IMPLEMENTATION OF A WEB-BASED LABORATORY INFORMATION SYSTEM (LIS) IN A HIV CARE AND TREATMENT PROGRAM: KENYATTA NATIONAL HOSPITAL COMPREHENSIVE CARE CENTRE (KNH CCC) CASE

Abstract

Laboratory  services  are  critical  in  initiating  and  monitoring of Antiretroviral  Treatment (ART)  in  HIV  patients. However,  timely availability  of laboratory  test results to  the  clinician  remains  is a  challenge  in  most health  care facilities due to misplaced or misfiled patients test results. The objective of this paper is to describe a web-based laboratory information system implemented to alleviate these problems at KNH CCC. As part of the University of Nairobi  Institute  of  Tropical  and  Infectious  Diseases  (UNITID)  fellowship  training  program  from  2010  to  2012, functional and operational requirements for the laboratory information system were drawn from a rigorous needs assessment  exercise  involving  all  stakeholders  through  iterative  discussions  and  workflow  analysis  of  the laboratory activities. The system was developed using J2EEE platform and hosted in Ubuntu server edition version 10.0.4. LIS integrates with the laboratory’s clinical analysers and uses language parsing technique to acquire test results electronically. Intensive training of users was conducted before the system was deployed for use in KNH CCC  laboratory.  Parallel-run  deployment  method  was  adopted  where  the  old  and  the  new  systems  were  used alongside each other for a period of one month. A web-based laboratory information system with specimen bar code labelling functionality has been deployed in KNH CCC. The clinician is able to access the results real time and the reception staffs are able to tell the % of analysis work done per patient. Since its implementation in March 2012, over 10,000 laboratory test orders have been captured. Electronic laboratory information system has a large potential to  improve  quality  of  care  by  improving  acquisition  and  transmission  of  laboratory  test  results.   Key lessons learnt for new system acceptability is that iterative discussions with all stakeholders followed by training sessions to all laboratory personnel are critical. Key words: Laboratory services, test results, timely, quality, needs assessment, training