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Healthcare providers can receive lab results at the point of care using our handheld application LabKeeper, part of our Enterprise offering. It represents a significant opportunity to make workflow more efficient—no more signing—on to a computer to view labs, or sifting through paper records in a chart to find pertinent information.
Security
LabKeeper adopts the security features of the PatientKeeper Platform and mPI. That means that users will only be able to access this application if the IT administrator gives that user authorization to do so. The administrator can set up "relationships" and "positions" for each user, indicating the patient data each user will have access to, including access to certain patients or certain types of lab results. No data for which a user does not have organizational or patient-level security will ever be sent to the user's handheld.
Also, an audit trail is created when a user views the lab data, recording the data viewed and the date/time of the access. This information is logged on the Mobilizer server. You can read more about security in the Mobile Patient Index (mPI) section.
Organization of Lab Tests
Individual lab tests or components thereof are assembled into "panels," which include tests that are related to each other in terms of the lab equipment on which they are processed, and their clinical similarity. All panels are a subset of a category, such as hematology or basic chemistry. The IT administrator decides what components to include in the various panels. This allows you to better manage the numerous results that may be attached to any one patient. It also makes it easier for you to filter and view results more efficiently.
Viewing Lab Results
LabKeeper initially displays a compressed view of the lab tests for each patient, along with the name of the test and date. To view the details within each panel in the compressed view, one simply taps on the panel name. Lab tests presented as discrete results will be available for viewing, but those results will require the opening of an attachment. All components of a panel without results will be hidden.
For CBC (complete blood count) or Chem-7 (the common 7 chemistries), LabKeeper can display the components in the familiar "stick figure" the manner. For each component or individual lab result, LabKeeper lists the name, the viewed status, the clinical status, and an optional field. This optional field may be either the normal range for the component, or the lab's comments for a component; the administrator selects the choice for all users upon implementation.
In addition to the compressed view, you can access an expanded view of lab results, which displays the results for the components associated with the panel. The details for the panel results can be viewed by taping on the individual panel. A display in spreadsheet format is also possible, allowing you to evaluate individual and multiple labs for trends. You can view trends by graphing any lab component, or zoom in on any portion of the graph.
Individual components can be marked as "important." Important components stay in LabKeeper until you unmark them, or the patient is removed from the your patient list.
Managing Lab Results
Just tap on LabKeeper tab within the Mobile Patient Index to access the lab results for patients on the patient list. By tapping on the patient's name, a list of all of the panels related to that patient will appear. Panels not yet viewed will be highlighted in bold. For each panel on the list, you can view the date a test was done, the abbreviated name of the panel, the viewed status and the clinical status of the panel. The panel is highlighted as "unviewed" if any of the components within the panel have not been viewed.
Each panel's clinical status can be marked as "normal," "abnormal," or "critical." This status is mapped to the master status list created from the administrator's lab information system. The status of the panel reflects the worst status of any of its component tests.
The administrator may elect to declare critical and/or abnormal lab values as "alerts" that will show up in the Mobile Patient Index and in Alert Keeper. This is a useful means of notifying the user that a certain lab value requires attention.
You can sort the list of panel results by the panel name, the date the test was done, status of the panel (e.g. critical, abnormal, normal), an "important" status of the panel, or whether or not the panel has been viewed. This allows you to more effectively display the.
You can see result listings for all the panels, or can filter the lab results by category, or by those that are marked as important to the user. The benefit here is that you may be interested in viewing particular types of labs at a given time, and can customize this experience. For example, you may only work want to with labs in a particular category (i.e. hematology) if you are a specialist and only interested in a particular set of lab results. The IT administrator determines how many days worth of lab data will be available for viewing.
Annotating Components
Add annotations to a component whenever you view the panel results. A text field is provided for free-text entry. Alternatively, you may add text by inserting a stock phrase. These stock phrases are built using the PatientKeeper site. For example, you may want a stock phrase to say a lab is abnormal due to "possible hemolysis" or due to an "immunocompromised state." The annotations associated with the components are saved on your handheld device and do not get copied to the PatientKeeper server.
Snapshots
Just as components can be viewed as part of a panel, components can also be viewed as part of a "snapshot". A snapshot is a set of components that are custom panels developed by PatientKeeper in conjunction with the customer and the individual user. This capability brings together, on one screen, labs that another provider wants to review for a particular clinical condition. For example, you may want to have a "cardiac" panel or a "bleeding/coagulation" panel. By default, the snapshot will show the most current results for each component as one panel. You may create, edit or delete snapshot panels using the PatientKeeper site.
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