Designing an autoverification system in Zagazig University Hospitals Laboratories: Preliminary evaluation on thyroid function profile

BACKGROUND AND OBJECTIVES: The current practice in Zagazig University Hospitals Laboratories (ZUHL) is manual verification of all results for the later release of reports. These processes are time consuming and tedious, with large inter-individual variation that slows the turnaround time (TAT). Autoverification is the process of comparing patient results, generated from interfaced instruments, against laboratory-defined acceptance parameters. This study describes an autoverification engine designed and implemented in ZUHL, Egypt. DESIGN AND SETTINGS: A descriptive study conducted at ZUHL, from January 2012-December 2013. MATERIALS AND METHODS: A rule-based system was used in designing an autoverification engine. The engine was preliminarily evaluated on a thyroid function panel. A total of 563 rules were written and tested on 563 simulated cases and 1673 archived cases. The engine decisions were compared to that of 4 independent expert reviewers. The impact of engine implementation on TAT was evaluated. RESULTS: Agreement was achieved among the 4 reviewers in 55.5% of cases, and with the engine in 51.5% of cases. The autoverification rate for archived cases was 63.8%. Reported lab TAT was reduced by 34.9%, and TAT segment from the completion of analysis to verification was reduced by 61.8%. CONCLUSION: The developed rule-based autoverification system has a verification rate comparable to that of the commercially available software. However, the in-house development of this system had saved the hospital the cost of commercially available ones. The implementation of the system shortened the TAT and minimized the number of samples that needed staff revision, which enabled laboratory staff to devote more time and effort to handle problematic test results and to improve patient care quality.