Caribbean Laboratories A Rich Source of Information for Clinical and Public Health Decisions
The Caribbean Med Labs Foundation, under its PANCAP Global Fund grant, conducted a situation assessment which found that the impact of medical and public health laboratories in the Caribbean can be substantially improved by enhancing their capacity to organise, analyse and communicate relevant information.
This is particularly important in view of the shifting burden of morbidity and mortality in Caribbean populations from communicable to non-communicable diseases. Yet, Public Health laboratories largely maintain their traditional surveillance focus on communicable diseases. Clinical laboratories also generate evidence to support Non Communicable Disease (NCD) surveillance, interventions and policy.
Because many Caribbean countries face significant resource constraints, a flexible set of information management systems held together by common standards for data storage, classification and data exchange will allow individual laboratory needs to be satisfied, while at the same time maintaining integrity of the overall information network. Once such standards are agreed, technology solutions can facilitate compliance with existing systems.
CMLF Associate, Dr Wayne Labastide, an Immunologist and qualified Information Management Specialist, with a focus on and experience with Medical Laboratory Information, conducted a survey in August 2011 to determine existing and missing elements of sustainable information management infrastructure in laboratories and host institutions. The results will inform strategic decisions to address common and country-specific issues.
The information was gathered through an interactive web-based questionnaire on the website of the Caribbean Cytometry and Analytic Society (CCAS). The questionnaire was also distributed by e-mail.
Preliminary results were shared at the CCAS annual meeting in Montego Bay, Jamaica, in August 2011 and participants were also asked to identify their primary areas of concern for implementation of a Laboratory Information Management System (LIMS).
The following picture has emerged from the survey:
- Smaller laboratories are as complex as larger facilities; but they have fewer staff and resources.
- Among participating laboratories, technical staff was somewhat more computer literate than clerical staff.
- The majority of laboratories maintain workload statistics.
- Anatomical Pathology was generally least diligent in this regard. But Microbiology departments did so without exception.
- The difference in levels of attention to statistical documentation may reflect the traditional focus on communicable disease surveillance.
- Ninety three percent of surveyed medical laboratories have access to IT support. However, power outages are a common challenge.
While the assessment has identified major resource implications, there is an urgent need to quantify these, particularly with a view to supporting the work of the newly formed Caribbean Public Health Agency (CARPHA).
However, the current information can be used to contribute to development of an implementation framework as the basis of proposals for funding by potential partners.
The major conclusion is that with few existing legacy systems, the Caribbean is free to design individual national systems but with the capability to communicate with and share their information with each other, thus operating as one regional system. Importantly, the relative absence of legacy systems in which there has been considerable investment of finance and other resources creates an unique opportunity for designing a truly integrated, connected system, to support surveillance in the Caribbean Regional Network of Medical Laboratories.
Results of the survey were also presented to an international audience at the annual conference of the African Society for Laboratory Medicine (ASLM) in South Africa in December, 2012.