title: Downtime procedures for the 21st century: using a fully integrated health record for uninterrupted electronic reporting of laboratory results during laboratory information system downtimes.
abstract: OBJECTIVE
  Downtimes of the laboratory information system (LIS) or its interface to the electronic medical record (EMR) disrupt the reporting of laboratory results. Traditionally, laboratories have relied on paper-based or phone-based reporting methods during these events.
  
  
  METHODS
  We developed a novel downtime procedure that combines advance placement of orders by clinicians for planned downtimes, the printing of laboratory results from instruments, and scanning of the instrument printouts into our EMR.
  
  
  RESULTS
  The new procedure allows the analysis of samples from planned phlebotomies with no delays, even during LIS downtimes. It also enables the electronic reporting of all clinically urgent results during downtimes, including intensive care and emergency department samples, thereby largely avoiding paper- and phone-based communication of laboratory results.
  
  
  CONCLUSIONS
  With the capabilities of EMRs and LISs rapidly evolving, information technology (IT) teams, laboratories, and clinicians need to collaborate closely, review their systems' capabilities, and design innovative ways to apply all available IT functions to optimize patient care during downtimes.
authors.affiliation: From Information Services, NewYork-Presbyterian Hospital, New York, NY;
authors.forename: Bulent
authors.initials: B
authors.lastname: Oral
authors.affiliation: From Information Services, NewYork-Presbyterian Hospital, New York, NY;
authors.forename: Regina M
authors.initials: RM
authors.lastname: Cullen
authors.affiliation: From Information Services, NewYork-Presbyterian Hospital, New York, NY;
authors.forename: Danny L
authors.initials: DL
authors.lastname: Diaz
authors.affiliation: Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY; and Clinical Laboratory Services, NewYork-Presbyterian Hospital, New York, NY.
authors.forename: Eldad A
authors.initials: EA
authors.lastname: Hod
authors.affiliation: Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY; and Clinical Laboratory Services, NewYork-Presbyterian Hospital, New York, NY. ak2651@columbia.edu.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kratz
mesh_terms: D002984:Clinical Laboratory Information Systems; D003628:Database Management Systems; D057286:Electronic Health Records; D005791:Patient Care
keywords: Downtime; Electronic medical record; Generalist; Informatics; Laboratory information system; Management/administration; Scanning