Medical Laboratories are perceived to be among the most expensive facilities in any health service, yet in the Caribbean, they remain a largely underutilised resource.
The majority of the data created in the process of in-vitro diagnostic testing is never converted into timely information to guide public health policy and health interventions.
Cost-effective laboratory medicine means maximum impact through timely, accurate and relevant information, presented to the right people in the most effective way.
While the USA claims that 80% of medical decisions are based on laboratory evidence, the extent to which this applies to the Caribbean is unknown. However, many medical decisions can only be made based on laboratory evidence.
Improving the information quality and proactivity of the Caribbean laboratories with respect to supporting Health situation analysis and Public Health interventions requires sustainable improvement in information management culture and practice.
This in turn requires a fundamental reorientation of perspective on the part of laboratory practitioners with respect to the needs of their key stakeholders, and an understanding that the primary value-added product of the medical laboratory is information for action; a readjustment of the culture and awareness with respect to information management in the laboratory itself, as well as among the users and stakeholders of the laboratory services.
Among the challenges that faced the SMLS project in impacting the issues of laboratory turnaround times, customer satisfaction and quality of surveillance data, stood the fact that few of the laboratories in question had a mechanism to regularly measure client satisfaction, few laboratories could routinely measure their turnaround times, and few could successfully achieve collection of even the minimum surveillance dataset.
The major objectives of the information management component were:
- Establish an electronic forum for various Communities of Practice in Laboratory Medicine
- Increase awareness and capacity of senior laboratory Staff in the region about the analysis and use of laboratory information for action.
- Establish a network among laboratories where those using electronic information systems are interconnected and connect with CAREC for surveillance and referral purposes.
- Increase the number of laboratories effectively using electronic information management systems
- Create sustainable infrastructure to support the Project’s activities beyond the formal life of the Project.
Major Achievements
This portal, was created to support the communities of practice that will continue to be the support network for all practitioners of laboratory medicine and related disciplines. This web-based platform will support:
- access to the information and knowledge generated by the SMLS project by appropriate stakeholders;
- links to relevant information resources in support of accreditation in particular, and improved laboratory practice in general;
- Collaboration, joint planning and sharing of ideas among communities of practice in laboratory medicine and related disciplines;
- Links to continuing education resources.
Four hundred and two (402) participants from nineteen countries were trained in the use of “Data for Action” though Subregional and in-country “Data for Action” Workshops. In this process, in-country information management teams were established that include laboratory personnel and other stakeholders such as Epidemiologists, Hospital Administrators, Information Technology Personnel, Nurses, and in some cases, Clinicians and Senior Health Ministry Professionals.
A Laboratory Costing Software application was completed tested, distributed to laboratories participating in data for Action II consultations, with orientation to the methodology and demonstration of the software.- Distribution included some private sector laboratories. The application and user manual are available for download on this portal.
A database application and user guide, designed or establishment of human resource database of laboratory personnel and persons of related disciplines, were completed and handed over to the Caribbean association for medical Technology (CASMET) for management of membership information and tracking of participation in continuing education activities. This application is also under evaluation by TTLABS for possible tracking of trained assessors and laboratory assessment visits. The application includes a searchable skills bank facility, allowing identification of individuals with any combination of up to three specified skillsets.
A conceptual framework for an integrated health information management system was developed and shared with a wide range of stakeholders.
Guidelines for the Establishment of Laboratory Information Systems in Caribbean Laboratories have been developed and are posted to this portal.