The institute of medical and veterinary science clinical laboratory computing system

Abstract

A system has been implemented to provide on-line monitoring of a variety of laboratory instruments, an information storage and retrieval system for all pathological tests carried out within the Institute and a large machine-readable data base for research purposes. The system was based on a 32K CDC 1700 with a full range of peripherals including 12M characters of mass storage, tape units, line printer, card reader and adequate analogue and digital input and output. Remote data entry was by four Selectric typewriters and six 211-13 display stations. Development of software to handle the laboratory requirements has been carried out solely by analysts and programmers at the Institute, with some special input/output drivers coming from CDC. Since there was a necessity to maintain a viable operating procedure throughout, as well as to implement the system as soon as possible, integration of all laboratory procedures into a total system has been proceeding in a number of denned stages. The first phase, which was fully operational, was to establish an indexed patient file which could be accessed by on-line instruments, remote terminals or local batch-processing programmes. Indexing was currently restricted to the laboratory number of the specimen but would shortly be expanded to include referencing by name and hospital identification number. Initial implementation interfaced SMA 12/60, SMA 6/60 and Coulter'S' analysers, with single channel autoanalysers added. Control for these instruments was either by Selectric typewriter or CRT. Initial emphasis was placed on the above instruments because of the high work-load placed upon them. Patient data was entered in batch-processing mode on cards. Whilst this appeared to work reasonably successfully, there were a number of problems involving time delays and lack of communication, which should be overcome by the use of data and test request entry on remote terminals. Hard copy terminals would be used in departments such as Bacteriology where the point of data entry could also act as the source of the report sent to the doctor. All departments stored the results of their laboratory examinations on the computer in some form, although only Biochemistry used the system for routine production of laboratory reports. This routine reporting had been expanded to include a large T.B. section and with the introduction of remote terminals, all divisions would be able to make use of this facility. However, already a large data base existed which was proving to be of great value in a variety of ways. The analysis of patterns of abnormal tests, the analysis of instrument performance and variations in the normal ranges of patients were possible. Further, the analysis of test results versus hospital separation data represented the basis for investigations into the correlation between test patterns and diseases.