We present below the functionalities of the computer programme we use. It is used both in our laboratories and hospital laboratories we rent, thus a portion of our presentation focuses upon the functions useful for hospitals.

Reception and registration of commissioned analyses and material received by the Laboratory

In our IT system the commissioned analyses come in two forms: printed forms and forms in electronic format. The printed forms are received by the Laboratory filled by hospital wards or collection posts. In the registration they are scanned by a fast scanner, with the aid of which the analyses marked on the printed form, together with bar code attached, are automatically entered into the system. After the commissioning form has been scanned, the person operating the scanner would check for the correctness of the analyses registered with that order form. After that, patient data is added, such as first name, surname, personal identification number (PESEL), possibly also the address or residence. Besides automatic registration of analyses, the system also enables manual registration, where the employee would register the analyses to be performed from a list, selecting them by code or by name.
At that time, the material for analysis goes to the distribution station, where each sample is scanned with a bar code scanner in order to check, distribute the material, find possible incompleteness in material or the order. From distribution the sample goes to laboratory proper, where it is analysed.
The apparatus, on which the sample is analysed reads the information concerning the type of analyses to be performed on the given material from the IT system, as the order forms scanned in registration are then electronically set via a network to specific devices.

The other type of order forms are electronic forms, which may get to the laboratory either from hospital wards, via terminals installed there (or from the system installed in the hospital) or from the Internet, in case of external orders filed. In such cases, they are verified in a similar manner are the orders on printed forms, by scanning the material in the laboratory distribution station.

Communication of the programme with other programmes and systems

The program/ system we have may communicate with the master system in the hospital, by means of  ATM or HL7 protocols, considered to be international standards for medical information exchange. Full synchronisation of both systems will be dealt with by the competent IT personnel, who developed the system we propose. After connecting both systems, it is possible to commission analyses from the hospital system to the Laboratory electronically, while after the analyses are performed and approved by the laboratory diagnostician, the results are sent back from the Laboratory system to the hospital system. Access to the commissioning module and result collection module is provided only for persons authorised by the hospital management. Moreover, the system has result browser, which may be made available in hospital wards.

Monitoring of the Laboratory work

The system enables following a given order within the laboratory. It will indicate where a given sample is located (at which analyser) and where it should go to. What is more, the system offers information about the results obtained, as well as about the history of a given analysis order.

Patient identification

Patient identification takes place via:

• first name and surname,
• personal identification number (PESEL),
• order number (bar code).

Each order may also be supplemented with telephone and address data, as well as information important for interpretation of results (e.g. month of pregnancy, and the like).

Keeping the Laboratory log

The requirements for IT systems include the obligation of keeping Laboratory log, containing the basic information about the orders from a given day, among them the date and hour of registration, surname and first name of the patient, her/his personal identification number (PESEL), analyses ordered, results of those analyses, person performing the analyses, and others.

The laboratory system we use fully complies with those requirements, allowing printing out such a log both for the entire Laboratory and for a single lab unit (work station), as well as archivisation of the log in electronic form. In case the guidelines for that type of documentation change, the system (software) allows for easy modifications of the content kept in the Laboratory log.

Material distribution station

The biological material is collected from hospital wards at set time intervals, a few times daily, by the Laboratory personnel, provided with suitable containers. That material, together with the material from collection posts, will go to the material distribution station in the Laboratory. There the coded order will be read by automatic scanners, in a similar fashion to all coded material, which will be identified and scanned for checking, whether the amount of material is in congruence with the orders. Immediately after that action, the list of missing items is generated, where possible lacks in material or inaccurately filled order forms are indicated. In case of orders placed electronically, check is performed whether the hard copy (paper) equivalents reached the laboratory. Electronic orders are also checked whether the material they refer to has reached the laboratory. In case of finding any missing items or doubts, the laboratory staff would call the respective wards to explain any problems encountered. Then, the material is distributed by type (e.g. blood serum, blood plasma, urine, faeces) after which it is arranged on stands, the colours of which refer to specific labs, and are supplied to the apparatuses at respective stations.

The system (software) is also provided with a function of archive keeping of biological material. Each blood serum is kept in archive, the amount of which would allow to possibly use it later on. Those sera are placed on suitable stands, their location on a given stand together with the number is registered in the software so as to find it later easily. Then the sera are stored for two weeks in the temperature of minus 20 degrees Celsius. Blood cell counts are stored for 24 hours. Also, a register is kept for the samples taken from the archive, together with the name of the person taking the sample, date, and hour. That system allows to find a desired blood serum very quickly.

Template definition

In connection with the requirement to change the order form template from time to time, the software has been equipped with the possibility of defining templates of order forms, (it is possible to use more than one order form), as well as result printouts, reports, and other documents used by the software. Practically, every hospital unit  has specific requirements, thus the function proves to be extremely useful.

Statistics

The system (software) we want to install should we be awarded the contract in tender procedure has extensive statistical and reporting functions. It offers a multitude of tables/ lists and reports, bearing in mind the analyses, patients, doctors ordering the analyses, prices, etc. Templates may be easily developed for reports, which entails that practically any required report, even if not available in the system today, may be readily added to it.

The reports available at present include, among others: the list of patients for a specific ordering person (entity) together with the ordered analyses, prices, and ordering doctors, summary of amounts of specific analyses for the contracting party, lab, apparatus (device), list of patients for whom a given analysis was ordered, list of invoices, and the like. It is possible to define the period, contracting party, etc., for each report.

Communication of the system with apparatuses (devices)

The IT system we use allows for integrating measuring apparatuses with it, on the condition the latter are provided with a communication interface. Orders registered in the system are then sent in the form of work-lists to apparatuses, where those lists are approved by the personnel of a given lab. The material received at the apparatuses is labelled with bar codes unique for a given order, which makes the automatic device identify the sample itself and attach to it the analyses to be performed. After the analysis has been performed, the apparatus sends the results back to the system software (programme). The system (programme) serves two-way communication with all measuring apparatuses provided with a suitable interface.

Result from apparatus

The software (programme), before the results are sent to the server and for printing, demands the staff of the lab to accept the results coming from the apparatus. It is possible to send the order for repeated analysis, to approve the displayed result, to add comments concerning the results. Only after approval of the correctness of results are they sent further on in the system. Any changes introduced to the results are registered by the system and it is possible to re-produce them later.

Quality assurance system

The system (programme) is provided with a quality control module, which monitors all the parameters of that system, e.g. standard deviations and others. It aids the quality assurance system functioning at each our lab, based upon the norm ISO 9001.

Authorisation of results

The results are authorised in two or sometimes three stages. First, if the apparatus is provided with the result authorisation option, it is authorised by a suitable person before being sent to the computer system. Stage two is the on-screen authorisation in the system, before the results are sent for printing or to the database. At that stage, determinations of results getting out of the norms defined earlier are helpful, as they substantially simplify the detection of overestimated or incorrect results. Stage three is executed via control of results after they have been printed, which is carried out by the laboratory diagnostician. The result sheets are also provided with auxiliary indicators, which help capture the results higher or lower than stated in the norm. In authorisation of results, the delta-check function proves very useful, as it allows to view the results of a given patient back in time, both in the form of digits and of diagram. The programme is provided with a module of automatic verification of results, on the basis of the boundary values introduced before.

Documentation

The system (programme) is flexible because of the possibilities of configuring all types of reports, printouts, etc. For that reason, it is possible to create any printouts on the basis of forms prepared by the Orderer, be they in paper or electronic form.

Electronic orders - hospital system

After the hospital system is integrated with the system functioning in the laboratory, it will be possible for authorised personnel to send electronic orders to laboratories, using the terminals in hospital wards, if need be they will be able to follow to work progress concerning the sample (sample tracing module), they will also be able to collect the results after approval. The scope of authorisation for hospital staff in the access to the data system of the laboratory will be determined together with the hospital management. In parallel, the laboratory must obtain the order on a suitable form, as medical documentation.

Operation and security

The system operates in Polish, it is highly intuitive and easy to operate. Generation of reports and templates for all types of documents is carried out without using database languages. Only short training is required for that purpose, along with the access rights. A big advantage of the system is the possibility of exporting any specifications, price lists, etc. in electronic form, e.g. in *.lxs file format (Excel).

The programme has the possibility of configuring the security system, that is one can define the requirements concerning the validity period for passwords, the required password length (number of characters),the need to change passwords, etc. Each programme function may be added or removed from the access rights of a given user. The scope of generated access rights may be generated freely. Access to the system is provided by stating individual login and password. That applies to laboratory staff, as well as outsiders ordering analyses. The server where data is stored is particularly protected, the access to it is provided only to the system administrator.

Registration and control of entries

The system registers all the entries to it and changes made, registering the dates and times of those, and the user making them. An authorised person has access to that register (log), may view it, print it, sort it, as well as export to files in selected format.

Archive keeping of data

The programme works on the basis of database server. It stores all the data indispensable for the functioning of the laboratory. However, due to security reasons, a ‘spare’ system is attached to it, to which every 15 minutes all the data is sent, as it is received by the system. What is more, at the end of each day, a back-up copy is made, which maybe recorded on a DVD. The system stores back-up copies for a week, yet that period is freely defined. In case of need, the system is provided with an application allowing to use the back-up copy, yet only the system administrator is authorised to perform such an operation.