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Chapter 48 : Computers, Utilization, and Knowledge Support

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Computers, Utilization, and Knowledge Support, Page 1 of 2

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Abstract:

Clinical pathology practice has emphasized the accuracy, precision, convenience, turnaround time, and cost of performing tests. It is entering a new era where correct test selection and result interpretation will become the dominant challenge. The fundamental technology that will be used is known as knowledge support (or clinical decision support). Electronic knowledge support is computer software that is able to present key factual information in such a way that it speeds or enhances the accuracy of a clinical decision. This chapter introduces the concept of knowledge support. It explains why knowledge support will be necessary to control utilization and standardize care. The chapter presents some current examples of knowledge support for laboratory ordering and interpretation and introduces the information complexity that will come with molecular genetic testing. The study by Carl van Walraven et al. shows that ordering protocols do actually work to decrease utilization across an entire population area. Internet technology will provide the conduit for either updating handheld devices or allowing continuous linkage to the World Wide Web or to an institution’s intranet. Laboratory ordering protocols are a specific, and rather rigid, instance of clinical practice guidelines (CPGs) that can be described as evidence-based, consensus-approved pathways for quality medical care in selected situations. Data mining is the practice wherein large organized repositories of information (databases) are examined to extract knowledge.

Citation: McNeely M. 2004. Computers, Utilization, and Knowledge Support, p 781-791. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch48

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Figures

Image of Figure 48.1
Figure 48.1

PDA menu for the LAS system showing the four program options.

Citation: McNeely M. 2004. Computers, Utilization, and Knowledge Support, p 781-791. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch48
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Image of Figure 48.2
Figure 48.2

An example ordering screen from the LAS system that shows how clinical features are collected prior to ordering tests to investigate a possible autoimmune disorder.

Citation: McNeely M. 2004. Computers, Utilization, and Knowledge Support, p 781-791. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch48
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Image of Figure 48.3
Figure 48.3

An example LAS result presentation. The test results are in the upper window. The interpretation is in the lower window. Both windows can be scrolled.

Citation: McNeely M. 2004. Computers, Utilization, and Knowledge Support, p 781-791. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch48
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Tables

Generic image for table
Table 48.1

Summary of utilization measures

Citation: McNeely M. 2004. Computers, Utilization, and Knowledge Support, p 781-791. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch48

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