Implementing IT to support Laboratory Services in a Large

Hospital in India

Joy Mammen MD Christian Medical College Vellore

India

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Disclosures

• None

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Where are we?

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Personnel

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Numbers of Patients

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Revenue

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RESEARCH

NATIONAL

Domains

LABORATORY

BLOOD BANKING

INSTITUTION IT

PROFICIENCY TESTING

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Pre-analytics

• CPOE • Sample collection – for most

of the labs • Barcoding

Collection Station

BC Robo

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Laboratory

• Clinical Pathology

– Middleware - Interfaces – Workflow management – Document management – Accredited 2 years

• ISO 15189 – National Accreditation Board for testing and Laboratories, India (APLAC signatory)

CBC Coagulation ESR Haemoparasites Urine Cavity fluids

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Haemostasis

Haematology

Haematology

Haematology - FCM

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14/06/2014 Joy Mammen CMC Vellore (APPI Mumbai 2014)

Registration station

Urinalysis Lab

Pneumatic Chute

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Laboratory

• Anatomic Pathology – Workstation development – Barcoding – Structured Data Reporting – Voice recognition

• Microbiology & Virology

– Workflow management – Interfaces

• Immunogenetics – Workflow

management – Interfaces

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Blood Bank

• Automation • Computerization • Regulatory standards • ISBT 128 (ICCBBA) compliant

– Donor management – Inventory management – Workflow (including interfaces) – Patient management – Haemovigilance

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The ISBT 128 Standard

compliant – Final label

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Blood Donor Drives

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New Workflow – bedside transfusion

Blood Request + Sample

(Labeled) – manual

Sent to BB

Register/Process/ Crossmatch

Bedside Verification PatID on Wristband vs

PatID on Blood Bag

Issue to Ward

Wrist Band: Barcoded

Blood Bag: Machine printed

Location: ONLY

bedside

Live /Single Source of Truth

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Android Application

Haemovigilance: Has the transfusion been started/Completed/Reactions?

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Institutional IT

• Policy • Administration • Design

– New applications – Adding new functions

• New technology platforms – – RFID for staff attendance/access management – SMS for patient interaction

• Standards – SNOMED

Hospital Infection Surveillance

* Multi Disciplinary Team Management * Pathology Biopsy Tracker

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National • National Knowledge Network • National Haemovigilance

Program • National Blood Transfusion

Service – PEPFAR grant – US Partner – CDC

• Training and Capacity building • Quality management Systems • EQAS • Technology

• Important changes

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Training & Education

• BSc Medical Lab Technology (3 year) • Undergraduate Medical, Nursing and other allied

health sciences students • Postgraduates –Transfusion medicine, Pathology

etc • Subspecialty – Haematology etc • Fellowship: Laboratory Haematology • International: WFH and ISTH recognized training

center

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External Quality Assessment Schemes

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Proficiency testing

• Haemostasis – National >500 participants – International – Sri Lanka, China, Philippines, South

Africa, Algeria • Immunohaematology

– National – 250 participants – Discussion with national authorities to extend to

all blood banks

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Research • Department of Computer Science, Madras Christian

College, Chennai • Imaging Informatics Feminna Sheeba, Thamburaj Robinson, Joy John Mammen, Atulya K. Nagar: Splitting of Overlapping Cells in Peripheral Blood Smear Images by Concavity Analysis. IWCIA 2014: 238-249 Feminna Sheeba, Atulya K. Nagar, Thamburaj Robinson, Joy John Mammen: Segmentation of Peripheral Blood Smear Images Using Tissue-Like P Systems. IJNCR 3(1): 16-27 (2012) Feminna Sheeba, Thamburaj Robinson, Joy John Mammen, Atulya K. Nagar: Detection of Plasmodium Falciparum in Peripheral Blood Smear Images. BIC-TA (2) 2012: 289-298 Feminna Sheeba, Thamburaj Robinson, Atulya K. Nagar, Joy John Mammen: Segmentation of Peripheral Blood Smear Images Using Tissue-Like P Systems. BIC-TA 2011: 257-261 Feminna Sheeba, Hannah Mary Thomas Thevarthundiyil, Joy John Mammen: Segmentation and reversible watermarking of peripheral blood smear images. BIC-TA 2010: 1373-1376

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Research

• NLP:

Clinical Research • New haematology parameters to assist in prediction of clinical conditions – MDS,

Sepsis • Drug resistance in platelets

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www.cmch-vellore.edu

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Acknowledgements

The Team (we are 215 people in the department) Association for Pathology Informatics