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Delivering Laboratory Results

To manage patients doctors should have access to their laboratory results. This applies to GPs no less than to specialists.

I have a _shred_ of sympathy for a colleague who wants to make sure none of us get access since he fears being overwhelmed by paper results for patients in the ITU, but for those of us who usually don't have patients in ITU it doesn't seem to me to be a problem.

The solution I prefer is to have secure networked access to the server holding the results, using an interface which at present would be basic HTML [1] and would tend to XML as time went on.

For these purposes I regard browser access using SSL from an access list of fixed IP addresses over our common perimeter network as being satisfactorily secure - it is certainly more intrinsically secure than our paper courier system [2]

The system could be automated in a set of ways - allowing us to script the acquisitioon of results and posting of them into existing or new record systems, access the result service in a page framed in a page of medical records, or perform a URL lookup based on the patient shared ID [3]

And uses cheap off the shelf technology maintainable by people present in every town.

[1] _very basic_ this is important because otherwise differentiation in products will add to the incompatibilities between our clinical record systems in GP, and to our overall costs. This is actually a prime example of an open standard

[2] although breaches of paper security are more often visible than a breach in a browser interaction.

[3] We have several ID strings. NHS number, local hospital/Trust number, practice ID string. Any of those presented to a web front end on the practice's clinical narrative server as part of a CGI string should be very satisfactory to bring up the notes. So one can brows the day's results, pulling the narrative and summary whenever a result suggests more information or action is needed. Fits the workflow.