Authors (including presenting author) :
Vincent NG(1), PC HO(1), John MOK(1), Vicky FUNG(1)
Affiliation :
(1)Information Technology and Health Informatics Division, Hong Kong Hospital Authority
Introduction :
Laboratory investigation is an integral part of evidence-based medicine. During the outpatient journey, a disproportionate amount of time is spent on waiting for the phlebotomy service. This not only impedes patients’ experience but also exerts pressure on frontline staff for quality service delivery. In Hospital Authority (HA), outpatients are only allowed to have their blood taken at designated phlebotomy service points. Doctors request tests via Generic Clinical Request System (GCRS). At the point of blood taking, these requests would trigger printing of specimen labels for patients according to the local hospital setup. Cross-hospital requesting is minimally limited to within-cluster hospitals, and specific requests. These all require request-specific setups. One of the major obstacles in actualizing cross-hospital requesting and blood taking is the highly localized nature of laboratory requests. With incrementing workload and growing queues for phlebotomy, cross-hospital requesting would help allow flexibility for patients and reduce waiting time. To achieve this, corporate infrastructure is the prerequisite to enable effective and efficient usage of resources.
Objectives :
To construct the HA Laboratory Test Request Catalogue To provide an infrastructure for cross-hospital requesting infrastructure
Methodology :
Interface terminology approach was adopted for construction of HA Laboratory Test Request Catalogue. The HA corporate reportable laboratory tests and specimens were retrieved from Information Architecture Management System (IAMS). A union set of laboratory requests from all HA institutes were also obtained. The requests were reviewed for the respective reportable tests and were subsequently grouped into HA requesting test list, with mapping to corporate standards. With verification by local laboratories and endorsement of the expert groups, HA test catalogue was established. (Fig. 1) The catalogue serves as the interface terminology for interoperability and as an integral part of the cross-hospital requesting infrastructure.
Result & Outcome :
There were 50,466 distinct local requests in HA. Through input from experts and local laboratories, a HA test catalogue consisting of 2,115 test requests. The request list and the local mapping were stored in two tables. A simplified dataflow was summarized in Figure 2. The new tables act as the backbone for interoperability. HA requesting tests were traceable to corporate standards; and local requests were mapped to the same code for same request. (Example 1) This design can easily facilitate cross-hospital requesting; and patient blood taking at alternative sites. With laboratory request standardization, the local requests becomes interoperable via the HA Laboratory Test Request Catalogue. The corporate infrastructure is the prerequisite to cross-hospital requesting and blood taking. This provides the cornerstone for corporate initiatives in providing more flexible blood taking service with reduction in waiting time.
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