Cytochemistry Clinapp

The bone marrow clinapp went so well that I have whipped off another one, this one for cytochemistry interpretation. We are almost out of opportunities for this kind of automation: soon the only interpretive reports without an app will be the very low volume reports.

Bone Marrow Clinapp

Just completed another clinapp, this one for Bone Marrow interpretation.

It is gratifying how the basic framework continues to provide such good service, seven years after the first app was done.

Like its siblings, this app provides:

• a work list of tech to-do (orders awaiting results)
• a work list of resident to-do (results awaiting preliminary interpretation)
• a work list of attending to-do (prelim interps awaiting review)
• same-screen access to relevant current lab results
• links to related clinapps reports for this patient
• context-sensitive access to the historical repository of lab results
• printable report PDF creation
• faxing support
• LIS interface

This app is using by attending from other departments, so I have validation that the UI works in more than one user context.

Tube Tracking

Our draw station software roll-out went swimmingly, but as with so much of life, it was a case of "what have you done for me...lately?"

The draw station app connects the labs and the draw stations. We had expected that the new requirement would all be on the draw station side, because  we understood the lab side: we were integrating into the existing inpatient specimen handling procedure.

Except for drop-offs: the lab folks decided that they would trust the phlebotomists to handle drop-offs via our app because the phlebotomists quickly demonstrated proficiency with our app. So suddenly every draw station was a potential drop-off point.

This greatly increased the tube traffic from the draw stations. Then the issue of tracking reared its ugly head as disputes arose between the three parties:

1. the draw stations (origin)
2. the courier (transit)
3. the lab (accepting delivery)

We were not eager to create a tube-tracking module, but the pressure became sufficient that we did it:

• the ability to batch draws into shipments (the draw station app knows how to map orders into tubes)
• the ability to create a barcoded shipping manifest
• the ability to mark a shipment as delivered

We discovered that all three parties were motivated to use the upgrade because each group blamed the others for the sometimes delays, rarely lost tubes. Once we provided a common context for a conversation, the problem dropped dramatically: the draw stations were more careful about packaging, the couriers had confidence about what they were carrying and the labs could look up individual orders to know that they were not delayed or lost, despite what the patient or doctor might claim, the tubes were safely in transit.