Delayed response to abnormal lithium results is no longer necessary

A survey of one year9s lithium results for a health district of 170 000 disclosed unacceptable delays in checking abnormally high values. Only 17% of moderately elevated levels were rechecked within a week. The problem was most marked with patients monitored in general practice, but one particularly high result in a patient monitored in psychiatric out-patients remained unchecked for over three weeks as a result of poor communication between general practitioner and psychiatrist. A trial of an on-the-spot monitoring service using new technology has simplified procedures and reduced to zero the number of results taking over a week to check.