Automating Reference Lab Reporting Team Members Janie Marrero

Automating Reference Lab Reporting Team Members Janie Marrero Ann Del. Bene Phyllis Straff Dorothy Schlette Mary Cashin Nancy Brown Sandy Serritelli Kris Kelly Bea Gregorio Sayeeda Wahab

Opportunity Statement There are opportunities to: n Decrease the use of multiple outside laboratories (22, 000 tests referred/yr) n Decrease the number of orders manually entered n Streamline result process by reducing paper reports received & manual entry into LIS

Goals n n n Reduce turnaround of reported results Improve result timeliness to physician Reduce potential for transcription error Consolidate testing to major reference laboratory Enhance staff utilization Streamline manual operations

Most Likely Causes Identified n n n Manual processes only Unmanageable filing system Lack of cross training among staff Multiple reference labs used Difficulty finding/ organizing specimens Workload exceeding staff resources

Solutions implemented n n Consolidated 80% of referred tests to one main reference lab Initiated cross training among staff Modified current filing system Implemented new specimen locating, organization, and packaging processes

Solutions Implemented n Installed Electronic Data Interface from Lab Info system to Reference Lab ¡ Referred tests automatically gathered onto separate “packing lists” for frozen, refrigerated, ambient temperatures ¡ Orders sent electronically to ref lab ¡ Results sent back electronically to LIS ¡ Results then sent electronically from Lab system to LUCI and EMR

Reference Lab Interface

Process “Before” Interface Specimen in Lab Test Manually ordered in Reference Lab Computer Packing List created manually Specimens packaged Samples sent to Ref Lab via courier Test result printed on paper report Results manually transcribed into LIS Paper report manually filed for future reference

Process “After” Interface Specimen in Lab Packing List printed from LIS Samples packaged Samples sent via courier Results automatically populate LIS, EMR, and LUCI systems

Pre & Post Interface Turnaround times in days Times measured for 6 high volume tests

Data Analysis of Results n n 37% average decrease in turnaround Results available 14 -44% sooner Results transferred directly from reference lab to LIS 80% referred testing consolidated to one reference lab

Next Steps n n n Continue to consolidate referred testing to preferred reference lab for best optimal service Continue to look at the advanced features of the Reference Lab Interface to further automate the process Continue cross training among staff on these standardized processes