, Text (free or pre-designed), Selected values (per test), Image.
•  Refference values: Defined by age and gender, pregnancy phases, menstrual cycle, age groups as well as with broader explanatory text.
•  Flags: unacceptable values, panic values, values outside normal limits.
•  Sample type (serum, urine, etc.)
•  Reagents used (code, quantity, reference values)
•  Calculation type (for calculated tests)

The software addresses the issue of changing the calculation method (chemistry) of a reagent in a test. This way, the accuracy of the data is not altered when an examination is performed by two or more analysers with different reagents.

Organization of test batches

Samples are organized into batches per machine, depending on their type, the existence of the necessary reagents, their scheduling, etc. This division is the basis for organizing work in the laboratory and contributes to saving reagents. The laboratory software controls the type and number of pending tests at the daily procedure level. In combination with the required reagents, it proposes a flow plan for the analyses.

Parametric test control rules file

The software includes rules that interconnect the relevant tests, the price relationships between them, as well as any messages from medical devices. The aim of this file is to help draw conclusions regarding the correctness of the results, while also providing some useful medical information.

Sample and tests Management

MediLab LIS provides many an automatic mechanism for sample identification, based on ordered test. Data entry is permitted in any case but it is mandatory for microbiological samples. These all provide the ability of a quick and efficient data entry for both single and multiple samples. A variety of styles and screens allow the lab to optimize the tests/sample registration process. Order tests per sample, using configurable templates allow the appropriate data fields to be available in an easy way.

Quality Control

The QC management tools that MediLab LIS software features include, are Westgard rules and Levey- Jennings plots. Additionally, include all the reagents management details, like lot and expiry dates.

Result Entry

MediLab LIS provides extensive capabilities that effectively streamline and reduce transcription errors in result entry. Automated result entry is provided via analyser connection and barcode system. More than bidirectional interfaces to the laboratory instrument, MediLab application provides key-in result entry option. There is also a flexible mechanism to support group samples and tests together so that they can be worked on collectively.

Samples and tests can be individually selected and results entered, as well as multi-selected and results entered in a spreadsheet format. For ease of operation, results can be entered using different layouts arranged by sample ID as well as by test. In addition to this, there is filtering of tests so that large result entry spreadsheets can be easily worked on test by test to simplify data entry.

External patient file Linking

Sometimes it is necessary to associate LIS data with information stored in files- perhaps raw data files, graphics images, or document files. ‘MediLab LIS‘ provides links between all database records and external files. It also can import external files and store in the database. The presence of a link to an external file is indicated by an icon on screen. The external file can be virtually any format. Then the LIS may display the contents of the external link file simply by a click.

Re-examinations

The system is able to highlight identical re-examinations per examinee, so that the user can ultimately choose one of them.

•  Possibility of executing repeats or pending examinations on another analyzer than the original one. It is supported if a test can be performed on more than one analyzer.
•  Urgent tests are given priority in execution. If the analyzer has the ability to schedule and execute urgent tests, they are scheduled as STAT.

Classifications for Result Management

The MediLab software supports the management of results in various ways to facilitate users in their handling. In these groupings, it is particularly useful to have “filters” for the laboratory and the date range. Groupings can be per sample, per Examination, per Patient, per referral. The distribution of results also includes sending data for further updating the medical file.

Results Printouts

The printing of results is done in various ways, per examinee, with a range of patient codes, per type of examination, per profile, etc. The printing forms provide complete freedom to users regarding their formatting (text format, images, graphs, headers, footers, etc.). The system has the ability to display graphic diagrams and allows data to be exported to third-party office automation applications.