{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T19:24:34Z","timestamp":1766690674582},"reference-count":10,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1992,7]]},"abstract":"<jats:p>AIMS: To devise a computerised management system protocol which not only proposes the laboratory investigations to be performed on each patient but also performs related clinical functions. METHODS: The system was designed by senior members of staff. The protocols defined all laboratory investigations including haematology, biochemistry, immunology and cross-matching, and included static and dynamic rules. Patients can be changed to different or additional protocols, as required; likewise proposed tests can be deleted or added. The software is written in MUMPS and runs on a 386 PC running MSM MUMPS under MSDOS. RESULTS: The number of clinical chemistry tests requested per patient per day fell by 9.5% (p less than 0.01) for transplant recipients and by 28.8% (p less than 0.01) for non-transplant recipients. The average time spent by junior medical staff requesting laboratory investigations and enquiring about results fell from 10 minutes per patient per day to 4.1 minutes (p less than 0.001). CONCLUSIONS: The introduction of this system in no way abrogates clinicians' responsibility for the management of patients, because all proposed investigations must be confirmed or modified by the authorising doctor. The system allows for the audit of requesting patterns and subsequent improvement in protocols by recording any alterations made to the proposed investigations. Significant benefits in terms of better use of house officer time and medical resources were also achieved.<\/jats:p>","DOI":"10.1136\/jcp.45.7.572","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T04:50:46Z","timestamp":1181364646000},"page":"572-574","source":"Crossref","is-referenced-by-count":25,"title":["Computerised protocols for laboratory investigation and their effect on use of medical time and resources."],"prefix":"10.1136","volume":"45","author":[{"given":"D","family":"Mutimer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"McCauley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Nightingale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Peters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Neuberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1992,7,1]]},"reference":[{"key":"ref_1","article-title":"Automatic application of rule-based decision support-a specialist unit investigation manager","volume-title":"Current perspectives in healthcare computing","author":"Peters, M.; Clark, I.R.; Parekh, J.","year":"1991","unstructured":"Peters M, Clark IR, Parekh J, et al. Automatic application of rule-based decision support-a specialist unit investigation manager. In: Richard B, ed. Current perspectives in healthcare computing. 1991."},{"key":"ref_2","series-title":"Proceedings of the MUMPS Users' Group Meeting 1991. College","article-title":"A MUMPS application of rule based processing","author":"McCauley, B.A.; Parekh, J.; Clark, I.R.","year":"1991","unstructured":"McCauley BA, Parekh J, Clark IR. A MUMPS application of rule based processing. In: Dayhoff RE ed. Proceedings of the MUMPS Users' Group Meeting 1991. College Park, Maryland: MUMPS Users Group, 1991."},{"key":"ref_3","article-title":"The Pathology Services. A Management Review. The Audit Commission for local authorities in The National Health Service of England and Wales","year":"1990","unstructured":"The Pathology Services. A Management Review. The Audit Commission for local authorities in The National Health Service of England and Wales. London. HMSO, 1990."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1056\/NEJM197901253000410","article-title":"To be complete","volume":"300","author":"E, Hardison J.","year":"1979","unstructured":"Hardison J E. To be complete. N Engl J Med 1979;300: 193-4.","journal-title":"N Engl J Med"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3076","DOI":"10.1001\/jama.1983.03330460058036","article-title":"Ordering of laboratory tests in a teaching hospital","volume":"249","author":"Wong, E.T.; McCarron, M.M.; Shaw, S.T.","year":"1983","unstructured":"Wong ET, McCarron MM, Shaw ST. Ordering of laboratory tests in a teaching hospital. JAMA 1983; 249:3076-80.","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1056\/NEJM198012043032304","article-title":"A trial of two strategies to modify the test ordering behaviour of medical residents","volume":"303","author":"Martin, A.R.; Wolf, M.A.; Thibodeau, L.A.; DzauV, Braunwald; E.","year":"1980","unstructured":"Martin AR,Wolf MA,Thibodeau LA, DzauV, Braunwald E. A trial of two strategies to modify the test ordering behaviour of medical residents. N Engi J Med 1980;303:1330-6.","journal-title":"N Engi J Med"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1093\/clinchem\/27.10.1717","article-title":"Effect of feedback to clinical staff of information on clinical biochemistry requesting patterns","volume":"27","author":"Grivell, A.R.; Forgie, H.J.; Fraser, C.G.; Berry, M.N.","year":"1981","unstructured":"Grivell AR, Forgie HJ, Fraser CG, Berry MN. Effect of feedback to clinical staff of information on clinical biochemistry requesting patterns. Clin Chem 1981;27:1717-20.","journal-title":"Clin Chem"},{"key":"ref_8","first-page":"197","article-title":"Medical audit in general medicine","volume":"15","author":"Heath, D.A.","year":"1981","unstructured":"Heath DA. Medical audit in general medicine. Roy CoU Phys Lond 1981;15:197-9.","journal-title":"Roy CoU Phys Lond"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"243","DOI":"10.7326\/0003-4819-90-2-243","article-title":"Use of laboratory tests in a teaching hospital: long-term trends","volume":"90","author":"PF, Griner; the medical house staff","year":"1979","unstructured":"Griner PF and the medical house staff. Use of laboratory tests in a teaching hospital: long-term trends. Ann Intern Med 1979;90:243-8.","journal-title":"Ann Intern Med"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1136\/bmj.281.6255.1610","article-title":"An aid to reducing unnecessary investigations","volume":"281","author":"Young, D.W.","year":"1980","unstructured":"Young DW. An aid to reducing unnecessary investigations. Br Med J 1980;281:1610-1.","journal-title":"Br Med J"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.45.7.572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T22:53:00Z","timestamp":1717195980000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.45.7.572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,7]]},"references-count":10,"journal-issue":{"issue":"7","published-online":{"date-parts":[[1992,7,1]]},"published-print":{"date-parts":[[1992,7]]}},"alternative-id":["10.1136\/jcp.45.7.572"],"URL":"https:\/\/doi.org\/10.1136\/jcp.45.7.572","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,7]]}}}