Pathology informatics: an expanded role for laboratory information systems

Pathology Laboratories, particularly Haematology and Biochemistry, lead the revolution in the utilisation of computers in medicine. The initial reasons were to provide control for automated analytical instrumentation. Later, computers were developed to handle correlation between patient demographic information and test results. Unlike our colleagues in other diagnostic services, Chemical Pathologists have, to a large degree, forgone their right to comment and to interpret their reports probably as a result of the volume of data generated. We wish to present some information suggesting that recent developments in computers can help rectify this situation. In the early 1970’s, EF Codd developed relational theory. As computer power became more available, Codd’s theories were turned into the relational data-base. More importantly however, was the ability to interrogate that data-base by so-called structured query language (SQL). This has led to a revolution in computing data-bases. In preparation for replacement of the current laboratory information system we have developed a prototype computer system using a relational data-base (Informix), As well as biochemical results, the data-base also contains information concerning patient demographics, discharge diagnoses (in the form of ICDN-9-CM codes) and discharge status. We are able to use the data-base to extract pathology information, ratner than data, in such areas as: • Stream-lining of analytical work-lists [by inclusion of previous results and autodilution). • Utilisation of patient data in quality control (thereby decreasing QC usage) • Lasting of possible causes of aberrant results, as determined by the data-base. • Diagnosis related epidemiological studies.