Laboratory results

Clinic, Laboratory. The patient and their reports on the left, one report open on the right.

The way a blood result harms a patient is almost never that it was wrong. It is that it came back abnormal on a Thursday and the doctor who ordered it was on leave. That is what the To review tab is for, and it is the reason this screen exists.

Filing a report that has come back

1Find the patient, then press File a report.
2Say which laboratory sent it and what was asked for. Choosing the panel — Full blood count, Renal profile — fills the test name in for you.
3Attach the file. The laboratory's PDF, or a photograph of the paper.
4Key the numbers in — or paste them, which is much faster. See below.
5Press File the report.

You do not have to key anything in. A report with the PDF attached and no numbers is a real record and it is filed. What the numbers buy you is the trend — the same test followed over years, which is what a diabetic's HbA1c and a dengue patient's platelet count are actually for.

Pasting the report instead of typing it

Filing takes the whole screen. Paste the laboratory's text at the top and the lines land in the grid below it.

Open the laboratory's PDF, select the results, copy them, and paste into the Paste box. Klinira reads each line into the grid with its name, its unit and the range the laboratory printed beside it. Check them against the paper before you save — that is what the grid is for.

Lines Klinira recognises arrive ticked. SGPT is understood as ALT, PCV as haematocrit, and so on for the names each laboratory prints differently.
Lines it does not recognise arrive unticked, with the name the report used. Tick one if it is a real result; leave it if it was a page number.
Lines it could not read at all are listed underneath. Nothing is dropped quietly.
A line whose numbers were printed in an order Klinira cannot be sure of — the range before the result — is listed rather than guessed at. Between the bottom of the range and the patient's own figure there is nothing the software can choose.

Ranges are the laboratory's, not ours

Whatever is printed beside the result on the paper is what gets stored, and it is what decides whether a value shows as high or low. Ranges differ between laboratories and between men and women, so Klinira never overrules the one on the report.

Where a line comes with no range, the value is filed and marked "Not assessed" — which means nobody has compared it to anything, and is not the same as normal. "Fill in typical ranges" puts Klinira's own ranges into those lines if you want them, and the screen says out loud that they are not the laboratory's.

Klinira never decides that a number is dangerous. If the laboratory marked a value critical, tick the Critical box and it carries that mark — the report is filed, it goes straight to the top of the review list, and the screen says to put it in front of a doctor today.

Saying you have seen a result

The To review tab. Every report nobody has read, worst first, and the longest waiting of those.

A report stays on this list from the moment it is filed until a doctor records that they have read it. Choose a line and the patient's whole record opens beside it, so you are not ticking a potassium without knowing it is the third high one this year.

Only a doctor can tick it. The nurse files reports and keys the numbers in; saying a clinician has read the result and taken responsibility for what happens next is a different act. If anybody could clear the list, the list would stop meaning anything.

Write what you did about it if you did anything — telephoned the patient, asked them to come in Monday, started treatment. In two years that sentence is all there is. Two doctors seeing the same report is normal and the record holds both.

Following one result over time

Under the report, choose a test the patient has at least two numbers for and Klinira draws it over time, with the laboratory's range shaded behind it. Every value is written out underneath as well as plotted, so it is readable on a printout and to somebody using a screen reader.

One reading is a result, not a trend, and the screen says so rather than drawing a single dot in an empty box. The shaded band is the range on the most recent report — ranges move when a clinic changes laboratory.

The line is drawn, and every value is written out underneath it as well. A picture shows the shape; the numbers are what survives being printed, and what somebody using a screen reader can hear.

Correcting a report

If a value was typed wrongly, or the laboratory sends an amended report, press Correct this report. What it already says is loaded into the form; change what was wrong, say why, and save. The old version stays with its date and your name on it.

A corrected report goes back onto the review list. The tick was for the numbers that have changed, so it does not carry across — which is exactly what you would want if the laboratory has just re-issued a result.

The report to run

Laboratory results nobody has reviewed — the same question as the To review tab, printed, with no cap on it. Worth running once a week by whoever runs the clinic, because it is the one list where a long tail means something has gone wrong with the routine.