Development and implementation of a custom integrated database with dashboards to assist with hematopathology specimen triage and traffic
Azzato EM, Morrissette JJ, Halbiger RD, Bagg A, Daber RD. Development and implementation of a custom integrated database with dashboards to assist with hematopathology specimen triage and traffic. J Pathol Inform. 2014;5:29. | doi: 10.4103/2153-3539.139709
Background: At some institutions, including ours, bone marrow aspirate specimen triage is complex, with hematopathology triage decisions that need to be communicated to downstream ancillary testing laboratories and many specimen aliquot transfers that are handled outside of the laboratory information system (LIS). We developed a custom integrated database with dashboards to facilitate and streamline this workflow. Methods: We developed user-specific dashboards that allow entry of specimen information by technologists in the hematology laboratory, have custom scripting to present relevant information for the hematopathology service and ancillary laboratories and allow communication of triage decisions from the hematopathology service to other laboratories. These dashboards are web-accessible on the local intranet and accessible from behind the hospital firewall on a computer or tablet. Secure user access and group rights ensure that relevant users can edit or access appropriate records. Results: After database and dashboard design, two-stage beta-testing and user education was performed, with the first focusing on technologist specimen entry and the second on downstream users. Commonly encountered issues and user functionality requests were resolved with database and dashboard redesign. Final implementation occurred within 6 months of initial design; users report improved triage efficiency and reduced need for interlaboratory communications. Conclusions: We successfully developed and implemented a custom database with dashboards that facilitates and streamlines our hematopathology bone marrow aspirate triage. This provides an example of a possible solution to specimen communications and traffic that are outside the purview of a standard LIS.
Figure above: Updated workflow utilizing the hemepath database and dashboard. Solid arrows represent physical movement of residents and specimens. Dashed arrows represent communications. For simplification, bone marrow aliquot transfers to downstream laboratories are not shown in this figure. © 2014 Azzato et al; reproduced under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)