Wednesday, October 21, 2009

Medical Testing Laboratories


The narrative features a Maryland-based medical laboratory known as Medical Testing Laboratories in its journey from manual system of database collection and requisition to automation of the whole laboratory system, including billing and invoicing. The narrated events by those who have been the primary actors that would eventually generate the required database tool like the administrators and managers and programmer of the company give us a full picture of this transition. What has been underscored in the recollection of these people is the crux that led the whole change.

Medical Testing Laboratories was founded by Dr. Healy to address the laboratory problem around Baltimore area. This need was on "comprehensive, emergency toxicology services" by the local medical community, whose specimes were sent initially to the local morgue for analysis and later shipped to Philadelphia General Hospital for more analysis. The whole proces was time-consuming and costly, which has debilitating effect as delayed tretments and lengthy hospitalizations.

Seeing these factors at hand, the originator of a loca llaboratory thought that his plan would "avoid these extra hospital costs and thus provide a significant and measurable contribution to the containment of health-care costs". And the facility was formally incorporated into th state of mayland in December of 1986.

The initial capitalizatin was provided by thirty-two pathologists who composed the stockholders on an equal-share basis. The incorporation has been designed to be non-profit and self-supporting, and the stocks pay no dividends. "Any operating profits are returned to the corporation in the form of expanded services and/or reduced charges.

By the end of 1987, the company was the first which opened its services to Baltimore Metropolitan Hospital community offering comprehensive emergency toxicology servies. The committed goal has always been "Quality, Services, and Economy".

Between 1987 to 1993, the company experienced a steady growth and it moved to a newly constructed 24,000-square-foot site and along with this was the stiff competition from other growing companies.

The detection of the need of automation was not palpable until 1995, when Joyce Windsor voiced her resentment at the whole manual system. This caught the attention of the founder to whom the concern was addressed. And, by July of 1997, the whole project jumpstarted when John Contreras the client services manager ran a client feedback campaign concerning satisfaction with the requisitioning and reporting formats. The result was client dissatisfaction. Though begrudging, Dr. Healy had consented and supported the project, and the board approved it in August of 1997.

In October of 1997, the project programmer Michael recommended the purchase of Data General Corpratin Aviion server attached to the lab's local area network. The system came with 128mB of memory, a 30-gB disk drive, a DG/UX Unix operating system with a license for up 50 users and a C++ programming language compiler. From then on, Michael came up with the program geared toward complete automation of the whole laboratory procedures and services.

A. Major/Main Problem

The primary problem of the study is to find the appropriate automation tool in the database collection and entry of test results and eventually the release of these laboratory test information to the patients in short turnaround time.

B. Objectives

a. To be able to come up with an automated system of database where collected specimen information is entered, thereby automatically organizes the data collected.
b. To be able to use the automated system for a short turnaround time.
c. To be able to use the automated system for an accurate collection
and procedure, and entry of test results on the specific patients.

C. Point of View

With the stiff competition now in the market of independent laboratory services, the need of database automation has been the challenge for a speedy turnaround time between data collection and result generation. This has a significant effect on two things: the lengthy hospitalization costs and treatment delays. Along with this need is the issue of privacy of patient information, which the literature from which the study is derived, has been basically underscored. Initially, the goal was to come up with an appropriate database tool for data collection, information retention, and generation of test results to the patients in a shortened time-span.

The importance of automated database system could not have been more than appropriate considering that the complex laboratory tests and procedures together with the demand of the clinical market for an expanded services and growing patient population. The requirement now is the shortened duration of these laboratory tests and procedure results to quickly address diseases and lessen the costs and length of hospitalizations.

D. Alternative Courses of Action

1. Manual entry of data test results.
a. Higher turn-around time
b. Higher risk of error of data input
c. Higher number of persons involved in data entry
d. Increased pressure on employee accuracy
e. Increased turnover rate
f. Increased price

a. Retention of the established reputation of being trustworthy of the company
b. Less risk for breach of privacy and more secure to confidential info
c. More direct and personal contact with patients
d. Less systems problems

E. Critical Analysis

The factors surrounding the need for automation brought by an increased population of clients, hence an increased number of specimens and samples, have demanded a computerized tool for a speedy generation of results, as this has direct result on the cost of hospital stay and clinical decisions by medical practitioners. The times have come that quick communication through the internet has brought pressure on all areas of life, and nowhere it more especially felt than in the area of laboratory medicine. On the downside is the risk of information confidentiality breach - an area which the company has always tried to minimize. Dr. Healy the founder of the Medical Testing Laboratories has built and expanded the company on the trust the clients have rendered on them.

The costly hospitalization and the delay treatment may be partially hinged on the duration of test result generation, since any clinical decisions would require full view of the pathological state of the patient. A good clinical diagnosis has a direct relationship to specific treatment and procedure. Misdiagnosis will have financial and prophylactic repercussions.

The computerized database system produced should be organized along the usual lines of toxicological tests, as the company has been largely catering specimen population to this kind. Computerization and automation is the best technological means in the market to meet the demand of growing need of fast laboratory results.

F. Recommendations

My recommendation revolves on the database program that would have multi-level toxicological tests aside from the usual demographic profiling. After the usual filling out of the primary information of the patients, test worksheets would print out after each specific tests are clicked on. After the tests have been completed and results were generated, it would be entered on the program, which could be sent electronically to the client hospital. Within this framework, there could be a need for another medical technologist to double-check manual errors.

G. Program Plan of Action

The study seeks to address the fundamental problem of quick and reliable generation and transmission of test results to client-patients by generating a program of such this kind. After a thorough analysis of the problem, the study could come up with what we can call Specimen Control System or SCS. This kind of program is practical but sophisticated to sort out data and exclude possibilities mishandling and erroneous result entry. It is designed to be 99-percent error free program, since it has a state-of-the-art edit-checks.

This test automation can start with gamma counter of radioimmunoassay will be interfaced with Data General using a protocol conversion program in C++ programming language. The Data General will perform the usual mathematical calculations, summations, graph generation, and automatic printing.

III. Reflection

The whole process of identifying the problem and the eventual production of the specific database program requires a tailored response. Since the company requires a fast transmission of test results, it should also have a parallel responsive tool to meet the requirements. It is not to downplay the fact that this technology requires constant perfection as time wears on.

Though how advance it may become in the future, still, this may be subjected to electrical downtime and system maintenance, which may still call for manual process. In any case, the need of fast communication of important data and results remains the top goal in this fast-paced world. It is hoped that with this technology, it would partially help lowering down the cost of long hospital stay and fast clinical decision-making.