CN101023416A - System and apparatus for medical error monitoring - Google Patents

Embodiment

In order to understand the present invention, it is as follows to define some term:

Definition

Client

Bearing

The collection container mark printer

Database

Adopt database (for example, sample management database (SMD) 44) to comprise one or more large-scale, structurized set of persistant data, these persistant datas are relevant with software usually to upgrade, to insert and the inquiry data.

Hand held object

Term hand held object (for example, the client hand held object 22) illustrates using point to carry out sample or the useful portable computer of medication management.The example of this portable hand-held construction element is Symbol Technologies PPT 1700 Series hand held object.This specific hand held object has IR and bar code scanning ability.Hand held object comprises and is used to show to gather the graphical user interface (GUI) of specimen sample Useful Information from patient.

Preferably, hand held object comprise microprocessor, such as the read element and the type element of barcode scanner.Read element can read identifying information and produce corresponding information flag from the patient identification code.Microprocessor can be handled the data relevant with identifying information.Hand held object comprises small-sized cognizance code reader in the ideal case.The cognizance code reader can be barcode scanner, imager, infrared identification reader, RFID reader or similar techniques.Barcode scanner can be integrated in the medical hand-held device or by auxiliary equipment and be fixed on the medical hand-held device.Similarly, the RFID reader can be integrated in the medical hand-held device, makes that when near container, the RFID of container can be read device and read.But hand held object preferably comprises battery, is used for the display screen pressing key of GUI, telecommunication circuit, memory element, be used for fixing the shell and the microprocessor of all hand held object subassemblies.Portable handheld device can be to comprise to be used for and the module of server communication and/or the portable digital-assistant of software (PDA), tabular PC or notebook.

HIS

HIS 38 network that uses a computer is thought that most of hospitals are movable to gather, handle and retrieval patient care and management information, to satisfy user's function needs.HIS also helps to provide the decision back-up system for the organ of power of hospital that develops and manage comprehensive health care policy.

HIS 38 comprises the integrated computerized clinic information system that is used for improved hospital management and patient health care.One or more patient's that they also provide accurately, store in the mode of electronics medical records.Usually, HIS is the concentrated message system that transmission is operated and management information designs rapidly, and comprises software and hospital or customizable other application module of health care facility that can optimize core data.

LIS

LIS is generally limited to laboratory information system, the information that this laboratory information system tissue is relevant with the laboratory task with tracking, such as, how to produce arrange single (order) and with its be communicated to the laboratory, how transmit patient or sample, how to register or prepare sample, how actual finish test, how with readout to the health care provider.LIS also can organize, follows the tracks of and determine how the work of finishing is repaid health enterprise and how to be exchanged reimbursemen information in the laboratory.

The LIS/HIS data-interface

Patient ID printer

The sample management server

Can not finish collection (UTC) function

The arrangement that LIS/HIS distributes to medical worker's generation of being gathered by qualified sampling with registration number is single.Distribute the method and the test figure of registration number in LIS provider, to change.When the titular medical worker of doctor or other required that patient carried out specific test, each test that needs generally speaking needed at least a portion of the single collection container of patient samples.But some tests need a plurality of containers of same test arrangement list, to adapt to analytical approach or to be in order to enough sample volumes to be provided.In first example, may need two different containers to gather and to hold the sample of same test arrangement list.In second example, single test arrangement list may need two identical containers to keep the sample of gathering with the purpose for volume.LIS also carries out some groupings, making needs the test of identical collection container to be combined, and makes, for example, need 4 tests of RED10 container to use " volumes of needs " data respectively, to determine whether from 4 tests of single container operation or whether to need a plurality of containers.

According to the LIS manufacturer that is utilized by health care facility, each test may be assigned with single registration number, perhaps, in other cases, a registration number can be distributed to the battery of tests that patient needs.Can be forwarded to LIS owing to have only with the relevant single message of the state of single test arrangement list (that is, arrange single must be done, is not done or is cancelled), therefore, this for existing error management device about having problems with communicating by letter of LIS.For some existing LIS manufacturers, can't say and arrange Dan Wei to be done.When the nurse or the blood drawing doctor when LIS returns message, he or she need have some states relevant with each test arrangement list; Otherwise LIS is gathered or is cancelled according to message format supposition arrangement is single.

For typical test, only use a collection container.Given successful condition, the user should be able to collected specimens and by error management system to its record and advance to next test or patient.Then to the successful collection of LIS report (for example, PDT is synchronous by HL7 interface and LIS).If owing to some reason tests no longer are essential, the user has the ability that cancellation is tested PDT so as qualified medical worker determines, this PDT reinforms LIS should be cancelled.If occur at present stoping the user to finish the incident of the single tube collection arrangement list that needs, the user can select test is deferred to the time of back so.In this case, PDT keeps Test Information and allows the user to turn back to test later in its storer.If the user skips whole registration number, gather after thus it being stayed, there is not message to be sent to LIS so.Not having action to be performed LIS is invalid event.Existing LIS is configured to only notified when test is gathered or is cancelled.

In the test of two or more collection containers of needs, the anomalous event after given first sample collecting, existing P DT can not pass on one or more container to be gathered and one or more is not also gathered to LIS.This is because current LIS system forces the collection standard that limits by the single result that notice is chosen to single registration number.Therefore, existing P DT can not pass on two results of test in the same registration number of a plurality of samples of needs.Native system and the solution that provides the restriction of LIS.

Hand held object also comprises the display 23 such as LCD, is used to show the information of the device of watching for the user.In addition, display 23 can be the sort ofly to push on display to carry out the display of related command with finger or contact pen.

Screen (not shown) on the display 23 can provide the tabulation of being distributed to the patient who is used to gather of hand held object 23 by the system manager.The following web interface of being convenient to system manager's operation that illustrates with reference to Figure 16～29 to server 20.The user selects patient then from tabulation, to watch the new screen of the test that is listed as this patient's arrangement as shown in Figure 6.In the example that illustrates, generate and arrange singly to think that imaginary patient " Peter Peterson " carries out a large amount of collections.Screen prompt user among Fig. 6 is to specific registration scanning container.The user finishes this point near as shown in Figure 5 collection tube being placed on scanner.

Fig. 6 represents the hand held object screen that is used to test, wherein registration number have relative two same types container (that is, RED).With reference to Fig. 7, Fig. 8 and Fig. 9, under the situation that can not finish a plurality of chamber tests (promptly, not every RED container is all successfully gathered) because the user can not gather sample, so hand held object 22 can show that the container of arranging in the list will be configured to the message (Fig. 8) of UTC.And hand held object 22 can produce the order (Fig. 9) of stamped mark, and this mark can be fixed to or insert and send in the breadboard sack.In case reception sack, laboratory technicians just can read sample and there is the sample collection deviation in identification.Thereby lab assistant can further arrange additional testing (with the relevant collection container of test), perhaps use to arrive breadboard sample and also may distribute a part from the sample of these containers to carry out essential test.And, can directly send a message to the laboratory, be used to make lab assistant to make suitable test decision to preparing to be considered to arrive breadboard collection sample at first.Can by the radio communication circuit in the hand held object 22 or when in bearing randomly by with server synchronously, send and notify.

Unscheduled event mistake or abnormal conditions supervisory communications feature are designed to provide the information of unavailability about the sample of expectation to lab assistant.As mentioned above, can provide this information by multiple possible method.One embodiment of the present of invention are used when selecting the UTC feature promptly to the single UTC of the application configuration of the arrangement of specific repetition by the button on the hand held object means to the printer output print command.Printable message marking of printer or even bar code with information of notice unscheduled event (for example fail gather).This information flag can be the part of the mark that exists or be affixed on the mark of existence, perhaps can gather with other and arrange single mark separate fully.This type information can be with being sent to the laboratory by the sample of the successful collection of suitable procurator (agent) operation.In addition, the UTC scheme can be transferred back to LIS by the mark of gathering message and be printed, as upgrading the LIS database and being sent directly to the wireless signal of lab assistant.

Other hand held object screen comprises specifies the icon (Figure 10) and the corresponding dialog box (Figure 11) of arranging singly to have special instruction.In addition, workload screen (Figure 12) and cancellation reason screen (Figure 13 and Figure 14) are also provided.Workload screen (Figure 12) is considered the type of record acquisition, comprises line extraction method (line draw method), and carries out the number of times of gathering with the trial that helps the workflow among the management medical worker.If hand held object user can not carry out collection, workload screen (Figure 12) can specify the third party to extract when needed so.The workload screen can produce after being scanned and being labeled at for example appearance collection or container.This screen make the hand held object user can specify by the personnel beyond the personnel of input image data collection type (for example, the finger that extracts, is used to fill little collection tube by venipuncture or VP, such as the pipeline by catheter thrusts or FS, heel is thrust or HS, arterial blood gas or ABG injection, such as be used to urinate or other open stream (open stream) collection) and collection.Other hand held object screen (not shown) can be including but not limited to according to the criterion of selecting (for example, such as the right of priority of the collection of STAT, extraction regularly or rule or such as passing through patient location by ward and/or ward) patient list of classification, arrange list or extraction program prompting or special operational order (for example, specific and predetermined extraction arrangement single) and arrangement list to cancel reason-code.

Because system 10 uses the scanning of hand held object user, patient and Container ID and this information is associated with sample collection, so it is favourable.According to a further aspect in the invention, can print identification marking when hospital's business process needs the mark of tape font code, to make these process judicial conveniences from system 10.Can be for the judicial convenience of the collection of the sample in the system 10 or for using bar code label with the irrelevant purpose of system 10 and sample collection.Usually, patient itself has identification he or she is the wrist strap sign whose has label independently.Generally the form with bar code provides this sign, but also can provide by the name of RFID label or the printing by demonstration.And portable hand-held thing or scanner are arranged in sanitary facility generally speaking, and comprise geographically consistent and relate to patient's the database of the part of the sanitary facility of distributing to hand held object.In addition, information-related with about with the sample collection arrangement list of those that part of patients' couplings of distributing to the sanitary facility relevant only away from the hand held object of LIS with hand held object.The patient information irrelevant with hand held object is left in the basket with the storer on the hand held object that avoids waste.Use hand held object so that the sample collection of the tracking judicial convenience of sample has comprised the hand held object that can scan patient, here, patient has LIS unsettled (pending) and arranges list and patient in tracked relevant patient's the database in hand held object of hand held object.But can exist in health care facility sometimes is not the condition that above all conditions all is satisfied.When for example not having unsettled arrangement list or arranging singly to be repeated, the dissimilar ID mark that these situations need to produce is to help the suitably sample of the collection of demarcation.

A this ID mark is a Generic Temp ID mark.The exemplary purposes of interim Id is when the user need gather sample, does not exist unsettled arrangement single for this sample when gathering in LIS.When arrange single not in system and do not need to gather immediately sample with patient's information when related with this sample, the present invention also provides to be produced as and comprises Demographic Temp ID mark and the Generic TempID mark that some patient informations also can use in this case.Server 20 can obtain patient's demographic information from ADT feedway (feed) or LIS feedway.

As described below the working of Generic Temp ID mark.Can be temporarily or for a long time patient is moved to the another location from a position of hospital.When with patient when he or she is suitably distributed a position of hand held object to move to him or she not to be assigned with the another location of hand held object, the information that is sent to the hand held object of distribution will not arrive the user who is responsible in she or she current floor, ward, position etc. gathering she or she sample.In this case, just in case doctor or practitioner need extract the blood sample of not arranged by LIS, he or she can activate GenericTemp ID process so.This process comprises following steps.

As described below the working of Demographic Temp ID mark.Patient can be arranged in the suitable zone of sanitary facility, and his or her information is associated with patient list on the hand held object in this zone.But, the condition of exist to require gathering not the sample of arranging by LIS sometimes.In this case, just in case doctor or practitioner need extract the blood sample of not arranged by LIS, he or she can activate Demographic Temp ID process so.This process comprises following steps.

In Generic Temp ID mark and Demographic Temp ID mark, mark all preferably comprise be used to place and at least temporarily property be fixed on bonding substrate (backing) on the container.In addition, such as described in the United States Patent (USP) 6428640, mark can comprise and be used for the breach aimed at collection container, comprises this patent as a reference at this.Another exemplary purposes of interim ID is to be difficult to gather sample and want from patient notify other user so that during gatherer process by the generation mark as the nurse.For example, when the nurse ran into the patient that is difficult to collected specimens (for example, because vein shrinks or is difficult to find vein) and nurse and wishes more experienced blood drawing doctor collected specimens, the nurse is printable to go out interim ID mark.Respond these needs, system 10 allows to print the ID of above-mentioned two kinds of addition type.If system 10 is not from the patient record of ADT or LIS, Generic Temp ID can be printed so.The content of Generic Temp ID can the person of being to use (or nurse) any content of scanning and the system user and the system time of login.The wrist strap that typical using method is the scanning patient makes mark printer print the system user of wrist strap identifier, system data and the login of barcode format.

1. login PDT.

2. chosen position.

3. from the patient list screen, knock Temp ID button.

4. interim ID mark screen occurs.

Scanning patient wrist strap on bar code.

6.PDT print interim patient ID mark.

7. after the collected specimens interim ID mark is being placed on the pipe.

8. additional if desired mark then uses the printing function again (knocking printer icon) on the PDT.

9. withdraw from PDT and put into bearing single to receive new arrangement.

Patient's arrangement is single received by the BD.id system and be downloaded to PDT after, login PDT.

11. chosen position.

12. on the patient list screen, scan interim ID mark rather than scanning patient's wrist strap.

13. single-row table occurs arranging.

14. knock the arrangement corresponding single (that is, the test for the red push pipe of needs (red top tube) scans red push pipe temporary marker) with pipe with temporary marker.

Think that this pipe produces sample marking 15. knock manual collection button (M).

16. sample marking is placed on the interim ID mark.

17. Fu Jia sample marking if desired then repeats this process.

18. the amount of finishing the work screen.

19. withdraw from PDT and be reentered into bearing.

Have dissimilar test (for example, gather), these tests need different mark groups with suitably gather sample and utilize the relevant clinical practice of mark group.According to another embodiment of the present invention, system 10 comprises database and the subsidiary logic rules that suitably make up and fill, and these logic rules are used for selecting and produce suitable mark group based on the pilot code that by system is patient identification system (PIS) reception.System 10 also can produce and show suitable workflow message and alarm, these workflow message and alarm (for example are shown near gathering on time and position, by the screen on the hand held object 22), and the action that guides the user suitably to utilize the mark group and in sample collecting and preanalysis processing, take need or recommend, for example, pipe operation, tag application, transmission conditions, record patient's key character and signing documents.These message can before the gatherer process, among and take place afterwards and can be configured based on user's input.Collection group and message can produce based on test/arrangement unitary code or clinic information system code (for example, blood bank, laboratory or microbiology) or about these codes.Example including but not limited to the ejection alarm on the hand held object 22 (for example, " after collection to doctor report to the police " or " sample must with ice storage ") and the peculiar subclass of mark or combination are (for example, the extra process bearing mark that is used for collection container or collection bag is so that authorize and the workflow supervision).The supervision that this aspect of the present invention therefore continues with respect to needs is to guarantee that message is identified the existing system that is performed with the operation relevant with specific collection and shows advantage.Different with the present invention, the mark group in the existing system does not produce on collection position, and the time of gathering must reach the collection point, be disadvantageous therefore.

System 10 preferably comprises the web interface (web interface) to server 20, so that system management function.The exemplary screen that Figure 16～26 expressions are produced by the web interface that can show on the administrator workstation that is connected (for example, by server 20) and addressable web interface with system 10 or other calculation element.In other webpage, the web interface provides unsettled sample collection page or leaf (for example, be used to watch the position of distributing to workstation or hand held object) and watch data page (for example, being used to watch single and the single or processing of single, the removed arrangement of the arrangement that is cancelled) from patient's arrangement.In other function, the web interface be provided for controlling patient's name and test demonstration (for example) based on user's security access levels, be used to limit the secure option of title and right of priority, and be provided for cancelling and arrange single option or reason-code.Web interface of the present invention such as security function (for example provides, such as changing and the access right that limits different security roles by the pressure password, the management user) and the management function of the selection (for example, making parameter in groups) of systematic parameter by PDT, unsettled sample page or leaf, system and web interface parameters.And web interface supply difference (variance) is followed the tracks of the NCCLS order of the container that (for example, difference group and difference are related with the actual acquisition incident) and extraction determine, the two is all illustrated in greater detail below.

It is single that the expression of unsettled sample collection page or leaf (Figure 16) is in patient's the arrangement of position of selection.These arrange single-passes cross that right of priority in the priority groups is grouped and by the position, then be berth, then be the scheduling date, be that container is classified then.This page can be used as the acquiescence page or leaf of BD.id system website and opens.

Security

Systematic parameter allows website to control whether the user must login before showing this page or leaf.In order to protect patient's secret, there are two systematic parameters of the quantity of the character that control will show for patient's name and test arrangement list.This patient data's part demonstration prevents that " accidental beholder " obtains patient and arrange single information.When the automatic refresh list of system, system is provided with based on the user patient's name and test arrangement list is shown " part " form.Refresh when link now when the user clicks, system shows whole patient's name and test arrangement list.

The position

Position button allows the user to select the position that will be shown.This window allows the user with suitable access right that workstation is set default location.But the user can edit these positions to watch arrangement single from other position under the situation that does not change default location.

The option definition

It is silent when choosing this frame to be stored as workstation, and the position of selection is stored as the acquiescence of workstation

The value of recognizing position.

Only watch PDT to be fated when choosing this frame, only on unsettled sample collection page or leaf, show money

The single lattice of lattice arrangement are sent to the arrangement list of PDT.

If do not choose this frame, show all arrangements of the position of selecting so

Single.Additional hurdle " E " expression is qualified to be sent to those of PDT

Arrange single verification mark.

Change the position of selection:

1. click location button.Show the chosen position pop-up window.

By click location from available list of locations chosen position, click right arrow button then so that this position is added in the list of locations of selection.

3. behind chosen position, the hit OK button.This will show the unsettled sample collection of the position of selecting.

Attention: click cancel button to restart.To remove the position from the tabulation of selecting, click it and click left arrow button then.Remove all clauses and subclauses in the tabulation of selection, click and remove all buttons.Select to recover default button to be chosen in the position of using in the last webpage.

Cancellation is arranged single

Changing classification arranges single

The unsettled sample collection page allows you that all priority groups are classified by rising or decline order based on patient, wrist strap, timetable, position and container.

● select patient, wrist strap, timetable, position or container title and click by the classification of rising order." A " represents the sorting technique that rises on the top of " Z " along with the decline arrow.

● click title by the classification of decline order with " A " and " Z "." Z " represents the sorting technique that rises on the top of " A " along with the decline arrow.

● use default parameters classification (by the room/berth in right of priority and the position in the collection date), click the default categories order button in the upper right corner that is positioned at the page.

Qualified (E) hurdle

When all arranged Dan Douyi to be restricted to occur on unsettled sample collection page or leaf, this page or leaf showed " E " hurdle under each right of priority title.The qualified arrangement list that downloads to PDT of " E " hurdle indication.In most of the cases, before expiring, sample collection will arrange singly to download to PDT in about 180 minutes.

Watch unsettled sample collection tabulation

1. open the BD shortcut on your desktop.Unsettled sample collection page or leaf is shown.Also can be by select unsettled sample collection option display list from the sample menu.

2. input if desired, your user's name and password.

3. click location button.The chosen position pop-up window is shown.

By click location from the list of available locations chosen position, click right arrow button then so that the position is added in the list of locations of selection.

Attention: remove the position from the tabulation of selecting, click it and click left arrow button then.Remove all clauses and subclauses in the tabulation of selection, click and remove all buttons.Select to recover default button to be chosen in the position of using in the last webpage.Click cancel button to restart.

5. work as you and finished chosen position, the hit OK button.The position display unsettled sample collection of system for selecting.

6. on unsettled sample collection, watch complete patient's name and test figure, click and refresh link now.Can require the user to login.

The title definition of unsettled sample collection page or leaf can be defined and edit by the user.With reference to Figure 21, these definition comprise the right of priority code of distributing to each title, the classification of the right of priority code in the title and the color that each title is used.Unsettled sample collection page or leaf divides into groups unsettled arrangement list by the right of priority code.The packet header that the user limits each right of priority code and user for example STAT, regularly, routine etc. is associated.If the right of priority code is used to fixed time testing, so with reference to the systematic parameter that is used to limit the time of fire alarming window of warning user's test regularly to be scheduled and not being cancelled.

The administrative preference group

Limit priority groups with title and color.

Administrative preference

The right of priority code is transfused to and is associated with priority groups.

Before the right of priority code, limit priority groups.

Import new priority groups:

1. from the sample menu, the sub-option administrative preference group under the selecting priority.

2. input your user's name and password.

3., watch the priority groups page of existence so if you have access right.

4. select the new button that adds.Adding the new priority groups page is shown.

5. with in the information input field.

6. to preserve, click and preserve.Ignore any variation, click cancel button.

Edit priority groups:

1. from the sample menu, the sub-option administrative preference group under the selecting priority.

2. input your user's name and password.

3., watch the priority groups page of existence so if you have access right.

4. click editor's icon.The priority groups page that editor exists is shown.

5. revise these hurdles.

6. click in abutting connection with the check box that shows right of priority, distribute to the right of priority code of this priority groups with demonstration with right of priority title mark.

7. to preserve change, click and preserve.Ignore, click cancellation.

Import new right of priority code:

1. from the sample menu, the sub-option administrative preference under the selecting priority.

2. input your user's name and password.

3., watch the right of priority page of existence so if you have access right.

4. select the new button that adds.Adding the new right of priority page is shown.

5. with in the information input field.

6. to preserve, click and preserve.Ignore any variation, click cancel button.

Edit the right of priority code:

1. from the sample menu, the sub-option administrative preference under the selecting priority.

2. input your user's name and password.

3., watch the right of priority page of existence so if you have access right.

4. click editor's icon.The right of priority page that editor exists is shown.

5. revise these hurdles.

6. click in abutting connection with movable check box, choose and forbid this right of priority with removal.

7. to preserve change, click and preserve.Ignore, click cancellation.

Systematic parameter makes the user can make system be fit to their environment.The key feature of system can be activated based on the internal procedure of each client site or forbid.These parameters are grouped according to following affected system module: PDT, the unsettled sample collection page, systematic parameter and network parameter.

The management of the difference of being undertaken by the web interface will be described now.For the various types of mistakes that occur in sample collection limit difference.In order to watch statistics by group rather than to watch each single difference, difference group (Figure 26) allows the user that each difference is distributed to certain kind.The example of difference group is: analyze mistake (haemocylolysis, short (short draw), the incorrect container of extracting), sample identification mistake, blood bank's sample mistake.For single difference is distributed to certain group, group specified title at first.

The difference form comprises following hurdle:

Difference is gathered in input

Import collection difference, the selection form is shown to find patient's the sample relevant with difference.After finding sample, click the additional difference pattern.System shows the deal with data (transaction data) of sample and allows you to choose suitable difference and import the name of report discrepancy.

The search of collection difference

Gathering the difference search is used to find patient specimens to import the difference that manually is recorded on the difference recording chart of laboratory.The data of patient specimens are shown and allow difference to be associated with sample and import the user of report discrepancy.

1. from Administration menu, select the sub-option under the management difference to gather difference.

2. input your user's name and password.

3., show and gather the difference input criterion page if you have access right.

4. the input criterion is also clicked patient/sample of searching for the criteria match that finds and import in the form of selection hurdle.

Attention: without any need for the hurdle.Click does not have the search of selection criterion will show the tabulation of titular all patient/samples.

5. show and gather the matching criterior page.

6. click the additional difference icon of wanting the patient information selected in abutting connection with you.The additional difference page shows with patient/sample information.

7. click the check box with the difference adjacency, so that difference is associated with this sample.

8. the user from system's combobox selects the user, perhaps, is the user of report discrepancy input user name in the user in system's frame or not.

9. click and preserve, or click cancellation to ignore this information and to return and gather the matching criterior page with the preservation different information.

The definition of editor's difference

Be the various types of mistake definition differences that in sample collection, occur.Increase new difference:

1. from Administration menu, select the sub-option editor difference definition under the management difference.

2. input your user's name and password.

3., show the difference definition page of watching existence if you have access right.

4. click and increase newly.Showing increases the new difference definition page.

5. in the difference hurdle, import data.

6. in the variance codes hurdle, import data.

7. select from difference group drop-down list.

Attention: before single difference being distributed to certain group, must at first define the difference group.

8. click and preserve or preserve ﹠amp; Increase another to preserve different information.Ignore, click cancellation.

Edit difference:

1. from Administration menu, select the sub-option editor difference definition under the management difference.

2. input your user's name and password.

3., show the difference definition page of watching existence if you have access right.

4. click in abutting connection with editor's difference (pencil) icon of the difference that will be edited.Show the difference definition page that editor exists.

5. revise the hurdle of this difference.

6. click in abutting connection with the check box of movable (active) and choose and forbid this difference with cancellation.

7. to preserve change, click and preserve.Ignore, click cancellation.

Editor's difference group

The difference group allows that each single difference is distributed to each kind and is used to watch statistics.For example, the difference group that is used to analyze mistake can comprise these single difference: haemocylolysis, short extractions, incorrect container, sample are discerned mistake etc.Before single difference being distributed to certain group, must at first define the difference group.Increase new difference group:

1. from Administration menu, select the sub-option editor difference group under the management difference.

2. input your user's name and password.

3., show the difference group page of watching existence if you have access right.

4. click and increase newly.Showing increases the new difference group page.

5. in difference group hurdle, import data.

6. in short name hurdle (Short Name field), import data.

7. click and preserve or preserve ﹠amp; Increase another with preservation information.Ignore, click cancellation.

Edit the difference group:

1. from Administration menu, select the sub-option editor difference group under the management difference.

2. input your user's name and password.

3., show the difference group page of watching existence if you have access right.

4. click in abutting connection with editor's difference group (pencil) icon of the difference group that will be edited.Show the difference group page that editor exists.

5. revise the hurdle of this difference group.

6. to preserve change, click and preserve.Ignore, click cancellation.Click deletion to remove the difference group.

In conjunction with Figure 27, Figure 28 and Figure 29 extraction order of the present invention aspect is described now.In hospital and laboratory environment, blood sample is frequently arranged to be used for blood analysis to gather and to be sent to the laboratory by the doctor.General venipuncture procedure by using some kinds with the sample collecting of blood in vacuum collection container or pipe.This process is including but not limited to the vein puncture device that uses such as wing group (wingset), both-end staight needle, catheter port etc.All these devices use with non-patient needle (non-patient needle), and this non-patient needle allows blood collection tube to set up the fluid passage at patient's vein with between the vacuum chamber in managing.

Blood collection tube has many mutation, and, when specific test is arranged, have different condiment, packing volume and other characteristic of all containers of causing therefrom selecting.For example, some pipes quicken condensing of blood and other delays or prevent condensing of blood.Other pipe provides concentration gradient to make that blood collection tube can be by centrifuging, thereby causes by proportion their cell component being separated.

Generally speaking, nurse or blood drawing doctor will be based on being received the order of gathering some pipe by the type of the test of laboratory and/or doctor's arrangement.Hospital's program according to conveying to nurse or what pipe of blood drawing doctor needs may lack and instruct the blood drawing doctor with the container of what order collection arrangement or the information of pipe.If since the additive on the former pipe pollute the blood collection needle be used for leaving sample in subsequently pipe so some pipe additive can in pipe subsequently, pollute sample, therefore this information is crucial.Usually, the order of extraction is designed to prevent the cross pollution of the laboratory result that can lead to errors.Sample is that patient's biology is represented, therefore, if the blood drawing doctor does not use suitable extraction order, the biology formation of this sample can suffer damage so, no longer is patient's faithful representation.Seem simple and when in this process, changing the order that extracts detection less than some things can produce the variation of the expression of this sample.Being concerned about and considering that suitable extraction order is crucial for good patient care, therefore, is crucial for the needs of the present invention that show.

For fear of the pollution of the additive between the pipe, set policy to avoid this potential problem by the normal structure of extensively admitting.This policy provides the order of answering collection tube of recommendation.A generally accepted normal structure is National Committee for ClinicalLaboratory Standards (NCCLS).Hospital and laboratory generally show the NCCLS suggestion order of recommending with pamphlet or placard in its entire mechanism, help nurse or blood drawing doctor to determine what order extraction tube in the time will extracting a plurality of pipe to certain test thus.

When the tabulation of suggestion was difficult to obtain, nurse or blood drawing doctor depended on his or her experience or the order of memory to select him or she to praise.The dirigibility that departs from preferred acquisition orders that nurse or blood drawing doctor have makes that some collections are gathered in the mode of mistake, makes some pipe may have incorrect laboratory result thus.In order to reduce and prevent hopefully the possibility of wrong collection, embodiments of the invention utilize hand held object sample order to show to reduce or eliminate wrong collection.

This embodiment comprises the proper order of the container that will be extracted is passed in algorithm from use to hand-held device.Can in LIS, in the server of bridge joint LIS and hand held object or directly, realize the present invention to hand held object.In certain embodiments, LIS can directly transmit those sample receivers that should gather from the patient who is assigned with unsettled sample at least one and normally a plurality of remote handset.When relating to direct communication, by the sequencing feature of the algorithm among hand held object resident program or the LIS, the priority list of the exportable container that on hand held object, shows of LIS.When relating to indirect communication, LIS sends intermediate system is translated into the suitable order that can receive and show on hand held object information to intermediate system.Intermediate system can be for example with the LIS server in communication.As long as intermediate system has and container is translated into the preferred sequence that shows makes the order of receivable extraction be sent to the user on hand held object, other intermediate system can just be considered and can use so.

Usually, LIS is defined for the database of the mnemonic code (mnemoincs) of each collection container of gathering patient specimens therein.For example, mnemonic code RED6 can be equal to serum (red top) pipe with 6ml extraction volume.Mnemonic code is used for passing on which pipe or container should be used to implement the sample collecting process to nurse or blood drawing doctor.Mnemonic code is generally limited by laboratory or hospital and such as being associated with specific pipe or container by pipe or container catalog number (Cat.No.).Usually, each container or pipe only have a mnemonic code and a relevant catalog number (Cat.No.).

By from residing in CIS (computer information system, especially, hospital information system, more particularly, laboratory information system) the order code in and container mnemonic code make up the database and the logic rules of suitably filling, physical product based on recommended standard for example NCCLS be shown with suitable acquisition orders.Remote computing device is preferred for showing this information to the nursing provider.

In one embodiment of the invention, server receives order from the CIS that comprises order code and container mnemonic code.The container mnemonic code determines that indirectly what physical product (pipe or container) can be used in the collection of sample.Server is to providing the order of these mnemonic codes with correct order from the user of patient's collection of biological fluids sample, makes that the order of the collection that physical product is recommended according to NCCLS is gathered.

Especially, the present invention's (such as server 20 of above-mentioned BD.id system) provides the means that physical product are mapped to the container mnemonic code, and the order of thus NCCLS being classified is associated with the container mnemonic code.For all types of containers with the identification of NCCSL classification order produce classification value.Higher right of priority NCCLS classification value means that the mode with expression like this provides container relevant with mnemonic code or pipe to blood drawing doctor or nurse.Do not having under physical product and the situation that the container mnemonic code is associated, minimum right of priority NCCLS gathers classification value and is applied to mnemonic code.On remote computing device, then by using the NCCLS classification value display order relevant with each container mnemonic code.Therefore, use remote computing device will know definitely which order should be used and with which kind of be used in proper order.

In one embodiment, the display on the hand held object can be with the order display order (commercial embodiment) of right of priority.In another embodiment, the display on the hand held object can be with the order display order different with the order of right of priority, but can show the right of priority identifier in addition, makes which kind of order draw samples the user knows with.For example, but the priority level adjacent vessel of each container be shown, make that even the order of the container that shows is not the order that is associated according to the priority level of being determined by the classification value generator, the user knows that still which container will at first gather.

Desirablely be used to gather the order of sample by the acceptable standard code in laboratory.Laboratory LIS within it portion have the NCCLS standard, derive from another third-party standard, by mechanism or the standard of hospital's exploitation or their combination.Preferably, the NCCLS standard suitable pipe that is used to be identified for to gather such as the container of the biofluid sample of blood extracts order.Therefore the collection which kind of type is the NCCLS standard can be depending on is performed, and considers that the present invention can confirm in the time will carrying out the collection of what type that difference also adjusts as required.(type of collection comprises and is used for venipuncture, syringe extracts or the vacuum tube purposes of kapillary extraction).The collection of the most frequently used type of carrying out in hospital is by using the vacuum blood collection tube.Other acquisition geometry extracts including but not limited to kapillary and syringe extracts.When being used for order that kapillary or syringe extract and comparing, the order that is used to extract blood collection tube can change.One aspect of the present invention is to provide distinguishes which mnemonic code algorithm relevant with the type of extraction, selects can be applicable to the suitable NCCLS standard of such gatherer process then.Below be the expression of recommendation with the NCCLS standard H3-A3 of the order collection tube of following extraction:

1) blood culture pipe or bottle (aerobic with anaerobism)

2) common (plain) serum tube (for example, red inhibitor (stopper)-non-adjuvant of glass or plastics grumeleuse activator)

3) * condenser tube (the sodium citrate pipe adjuvant that for example, has blue inhibitor)

4) the non-citric acid adjuvant of * * pipe is called adjuvant pipe (for example, having green, lavender or grey inhibitor or other adjuvant pipe) here.Example comprises liquaemin, heparin lithium, EDTA, oxalates fluoride etc.

* when need the top be black the sodium citrate pipe of buffering is arranged the time, it should be after the normal serum pipe but before the adjuvant pipe, therefore be filled before condenser tube and afterwards.The sodium citrate pipe that buffering is arranged that the top is black is used for rate of sedimentation.

* is when a plurality of adjuvant pipe of needs, and the order of their extractions in condenser tube is before non-citric acid adjuvant pipe.When several different non-citric acid adjuvant pipe of needs, their order in wideer group is also very important.For example, the order of adjuvant pipe is as follows:

1. (green inhibitor) pipe that contains Heparin.

2. contain K ₂EDTA or K ₃EDTA (lavender inhibitor) pipe.

3. the fibrin ferment that contains grumeleuse activator (grey and yellow inhibitor) pipe (CAT).

4. gel or mechanical isolators (golden yellow inhibitor) are managed (that is, serum is isolated organ pipe or SST).

The order of gathering a plurality of pipes can influence the result of test." order of extraction " is to be worked out so that the minimized cover policy of the problem relevant with a plurality of pipe collections by National Committee for Clinical Laboratory Standards (NCCLS).So that the blood culture of the minimizing possibility of microbial contamination or other test,, use the order of vacuum tube different except needing special technique with the order of filling pipe when using syringe when extracting blood.This order is designed to reduce by the interference that is not intended between pipe in the sample testing that additive package causes.This can take place when the blood in comprising the pipe of adjuvant contacts with the pin on the rubber top of thorn poling.The blood that is retained in the pin can be transferred to next pipe, thereby pollutes this pipe, influences the test findings of this sample thus.Each laboratory can have the order of their extraction policy.

The system that illustrates based on the present invention above Figure 27, Figure 28 and Figure 29 more clearly represent.As illustrated, each system provides the policy about " order of extraction ", and this policy is used and is used for providing to hand held object with the order of gathering needs the suitable tabulation of container.Figure 27, Figure 28 and Figure 29 represent the different structure of system respectively.For example, Figure 27 represents a kind of like this system, in this system, LIS 100 receives the policy of acquisition orders 120 in the database 105 of container and associated vessel right of priority, and uses the tabulation of this database 105 with the new container of the list producing 104 that is translated into tabulation from registration number then.As shown in figure 27, system may further comprise the steps.At first, be particular patient arrangement test 101, produce registration number 102 in LIS, LIS translates into registration number the tabulation 103 of the container of gathering with the order of not following policy then.LIS will tabulate by the database 105 that uses container and associated vessel right of priority according to policy in the new tabulation of adding 104, follow the new tabulation of the container of policy with generation.LIS transmits the suitable order of 106 containers that will be gathered then to hand held object.In last step 107, hand held object 110 is with the tabulation of the order receiving vessel determined by policy, and, when being visited, on hand held object, show this order by the user.System shown in system shown in Figure 28 and Figure 27 is very similar.But, carry out the step 204 that will add from the information of database in the new tabulation by hand held object 210 now, and be stored in the hand held object 210 according to the container of policy and the database 205 of associated vessel right of priority, make directly visit policies 220 and show the tabulations of 204 pipes with suitable order of hand held object 210.At last, Figure 29 represents that server 330 resides in the system between LIS 300 and the hand held object 310, and the feature of adding 304 and stored data base 305 provides by server 330.

In can be applicable to an embodiment of blood collection tube, test can be sent to hand held object from LIS, and here, test does not need serum tube (red top), but needs condenser tube (pale blue top).Though this situation does not need serum tube especially, another embodiment of the present invention can be indicated to the user and be used discarded pipe (discard tube).Do not use discarded pipe, in venipuncture, exist tissue thromboplastin can pollute the possibility of condenser tube sample.For fear of this possibility, blood drawing doctor or nurse are apprised of usually and use serum tube (red top) and before the extraction condenser tube this pipe is discarded in the suitable disposal container of setting up usually that is used for clinical waste in hospital.In order to encourage the following steps of this process, the invention provides the embodiment of the information that server uses in the process that hand held object passes on the user gathering.For example, if test is arranged, test does not here need serum tube (red top) but needs condenser tube, and this can take place so, and server or LIS can carry out in the following incident:

1. passing on " discarded pipe " or normal serum pipe on the hand held object that is extracted before the condenser tube, to provide label to the user.

2. discarded pipe is added the tabulation of the pipe that will be extracted.In one embodiment, this can be shown as red push pipe.In another embodiment, this can be shown as " discarded pipe " or its equivalent expressions mode.

Another embodiment comprise be defined in gather after and during scanatron, have Guan Yingxiang user's dispatch tube such as the label of the bar code that is read by the hand held object scanning element and will be dropped and be not sent to breadboard message.Can by the user is produced the scanner of the warning that can listen, message on the hand held object shows or by not printing new pipe mark when the scanatron, realize this point, here, the pipe in scanning patient's the tabulation that will be extracted can be directly or indirectly from the printer prints of hand held object numeral or analogue communication.

In another embodiment of the present invention, LIS can send the mnemonic code that is associated with the little collection tube that is used for the capillary blood collection.Little collection tube does not have the vacuum in the blood suction container, because they depend on capillary action and gravity to fill sample receiver.And,, carry out the capillary blood acquisition technique conventionally by incision patient's finger or the capillary bed of heel rather than arrival patient's vein.The skin that cuts patient makes blood become to drip on patient's skin surface, and by the method for being carried out by nurse or gravity of drawing little collection container is filled thus, and wherein, pipe obtains the drop of blood that falls from patient's skin.If LIS sends (directly or indirectly passing through server) and the mnemonic code that little collection container is associated to hand held object, the order that is shown in the extraction on a patient's the hand held object screen can depart from the order that is used for the vacuum blood collecting system.Therefore, system will appreciate that mnemonic code is relevant with the capillary blood collection, and the collection right of priority that can use different groups thus is to set up the order that provides to the user.

In one embodiment, the following order of hand held object shows the kapillary collection container:

1.EDTA

2. the adjuvant pipe that is used for whole blood

3. serum tube

As mentioned above, system can be the NCCLS classification order that each product provides acquiescence.NCCLS classification order needs to be mapped to the container of the product with NCCLS right of priority.If container is mapped at least two products and these products have different NCCLS right of priority, should use lower NCCLS right of priority (higher numeral) to list container so.

(example)

Container mappings seems to be similar to:

In all embodiment of the present invention, must carry out the order of the pipe that extracts by accessing database.In all embodiment of the present invention, the type of pipe must be clear and definite.Therefore, but arbitrary system acceptance test and make up then which pipe is connected with this test and be that the pipe that shows on hand held object sorts at last.In addition, system can receive the tabulation that the LIS system has been identified as the pipe that is required, and wherein, the order of the pipe that system only proofreaies and correct or guarantees to be extracted is accurately for standard.

Embodiments of the invention have been described, have the invention is not restricted to its details but should understand.In above-mentioned instructions, proposed various modifications and replacement scheme, and those skilled in the art can expect other modification and replacement scheme.The purpose of these all replacement schemes is to be contained in the scope of the present invention that is limited by the accompanying claims.