Preparing Laboratories for Interconnected Health Care.

Thomas Streichert,Andreas Bietenbeck

doi:10.3390/diagnostics11081487

Abstract

In an increasingly interconnected health care system, laboratory medicine can facilitate diagnosis and treatment of patients effectively. This article describes necessary changes and points to potential challenges on a technical, content, and organizational level. As a technical precondition, electronic laboratory reports have to become machine-readable and interpretable. Terminologies such as Logical Observation Identifiers Names and Codes (LOINC), Nomenclature for Properties and Units (NPU), Unified Code for Units of Measure (UCUM), and SNOMED-CT can lead to the necessary semantic interoperability. Even if only single “atomized” results of the whole report are extracted, the necessary information for correct interpretation must be available. Therefore, interpretive comments, e.g., concerns about an increased measurement uncertainty must be electronically attached to every affected measurement result. Standardization of laboratory analyses with traceable standards and reference materials will enable knowledge transfer and safe interpretation of laboratory analyses from multiple laboratories. In an interconnected health care system, laboratories should strive to transform themselves into a data hub that not only receives samples but also extensive information about the patient. On that basis, they can return measurement results enriched with high-quality interpretive comments tailored to the individual patient and unlock the full potential of laboratory medicine.

Highlights

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
In an interconnected health care system, a team of specialists replaces the single physician who is solely responsible for a patient
This work examines how laboratories and laboratory medicine can prepare for these changes on a technical, content, and organizational level

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Laboratory measurements of a patient are no longer conducted in a single laboratory. Using electronic patient records or other IT infrastructure, laboratory results will be exchanged and aggregated. Transmitted electronically, they are always available at the point of treatment. Various medical specialists are no longer the only recipients of the laboratory report. Other entities, such as machine learning algorithms, receive laboratory reports electronically to predict diseases or disease progression [1]. Patients see themselves in a more active role and request their laboratory reports to manage their lifestyle and health. This work examines how laboratories and laboratory medicine can prepare for these changes on a technical, content, and organizational level

Results

Interpretive Comments Are a Crucial Part of Electronic Laboratory Reports

Interconnectivity Requires Traceable Measurements

Opportunities Inside the Laboratory

Laboratories Need to Engage All Stakeholders

Discussion