| 中文摘要 |
自動驗證（autoverification）是指利用電腦所設置的規則來執行臨床實驗室檢驗結果的查核，其過程不需人工審視。至今，臨床血液室方面的自動驗證文獻還不多，而且關於如何建立自動驗證的規則，目前也尚未有文獻詳細說明。在此篇研究中，我們說明CBC（complete blood count）、WBC－DC（differential count）的自動驗證規則設計和實施情形。所有自動驗證規則建立皆根據CLSI（Clinical and Laboratory Standards Institute）的AUTO10－A文件制定。自動驗證規則會寫入中繼軟體WAM^(TM)，如果實驗室臨床數據通過自動驗證規則，數據便可從WAM^(TM)傳送到檢驗資訊系統（LIS, Laboratory Information System），之後立即發送報告給醫師。為了評估自動驗證規則，我們收集2018年5月1日至2018年7月31日使用自動驗證規則的數據。經由自動驗證發出的報告比率為68.1%，我們也統計了門診、住院、急診的急件報告時效（TAT, Turn Around Time）分別下降了2.82分鐘、418分鐘以及5.8分鐘。此外，在血液室中急性腦梗塞患者的CBC報告是具有報告時效壓力的，在實施自動驗證後此項報告自動驗證發出的比率為92.6%。透過施行自動驗證，可降低TAT和減少線上醫檢師的工作量，幫助節省時間，提供更好的醫療品質服務。
Autoverification is a process of using computer-based rules to verify clinical laboratory test results without manual review. To date, there was little published data on the use of autoverification over the course of years in a clinical hematology laboratory. The establishment of the autoverification rules is still unclear. In this study, we present the design and implementation of autoverification rules for CBC and WBC-DC. All autoverification rules were established according to AUTO10-A and were written into the middleware: WAM^(TM). If the clinical results passed the autoverification rules, they could be sent from the WAM^(TM) to the LIS then sent to the doctor immediately. To evaluate the autoverification rules, we collect the data from May 1, 2018 to Jul. 31, 2018 with the autoverification rules. The average autoverification passing rate was 68.1%. We prospectively computed the TAT (turnaround time) of stat in outpatient, inpatient and emergency (ER), and the value were reduced 2.82 min, 4.18min and 5.8 min, respectively. Moreover, the acute ischemic stroke patient's CBC report is timeliness in the hematology laboratory; after implementing the autoverification rules, the autoverification rate was 92.6%. Through implementing the autoverification, which decreased the TAT and reduced staff workload, we can save more time and offer higher quality medical services. |
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