title: Development and implementation of a custom integrated database with dashboards to assist with hematopathology specimen triage and traffic.
abstract: BACKGROUND
  At some institutions, including ours, bone marrow aspirate specimen triage is complex, with hematopathology triage decisions that need to be communicated to downstream ancillary testing laboratories and many specimen aliquot transfers that are handled outside of the laboratory information system (LIS). We developed a custom integrated database with dashboards to facilitate and streamline this workflow.
  
  
  METHODS
  We developed user-specific dashboards that allow entry of specimen information by technologists in the hematology laboratory, have custom scripting to present relevant information for the hematopathology service and ancillary laboratories and allow communication of triage decisions from the hematopathology service to other laboratories. These dashboards are web-accessible on the local intranet and accessible from behind the hospital firewall on a computer or tablet. Secure user access and group rights ensure that relevant users can edit or access appropriate records.
  
  
  RESULTS
  After database and dashboard design, two-stage beta-testing and user education was performed, with the first focusing on technologist specimen entry and the second on downstream users. Commonly encountered issues and user functionality requests were resolved with database and dashboard redesign. Final implementation occurred within 6 months of initial design; users report improved triage efficiency and reduced need for interlaboratory communications.
  
  
  CONCLUSIONS
  We successfully developed and implemented a custom database with dashboards that facilitates and streamlines our hematopathology bone marrow aspirate triage. This provides an example of a possible solution to specimen communications and traffic that are outside the purview of a standard LIS.
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Azzato
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Jennifer J D
authors.initials: JJ
authors.lastname: Morrissette
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Regina D
authors.initials: RD
authors.lastname: Halbiger
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Bagg
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Daber
keywords: Custom informatics; custom laboratory database; dashboard; hematopathology; pathology informatics