Abstract
BackgroundReducing laboratory errors presents a significant opportunity for both cost reduction and healthcare quality improvement. This is particularly true in low-resource settings where laboratory errors are further exacerbated by poor infrastructure and shortages in a trained workforce. Informatics interventions can be used to address some of the sources of laboratory errors.ObjectivesThis article describes the development process for a clinical laboratory information system (LIS) that leverages informatics interventions to address problems in the laboratory testing process at a hospital in a low-resource setting.MethodsWe designed interventions using informatics methods for previously identified problems in the laboratory testing process at a clinical laboratory in a low-resource setting. First, we reviewed a pre-existing LIS functionality assessment toolkit and consulted with laboratory personnel. This provided requirements that were developed into a LIS with interventions designed to address the problems that had been identified. We piloted the LIS at the Kamuzu Central Hospital in Lilongwe, Malawi.ResultsWe implemented a series of informatics interventions in the form of a LIS to address sources of laboratory errors and support the entire laboratory testing process. Custom hardware was built to support the ordering of laboratory tests and review of laboratory test results.ConclusionOur experience highlights the potential of using informatics interventions to address systemic problems in the laboratory testing process in low-resource settings. Implementing these interventions may require innovation of new hardware to address various contextual issues. We strongly encourage thorough testing of such innovations to reduce the risk of failure when implemented.
Highlights
Laboratory testing plays a vital role in clinical decision-making
To maximise the value of the LIS, we considered problems identified in the laboratory testing process and described in previous publications.[11,13]
We have described the process used to implement a LIS in a low-resource setting, at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi
Summary
Laboratory errors include a wide variety of mistakes in the testing process and have no universally accepted definition. In 2001, it was estimated that laboratory errors accounted for $200 million – $400 million in American healthcare expenditures per annum.[6] Since the rate of utilisation of laboratory services has increased, making the reduction of laboratory errors a significant opportunity for cost reduction and healthcare quality improvement. Reducing laboratory errors presents a significant opportunity for both cost reduction and healthcare quality improvement. This is true in low-resource settings where laboratory errors are further exacerbated by poor infrastructure and shortages in a trained workforce.
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