Moonchase. Lab Online

Transcription

1 Moonchase Moonchase is a Belgian specialist in design, delivery and maintenance of information systems for medical laboratories. The company was established in 2009 by a team of IT-engineers with decades of director experience in the creation of globally used diagnostics software (LIS and middleware). Lab Online Moonchase developed a completely new, web-based product called Lab Online, connected to your LIS and providing care providers with a user-friendly and flexible interface to the laboratory s services. Using only a (mobile) web browser they can view their patients test results, download reports, communicate with colleagues, create or modify prescriptions, register sample collection, consult laboratory guide articles, order sampling equipment and much more, all in one integrated solution. Lab Online is designed for use in private laboratories as well as in hospitals. For private laboratories, it includes integration with practitioners software, data sharing for collaborating practitioner groups, registration of new patients, prescription price calculation, consumables ordering and sample registration in collection centers. For hospitals, it includes integration with the Hospital Information System (HIS), ADT message process- Architecture ing, pathway-driven prescriptions, ordering of blood products and organization of sample collection in the wards. Access from mobile devices The web user interface doesn t require any browser plugins except, optionally, one to view generated PDF documents. Mobile browsers

2 Users can specify which records should be retrieved and which fields should be displayed. For example, it is possible to retrieve prescriptions only if they contain orders for specified tests, and to display the results of these tests directly in the overview. For every page, Lab Online remembers the user s last settings. This avoids the need to re-specify search criteria and allows data to be retrieved and displayed immediately. Users can also store combinations of settings as personal or group favorites, and reuse them at any time. Result consultation My patients. From here, prescriptions can be created or detailed information can be opened. A map is useful for care providers visiting the patient at his residence. are automatically detected and appropriate pages are served, taking into account device limitations. Using HTTP request parameters, it is easy to set up direct access from 3rd-party EMR products, reusing user credentials and preserving patient context. In addition to the web user interface, a rich client desktop user interface is available to internal laboratory staff. Besides the functionality also available in the web user interface, it includes tools for background process configuration and monitoring. In private laboratories, Lab Online maintains a strict separation between individual physicians, so that they only can see their own patients and prescriptions. Nevertheless, group practices can be defined, the members of which have access to each other s patients and prescriptions. Clicking on a prescription yields a result overview. This is a table of the prescribed tests, grouped by discipline, with columns for the result value, unit and reference range. Test names are hyperlinked to the corresponding article in the laboratory guide. Each result records stores the value and annotations (units, reference range, flags and comments) as originally transmitted by the LIS. Consequently, no subsequent modification of the test definition can Start page Care providers entering Lab Online arrive on the detail page of the patient they selected in their EMR package, or else on their preferred start page. Often used start pages are patient and prescription overviews, displaying a configurable subset of all records the user is allowed to access, as determined by privileges, group membership and result copy targeting. Prescription records containing new information for the current user are highlighted. Page 2 of 8 Patient detail page. Note prescription search by occurrence of listed tests, as well as result values in prescription list.

3 generated by Lab Online itself, using available partial results. In this way, Lab Online can decouple data from its rendering, and produce rich visual representations without any storage cost in the database. Result overviews can be printed locally or stored as PDF documents containing all current as well as historical results, comments, images and any attachments. They can be ed to colleagues or to the patient. In addition, the prescription issuer can determine whether or not the patient can consult the results directly (provided the patient obtained a Lab Online account from the laboratory). Order entry Result overview including haematology and microbiology sections impact the faithful representation of historical results. Lab Online optionally converts results and reference values for display in the user s preferred units (conventional or SI). The result overview can contain additional columns, with result values of earlier prescriptions for the same patient. The number of such history columns can be set freely, as allowed by screen dimensions. When more prescriptions than columns are available, the user can navigate the history by shifting column content. Some tests have composite results, consisting of one or more sub-results. Examples of such hierarchical structures are found in microbiology, where the initial culture order can spawn antibiograms and colony counts which themselves are grouped per identified organism. Lab Online will render such structural relationships if they are evident in the HL7 result messages. Alternatively, if the LIS itself renders the results as formatted text, Lab Online will preserve the LIS s formatting. Not all results are text. Some are images. Images can originate from analysis instruments or they can be From a patient or prescription context, new prescriptions can be created or copied from existing ones. Although the physician can entrust creation of prescriptions to his staff, he has to formally approve them himself later. Users can check the tests to be performed in one or more electronic test order forms. Laboratories have full control over the content The result history of numerical tests can be displayed graphically along a time axis, either individually or grouped. Page 3 of 8 Visualisation of fatty acid test results, generated on-the-fly from raw data

4 user s initiative. Any samples already available (e.g. in case of pathology or microbiology) can be registered explicitly, along with their type, collection method, source site and other information as required. Compatibility between tests and sample types is automatically verified, as is compatibility between some tests and patient gender. Lab Online also warns if test orders are redundant and displays the most recently obtained results if they are. Previewing a result report with graphical history and appearance (fonts, colors ) of these forms. They can choose to either replicate existing printed forms, or to create new ones with multiple tabbed pages. Form items can have associated numerical identifiers, allowing rapid order entry by experienced users. For occasional users who are unfamiliar with the form contents, Lab Online offers test searching by name or by synonym. This is enhanced with smart popup lists, adapting dynamically to whatever text is being typed. As individual test orders are added or removed, a hierarchical overview dynamically displays the prescription s sampling requirements (with volumes), as well as pricing information. If any ordered test requires specification of diagnostic or other information, a data entry grid appears, prompting for the missing data and validating them as appropriate. Optional information such as clinical data can be specified on the Priority and comment can be specified per test order and per sample. In case of priority prescriptions, users can indicate how they want to be informed automatically (e.g. by or SMS) about the availability of new results. Users can specify who is to receive a copy of the result report (apart from fellow group members who have automatic access to the results). Copy receivers may include colleagues outside the care provider s group, as well as the patient. On prescription validation, Lab Online enforces any regulatory re- To save time, users can compose favorite test panels for themselves or for their group, and store them for later reuse. Forms automatically include hyperlinks from test names to the associated laboratory guide articles, containing detailed information about the selected test (sampling procedure, clinical significance etc.). Page 4 of 8 Order entry. Note configurable forms, test redundancy checking, dynamic information panel and hierarchical overview.

5 Pathologists can use Lab Online for authoring a multilingual laboratory guide, containing for each test an article with detailed current information. Of each article, all successive versions are maintained, together with auditing information such as author and time of publication. Authors can compare new and released versions side by side, with or without styling applied. The styling itself is also version-controlled. Care providers can access the latest released version of every article, either via lookup pages or via hyperlinks on test order forms and result overviews. Communication architecture Order entry. Note smart sample data panel, clinical data input, order comments and optional test selection via numeric keypad. quirements. For example, it can detect if the prescription contains unauthorized test order combinations or tests without the diagnosis required for refund. If applicable, appropriate warnings appear. The physician then still has the opportunity to either modify or not modify the prescription, prior to its storage. Finally, the prescription is stored in the database and a test order report is generated. It contains an overview of ordered tests with their associated information, and optionally peel-off barcoded labels for the required samples. Sample labels can also be printed later. If the samples have yet to be collected by the laboratory, Lab Online offers extensive possibilities for the organization of sample collection. repeated in the future. Care pathways allow modelling of test order combinations, as well as their automatic scheduling during specific patient treatments. Laboratory guide Lab Online works together with the LIS by exchanging standard order and result messages. To maximize independency and availability, it uses its own dedicated database (in MySQL, ORACLE or SQL Server ). The logical structure of this database was designed from the ground up with connectivity in mind, and modeled after standard HL7 structures. The need for manual entry of configuration data is minimal: in the background, care provider and test records are automatically kept synchronized with the corresponding ones in your LIS. Several important LIS-systems have been successfully connected with Lab Online. Under certain circumstances (for example when reviewing partial result reports), test orders can be added to existing prescriptions, even if they are already in process. Lab Online will then take into account such concerns as sample shelf life and reusability per test. If specified by the order issuer, prescriptions can be automatically Comparing successive lab guide article versions side by side Page 5 of 8

6 HL7 communication monitoring from the desktop user interface In hospital environments, LAB Online also receives HL7 ADT messages from the hospital information system, containing current information about patients and visits. This enables Lab Online to know about patient whereabouts and to provide adequate views for users in the wards. Although, in most cases, Lab Online is connected to one LIS system, it can also communicate simultaneously with the LIS systems of several laboratories or workplaces. Each workplace may offer different tests. Lab Online can split prescriptions into different LIS-specific parts, and later recombine the results back into a single document. Care providers never need to be aware of the fact that different subsystems contributed to the eventual report. Lab Online is equally capable of communicating directly with analysis instruments or with middleware, because all of these assume a similar workplace role as far as Lab Online is concerned. For each actor in the Lab Online communication ecosystem, independent configuration is possible. The choice of workplace for executing any individual test order is determined by the configuration of alternative procedures. Per procedure, specific sampling requirements can be specified. Each procedure may require one or more samples, each with their own type, volume and relative collection time. This allows easy configuration of such complex tests like glucose tolerance or creatinine clearance. Laboratories can define the conditions triggering the initial and subsequent transmission of test order messages to the workplace. In hospitals, this is often as soon as the prescriptions have been committed. In extramural laboratories, this is often only after receipt of the samples. Per individual test order, every status change can be exchanged with the LIS, and the requesting physician can monitor these status changes at all times. As destinations for incoming messages, Lab Online provides shared folders and/or TCP/IP server ports. High performance, multithreaded background processes await input and can easily handle and respond to dozens of messages per second. For HL7 order- and result messages, Lab Online adheres to the guidelines of the IHE Laboratory Technical Framework, but other standards are supported as well. Messages may contain encoded binary content such as images or other attachments. Users with administrator privileges can control and monitor background processes with consoles, log viewers and dashboards available in the desktop interface. In- Issuers can monitor the status of their prescriptions. In this example, a sample appears appears to have arrived broken at the lab. Page 6 of 8

7 Collectors with mobile equipment can register sample collection at the patient s bedside by scanning the barcodes. For extra safety, this can be combined with scanning the barcode on the patient s wristband, eliminating mix-up. Alternatively, collection can be registered later, simultaneously for one or more samples on a particular sampling list. If, on any scanned sample, tests are to be performed for which not all required information (e.g. body temperature) is available, the collector is automatically presented with a data entry grid prompting for the missing data. Sampling in collection center. Note cap colors, sampling instructions and information capture. coming messages can be stored literally as database records, together with any error messages describing issues occurred during processing. This enables administrators to reprocess such messages after the problem has been mended, without requiring resend from the LIS. printers or one by one with special label printers supporting the ZPL II page description language. Alternatively, Lab Online also provides means to associate preprinted stock labels with prescriptions and samples. Using Lab Online, laboratories can offer sampling equipment or other consumables to physicians collecting patient samples themselves. An interactive form with pictures of the available items is used to submit orders and to monitor processing of these orders. Management tools Per database table, administrators can set the required tracing level. Sample collection In hospitals, Lab Online can generate sampling lists to assist sample collectors during their collection tours. Sampling lists are lists of uncollected samples meeting any search criteria (target collection time, ward, type and/or priority), grouped per ward location. They come with a list of required containers and a set of matching sample labels. Sample labels generated by Lab Online carry information about their associated patient, target workplace and type (possibly a color matching the container s cap). In addition, they carry a configurable barcode following the requirements of the LIS. The labels can be printed either in bulk with ordinary Sampling lists come with a matching set of sample labels, separated by patient labels Page 7 of 8

8 Ordering of consumables Tracing involves storing all consecutive modifications per individual record, with time stamp and author. Per record, reports are available showing local modifications as well as modifications to subordinate records, chronologically and detailed. Even the execution of menu actions can be traced, along with the action settings used. Many events are traced always, without the need for activation by administrators. Examples include all login attempts (both failed and successful) and all test result consultations. Login records are also used in session statistics, providing insight in the evolution of Lab Online usage. Lab Online also offers other statistics, including those providing insight in the prescription behavior per physician or in the ordering frequency per test. They can help in decision support or for the assessment of laboratory performance indicators. Roadmap Lab Online can assume several LIS functions, including local entry and automated annotation of test results, communication with analysis instruments, quality control and collection of statistics for decision support. In a number of areas, this is largely sufficient for the use of Lab Online as a mini-lis. Moonchase is continuously adding features, even beyond those of traditional, vertical LIS-systems, so as to offer an integrated solution and readily accessible source of information for care providers, policy makers and patients. Because not all laboratories use Lab Online for the same needs, the product was subdivided into a basic framework and several separately available modules. Lab Online customers are currently located in The Netherlands, Belgium (where Moonchase works together with Cegeka ), Switzerland and France (where Moonchase works together with Haemonetics ), in combination with various LIS-systems, in hospitals as well as in extramural environments, some of which are among the largest in their country. Thousands of care providers use Lab Online regularly. Please contact Moonchase to discuss your requirements. Our team of highly experienced solution architects is very accessible, incurs little overhead and disposes of the flexibility enabling rapid fulfillment of customer-specific needs. Management tools include different statistics, including test orders per test and per care provider. Page 8 of 8