eLab Electronic Pathology Ordering: Aotea Pathology's Successful Implementation

eLabDr Karen Wood

Pathologist, CEO Aotea PathologyFebruary 2012

Aotea Pathology

•

Aotea Pathology

Aotea Pathology

• Serves all community laboratory referrals for HVH and CCH DHBs

• Established in 2006 for 5 year fixed term contract

• 3 year extension to November 2014

• In house LIS – Lab Solutions

Electronic ordering• July 07 electronic ordering proposal to

investigate signed off• MOU with Healthlink• Focus group meetings with referrers• Specifications developed• 2008 – Danish system – DMDD• 2009 Development• 2010 Two pilots• 2011 Launch and implementation

Aotea Pathology September 2011

Aotea Pathology

Roll out• Roll out by region

• To date ~ 30% of GP referrers

• Team visit with presentation and hands on training, food supplied

• 17% of referrals are by eLab

• Laboratory front end processing under review

• Collection services facility changes

Creating an eLab Order

3

Pathology lab adds to eLab:• Test specific clinical advice• Specimen and patient

requirements

Request Form printed advises patient:• Nearest collection rooms to GP’s

Practice• When to have the test• Fasting or other instruction• Unique barcode order number

4

eLab copies the request to MedTech:• Time, date, tests ordered• Image copied into Patient Advanced Forms and

Daily record

Patient presents at Collection Rooms• All information is available• Specific advice to collectors for unusual

Tests• Sample collected and barcoded

5

1

MedTech populates the eLab order screen

GP loads selected tests and required clinical information

2

eLab Form View Screen

eLab Normal View Screen

eLab Page Two Screen

Collection cubicle fit out

Advantages

• Data entry error reduction• Better demographic information: patient, referrer, copy to• Better quality clinical information from referrers• Improved laboratory reporting• Relevant clinical advice available• Less specimen error• Better patient preparation• Online reflex testing and house call requests• Service efficiency• Based on industry standards

User acceptance

• Positive from referrers

• Fully supported by laboratory

• Speed is paramount

• Reliability essential – no going back

• Closing the loop on a referral – copy back into “Tasks” in PMS

The NZ Environment

• Internet access and speed variable

• Not compulsory – no contractual obligation

• No national ID card

• No national request form

• Larger volumes of laboratory collected samples

• Greater imperative to follow up on critical tests

Future developments

• MedTech tasks generated (early 2012)

• Enhanced clinical advice – demand management

• Barcode within the practice

• Interlab transfer of specimens

• Search for previous results

• Implement within DHBs

• Enhanced internal processing eg tracking

• Patient and test billing