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Biomedical subjects

R D Aller

Publications and source records attributed to R D Aller.

At least 37 records · Page 2Linked to original sources
PubMed1999

Creating integrated regional laboratory networks.

In this decade, a new model of laboratory organization has begun to emerge: the regional, integrated laboratory system, optimized to serve the needs of both the hospital population and the physician's office market, while operating at a cost considerably lower than that of an equal number of separate hospital laboratories. This article briefly reviews the comprehensive new design, implementation, and operation of an integrated regional laboratory system and focuses on the informatics aspects of these regional networks.

Clinical Laboratory Information Systems↗
PubMed1997

The pathologist's workstation.

To leverage the time and expertise of the pathologist, a comprehensive workstation is a useful tool. Because the practice of pathology is so diverse, however, there is no one standard for what constitutes a workstation. The author reviews the several elements and components which must be included (access to your LIS, word processing, electronic mail, Web browser, literature search), and also reviewed are the many more which may be included, depending on the specialized needs of the practitioner (statistical analysis, ROC curves, image analysis, voice synthesis). It is, however, up to the pathologist to determine which of these components are required and to assemble them in as seamless a manner as possible.

Computers↗
PubMed1997

Outcomes and informatics.

OBJECTIVE: To provide an overview of the potential contribution that informatics can make for pathologists who become involved in outcomes assessment and management. DATA SOURCES: Contemporary scientific articles centered on pathologists and the assessment of outcomes, the definitions of outcomes assessment and management, and related methodologic issues, especially those pertaining to information technology and outcomes, and a summary of eight independent group process sessions involving volunteer pathologists and a group facilitator discussing issues related to informatics and outcomes as structured by a clinical scenario with focusing questions. STUDY SELECTION: Articles reviewed were drawn primarily from the literature published since 1985 and found through Medline key word searches of titles and abstracts; likely articles were then selected for subsequent detailed review on the basis of the abstract's contents. Group process data were drawn from summaries of each of the eight groups as prepared by the facilitator from notes taken during the session by a designated scribe. CONCLUSIONS: It is crucial for pathologists to participate in clinical outcomes studies. Informatics can serve as a tool kit for performing outcomes studies relevant to pathology (eg, collect data or analyze data), or it can be seen as a malleable component of health care processes that can be modified to achieve improved outcomes. Pathologists see many potential avenues for using informatics to leverage the impact that the pathologist and laboratory can have on clinical outcomes. Focusing on some specific informatics learning objectives can help the pathologist become a leader in outcomes studies.

Databases, Factual↗
PubMed1996

Rapid accurate entry of microbiology results.

OBJECTIVE: To develop techniques to improve efficiency and accuracy of data entry in microbiology, using a commercially available laboratory information system that is keystroke-intensive. DESIGN: A combination of technologies, including bar-coded phrase sheets, keyboard macros, and bar-coded specimen labels, are used to automate the entry of commonly used keystroke sequences and combinations of culture findings. SETTING: An acute care hospital laboratory. PARTICIPANTS: Laboratory technologists. OUTCOME MEASURES: Feasibility, report error rates, and technologist time. RESULTS: Qualitative: implementation of all three technologies proved feasible and practical. Quantitative: a 25-fold decrease in misreported cultures, as well as a 50% saving in reading time for new urine cultures. CONCLUSIONS: This set of technologies for keystroke reduction would be of general applicability to laboratories with a variety of different laboratory information systems.

Bacteria↗
PubMed1996

Software standards and the laboratory information system.

Software standards simplify communication and cooperation between applications provided by different software vendors. However, adherence to a rigid standard can stifle innovation. Open standards, which are not proprietary to any particular vendor, are particularly useful. Many standard-setting organizations have provided useful tools for laboratory informatics, including the American Society for Testing and Materials (ASTM), Institute of Electrical and Electronics Engineers, National Committee for Clinical Laboratory Standards, and the College of American Pathologists. Data communication standards, such as ASTM 1238, HL7, and Digital Image Communication of Medicine, have reduced the cost and improved the timeliness of interfaces. Nomenclatures, particularly the Systematized Nomenclature of Medicine (SNOMED), have facilitated the structuring of medical information, and decision rules can be communicated with ASTM E1460. Laboratory Observation Identifier Names and Codes has eased the problem of identifying tests during interchange of laboratory data. Implementation standards are useful references for those deploying information systems. Standards have provided multiple benefits to laboratories and to the health care organizations of which they are a component.

Clinical Laboratory Information Systems↗
PubMed1996

Laboratory computer availability: a College of American Pathologists Q-probes study of computer downtime in 422 institutions.

OBJECTIVE: To determine the frequency, duration, and impact of computer downtime on laboratory operations. METHODS: Four hundred twenty-two laboratories monitored the frequency of computer system downtime and other computer malfunctions over a period of 30 days. Participants classified each instance of unavailability according to its cause, duration, and consequences. In all, data from 11 967 instances were submitted for analysis. RESULTS: During the 30-day study period, the participating institutions experienced a median of eight episodes in which all or a primary computer function was unavailable. The cumulative median duration of downtime during these 30 days was 14.3 hours. The most unfortunate 10% of participants reported having 44 or more episodes in which all or a primary computer function was lost during the 30 days, for a cumulative duration of 77.7 or more hours of system unavailability. Computer installations that served two or more full-service laboratories were significantly more likely to experience unscheduled loss of all or a primary computer function than were sites that served only one laboratory, and unscheduled events were more likely to be of longer duration. Participants reported that 1.3% of downtime events required the use of staff overtime to perform required work. Overtime was more likely with longer-than-average periods of downtime and losses that had not been scheduled. Of all the downtime instances, 0.2% led to the release of inaccurate results, and 0.1% led to an adverse clinical outcome. These events were associated with software failure, unscheduled downtime, a site's overall frequency of downtime, particular software vendors, and not having installed a software patch in the previous 1000 days. CONCLUSIONS: The frequency of laboratory computer downtime varies widely among institutions and is occasionally associated with adverse clinical outcomes or additional staff expense.

Chi-Square Distribution↗
PubMed1991

Acquiring a laboratory computer system. Understanding the issues.

This article reviews the issues involved in introducing or upgrading computer automation in the clinical laboratory. The strengths and weaknesses of computers and computer systems are discussed. Information on selecting and educating the laboratory team who will use the computer and analyzing the needs of a particular laboratory is included.

Clinical Laboratory Information Systems↗
PubMed1991

Information for medical decision making. Improving our laboratory reports.

The primary product of the laboratory is information. Greater attention should be devoted to how laboratory reports are presented to ensure that information is being conveyed effectively to the clinician. Different reporting techniques, including test-by-test, interim, cumulative, and completed accession reports, are appropriate for different patient populations and physician needs. This article includes many suggestions for improved layout and content of laboratory reports, including the use of PostScript-based laser printers, as well as display work-stations and voice response.

Clinical Laboratory Information Systems↗
PubMed1991

Acquiring a laboratory computer system. Vendor selection and contracting.

The steps involved in acquiring a computer system, from writing the request for a proposal to signing the contract, are discussed. Guidelines for selecting a system include information on the merits of different hardware and software available for use in the laboratory.

Clinical Laboratory Information Systems↗
PubMed1991

Open systems architecture. The multivendor hospital information system.

Optimum productivity and performance are attained by permitting each functional division of a hospital to choose the optimum information system for its own needs. Quality patient care depends on the ability to coordinate and communicate the information generated in each department to the patient's bedside. Communication standards are now available to facilitate the melding of these two disparate requirements.

Database Management Systems↗