LabLink, electronic data collection using a uniform protocol
The SHM database has an extensive collection of laboratory results. In particular, information on HIV viral load and CD4 cell counts are amongst the most important and widely used data for both clinical practice and research. In addition to virology and immunology, extensive data sets are collected for haematology, clinical chemistry, hepatitis and STIs.
Collection of laboratory results
The manual collection of laboratory data by the data collectors involves entering data one at a time from individual laboratory information systems into the SHM database. This is a simple, but also error-prone and tedious task, especially when considering that blood spot tests are often taken every three months in HIV patients. In the age of electronic information and data exchange, the manual collection of such data seems unnecessary. Electronic input of laboratory data is more up to date than manual entry, allowing information to be used for patient care.
Introduction of LabLink
In 2005, SHM launched the project ‘LabLink’, wherein laboratory data is selected from the laboratory information system, for example GLIMS, and is then forwarded to SHM. These data are processed by the Clinical Research Unit (CRU) at the Academic Medical Center in Amsterdam and entered into the SHM database. To date, there are 8 treatment centres with LabLink.
Creation of uniformity
In the past, treatment centres independently determined the format for sending laboratory data. This was convenient for the treatment centres but made entering data into the SHM database a very time consuming process and established discrepancies on SHM’s side, because each data set had to be treated separately.
In 2011, therefore, the CRU together with the IT department at the AMC proposed the standardisation of LabLink according to international guidelines. In the same year, SHM started with the implementation of LabLink using the HL7 format. This means that messages sent via a secure VPN-connection are sent from servers in the different treatment centres to SHM’s server. Then, the data is imported into the SHM database via a number of steps. During this process, the CRU performs technical checks and SHM’s data management group checks the content of the data. Extensive checks take place every quarter and a control system is currently under development which will carry out the most important checks twice a week.
Rollout of LabLink
There are now 8 treatment centres that use LabLink, namely the UMC Utrecht, St Elisabeth Tilburg, Leiden UMC, MC Alkmaar, Medisch Spectrum Twente, Isala Zwolle and Maasstad Rotterdam, all of which use the HL7 format for the transfer of their lab data. The AMC uses a direct internal connection as the data doesn’t have to leave the hospital.
Erasmus MC, Slotervaart Ziekenhuis, Maastricht UMC and the Kennemer Gasthuis Haarlem are currently in the testing phase and LabLink will go into production in 2013 for these hospitals. The remaining 14 sites have indicated their interest in the project, but are unable to plan implementation in the short term due to other IT-related activities, such as the implementation of new EPDs. In 2014, another 4 treatment centres will hopefully take the step towards introducing LabLink.