Speakers
The Association of Clinical Biochemistry & Laboratory Medicine
Laboratory Medicine is exemplary in its quality management, its efficiency, its informatics and its educational attainment… within the walls of the laboratory. But in the stages of the request-report cycle that lie outside the error rates are higher and the responsibilities and accountability much less clear.
Requesting is predominantly performed by clinicians under great pressure. But we know that computerised decision support can safely help.
Viewing of reports is done with error rates that we would consider totally acceptable within the laboratory. But we are implementing clinical information systems that do not support escalation on failure to view, and there are few current trials of computerised decision support that might make some viewing by staff unnecessary.
The value and appropriate use of point of care testing is being increasingly understood. But we are still procuring systems that do not automate the transmission of reports or support remote management of devices and stocks.
Viewing of reports by patients is becoming more common in the UK. But reports are being displayed that do not help the patients to understand what they mean, despite Lab Tests Online UK having been available for many years.
The good news includes renewed work on data standards, the cross-tribal collaboration seen in parts of the NHS Virtual Wards programme and similar local initiatives, and the recognition that moving investigations upstream can help in earlier diagnosis of cancer.
The technological tools that support and can improve all of these are becoming cheaper and easier to implement. But they will not be implemented rapidly or at scale until we have a radically different approach to responsibilities.
Jonathan spent most of his career as a chemical pathologist in Oxford. He has also been Clinical Informatics Director at NHS England, Professor of Health Informatics at University College London and City University London, and Chair of the Faculty of Clinical Informatics.
His research interests include the process of clinical investigation, medical knowledge management, and everyday technology at the point of care. With Ian Smith he developed the point of care testing implementations across the Oxford hospitals and the Oxfordshire Emergency Multidisciplinary Assessment Units. He has been a board member of Lab Tests Online UK since its creation.
He spends as much time as possible acting, walking and cycling.