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In the past ten years, laboratory medicine has developed rapidly, and the advent of many new technologies has completely changed the traditional laboratory work mode, and at the same time reduced the labor intensity of the staff. However, the management of hospital information is far from keeping up with the rapid development of information technology in laboratory medicine. Laboratory quality control, intelligent management, standardization and integration have brought crises to the research and management of laboratory medicine.
Modern medicine requires medical institutions to collect, archive, process, supervise and manage a large amount of inspection and treatment information. The records formed by the hospital’s traditional manual copying and thermal paper reports are far behind the development of laboratory medicine. Even if it is a Chinese stand-alone report and the internal network of the laboratory, the computer is only used as the processor of the department or department to receive, store, print or send data, but it does not make full use of the resource advantages of the computer network, so that the computer management only stays in one direction. Net or Ke intranet status.
The Run Run Run Run Hospital affiliated to Zhejiang University School of Medicine was established in 1994. It was donated by the well-known Hong Kong businessman Sir Run Run, supported by the Zhejiang Provincial People’s Government, and assisted by the Loma Linda University Medical Center in the United States. A sex, research-oriented tertiary class A hospital. The hospital is located in the downtown area of Hangzhou. There are 33 clinical departments and a Shaw Clinical Research Institute of Zhejiang University.
A first-class hospital needs a first-class information system to improve the operating efficiency of the entire hospital. Run Run Run Shaw Hospital has applied automatic identification technology to the laboratory department, which has greatly improved the hospital’s information management level. They have introduced an advanced management model, operating laboratory management. The system integrator has designed a reasonable data flow, implemented practical plans, and selected the best equipment through full communication and communication with the hospital’s inspection personnel, making the hospital’s inspection information operation unprecedentedly efficient.
Data flow
The inspection data of the hospital is mainly concentrated between the nurse station and the laboratory (Figure 1). The working process of the nurse station, that is, the process of generating a medical order for inspection includes: medical order application, label printing after verification, sampling, signature (work number, time), and submission for inspection.
The workflow of the laboratory, that is, the flow of an inspection order in the laboratory: sample receipt, confirmation, automatic charging, distribution to groups, task list formation, computer measurement, result review, and regular printing at the corresponding nurses’ station.
Laboratory maintenance and quality control process: maintenance operations (such as cleaning the instrument, scrubbing the workbench, recording temperature, preparing cleaning agents, instrument calibration, etc.)-quality control on the machine to determine the quality control results.
implementation plan
The doctor’s order number and specimen number are commonly used in the daily work of the laboratory. The medical order number is a serial number generated when the LIS is executed when the medical order is issued by the applicant. It corresponds to a record in the medical order execution form. The specimen number is the number compiled by the operator when analyzing the specimen. There is a one-to-one relationship between the medical order number and the specimen number. The medical order number or the specimen number adopts barcode technology, and the analyzer and equipment can be connected to identify the specimen. Combined with the LIS, the degree of mobilization of the experiment is improved. One-dimensional barcodes are commonly used in laboratories, and the barcodes are pasted on the circular test tube to ensure the recognition rate. The bar code label is customized by a specialized manufacturer, using materials that are thin, sticky, and anti-static. The information is dynamic, and barcodes can only be printed on-site with a dedicated barcode printer.
The bar code is printed by Renye bar code printer, which has clear quality, replaces the original application form that needs to be written by hand and replaces the label affixed to the test tube or container after sampling, in order to facilitate the identification of the inspection instrument. Barcodes need to be posted vertically, and the angle should not exceed 15 degrees.
Barcode labels are double or triple, one is affixed to the test tube or container, and the other is left or given to the patient, reducing manual loading. By adopting the method of collecting documents and labels, patients can clearly know the report time and place of collecting documents.
Figure 1 Hospital data flow chart
The outpatient service desk is equipped with a barcode reader to realize that the patient can automatically print the receipt by scanning the label of the receipt voucher. The bar code enters the analysis instrument directly, and some instruments use two-way communication, that is, the instrument sends a request to the computer system through the RS-232 serial port after identifying and reading the bar code information. Information such as liver function waits until the instrument, the instrument automatically conducts the test, and sends the result to the computer after completion.
The laboratory workstation is equipped with a handheld barcode reader for fast and accurate reading of barcodes. LIS uses barcodes to query specimen information, status on the analyzer, audit results, query reports, specimen logs, and all specimen-related tasks.
In order to facilitate the distinction between specimens in emergency, inpatient and outpatient settings, it can be easily achieved by using different color ribbons. For example, all printers in the emergency room use red ribbons and the bar codes are green. After the specimens are sent to the laboratory, they are easy to distinguish. Handle emergency specimens as soon as possible. However, due to the relatively high price of non-black ribbons (5-10 times that of black), they are currently used less frequently.
Equipment selection
According to the actual situation of the Run Run Run Run Run Run Hospital affiliated to Zhejiang University School of Medicine and the characteristics of the data flow and plan, the system integrator selected the equipment for the project.
The server door operating system selects Windows 2000 Advance Server, UNIX, LINUX, etc.; the database software is mainly Microsoft SQL Server 2000, ORACLE, ACCESS, etc. The workstation operating system uses Windows98, Windows2000/XP, etc. The program development tools are POWERBUILDER, DELPHI, VB, etc.
Servers, workstations, printers, and card hardware equipment indicators are configured according to the scale of the hospital.
The selection of bar code related equipment and consumables is based on the principle of reasonable and effective procurement. Choose Ze b r a TLP2844 for the barcode printer. The machine has the characteristics of fast printing speed, simple operation, expandable memory, suitable for all kinds of one-dimensional bar codes and MaX i C o d e, PDF417, Datamatrix two-dimensional bar codes and so on. Fully consider the scalability of the system. In addition, the machine is optional with LAN/Ethernet via EPL PrintServer and has a unique and simple EPC2 programming language. The barcode readers, ribbons, labels, etc. required for this door have also been selected.
The application of automatic identification technology in the Run Run Run Run Hospital of Zhejiang University School of Medicine has achieved obvious application effects. Realize true fully automatic operation. Bar code technology was successfully transplanted into the process of inspection and analysis, so that the instrument can identify the relevant information of the specimen, and automatically perform various operations according to the bar code information or the information sent by the host, eliminating the need for manual input of various inspection instructions on the instrument, simplifying the process The working procedures have made fully automatic analysis a reality.
Reduce human error. Due to the application of barcodes, the original test tubes from which blood is drawn can be directly placed in the instrument for testing after centrifugation. This avoids possible mistakes in the specimens when separating serum, mutual contamination between different specimens, etc. Errors improve the accuracy of the results.
Increased the flexibility of operation. The real-time two-way communication between the computer and the HOST makes the operation more flexible. When necessary, a certain command can be issued on any of the computers, such as making the instrument review a certain item.
Reduce workload, improve work efficiency and inspection quality. A barcode is attached to the specimen collection, and routine laboratory operations such as specimen classification, data transmission, analyzer two-way communication, audit results, inquiry report, and specimen preservation are completed according to the barcode. The bar code uniquely identifies the specimen in laboratory operations and communicates with the analyzer in two-way, which simplifies the laboratory workflow. The application of bar code technology in the laboratory. Effectively improve work efficiency, result reliability, and degree of automation, which is the direction of laboratory development.
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