Integrated clinical and laboratory databases

Abstract

Many clinical laboratories routinely provide electronic reporting of laboratory results, and there is an increasing trend for users to capture these data in their own departments' clinical information system. This allows laboratory data to be interpreted in the context of the rest of the patients' electronic healthcare record. Integration of clinical data from various sources (e.g., clinical, laboratory, and radiology systems) combats fragmentation of healthcare, facilitates audit, and can lead to improved patient outcomes. The development of international standards such as Health Level 7 for clinical data interchange has facilitated this process. Also, the availability of evidence-based guidelines and integrated care pathways in clinical domains where laboratory data are critical has given a further stimulus to integration. Decision support systems and clinical data mining techniques may also be used to interrogate or search large data ‘warehouses' containing integrated clinical and laboratory data. In this presentation, the benefits and some limitations of integrating laboratory data with clinical information systems in selected clinical domains such as diabetes will be reviewed. International developments and selected applications from primary and secondary care will be reviewed, including the role of laboratory data in online personal health records, in remote telemonitoring, and in virtual clinics (‘e-clinics').