title: Invention and validation of an automated camera system that uses optical character recognition to identify patient name mislabeled samples.
abstract: BACKGROUND
  Mislabeled samples are a serious problem in most clinical laboratories. Published error rates range from 0.39/1000 to as high as 1.12%. Standardization of bar codes and label formats has not yet achieved the needed improvement. The mislabel rate in our laboratory, although low compared with published rates, prompted us to seek a solution to achieve zero errors.
  
  
  METHODS
  To reduce or eliminate our mislabeled samples, we invented an automated device using 4 cameras to photograph the outside of a sample tube. The system uses optical character recognition (OCR) to look for discrepancies between the patient name in our laboratory information system (LIS) vs the patient name on the customer label. All discrepancies detected by the system's software then require human inspection. The system was installed on our automated track and validated with production samples.
  
  
  RESULTS
  We obtained 1 009 830 images during the validation period, and every image was reviewed. OCR passed approximately 75% of the samples, and no mislabeled samples were passed. The 25% failed by the system included 121 samples actually mislabeled by patient name and 148 samples with spelling discrepancies between the patient name on the customer label and the patient name in our LIS. Only 71 of the 121 mislabeled samples detected by OCR were found through our normal quality assurance process.
  
  
  CONCLUSIONS
  We have invented an automated camera system that uses OCR technology to identify potential mislabeled samples. We have validated this system using samples transported on our automated track. Full implementation of this technology offers the possibility of zero mislabeled samples in the preanalytic stage.
authors.affiliation: ARUP Laboratories, Salt Lake City, UT;
authors.forename: Charles D
authors.initials: CD
authors.lastname: Hawker
authors.forename: William
authors.initials: W
authors.lastname: McCarthy
authors.forename: David
authors.initials: D
authors.lastname: Cleveland
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Messinger
mesh_terms: D002984:Clinical Laboratory Information Systems; D019411:Clinical Laboratory Techniques / Q000295:instrumentation; D006801:Humans; D055096:Optical Devices; D010355:Patient Identification Systems / Q000379:methods*; D010781:Photography / Q000295:instrumentation; D012371:Robotics