PostHeaderIcon HIMS-MLIMS

 

 HIMS MLIMS

Establishment of Medical Laboratory Information Management System

(MLIMS) for the Medical Research Institute

 

At MRI we face several major issues with the existing manual paper-based system such as, incorrect data entries, data duplication, increased clerical work, coping errors, unacceptable laboratory turnaround time (TAT) missing of samples, difficulty in tracking a sample etc.  Also it has affected to conduct research activities on available data, generate timely statistical data, difficulties in stock

management etc.

An Automated Medical Laboratory Information Management System (MLIMS) is a software system used in laboratories for the management of samples, laboratory users, instruments, standards, quality control and other laboratory functions such as invoicing, stock management, and workflow automation.

 

Implementing automated MLIMS at MRI will be the answer to most of the above-mentioned issues as many other laboratory services at private sector have already achieved. This will be an essential component to provide efficient Laboratory services at MRI.

 There were several attempts to implement an automated MLIMS at MRI during recent past from year 2011 and so far we were unable to achieve it due to various reasons. 

Year

details

Description of the positive or negative effect

Recommendations

2011

BIKA Health (Cape Town, South Africa)

Customization was possible only through the developers

Since there was an issue with the customization, error correction and sustainability, another system had to be considered

2013

Establishment of HIMU

Two staff was allocated

A proposal with the essential requirements was submitted to Director MRI

2014-2015

Quotations were called from companies openly

There were three quotations received

TEC was appointed. Chairperson: Dr Anil Samaranayake (Deputy D-MRI), Members: Dr Deepaka Sanath, Dr Chaminda Weerabaddana( MO-HI-MOH), Mr. S.A.L.P. Suraweera (Sup.MLT), Mr Sujith Jayasooriya ( ICTA) and suggested to try with HIMS already established at Cancer Institute, Maharagama.

2015

As a project by 4 students of SLIT

A system was developed only to cater Virology needs and not piloted till 2017

If the system was developed according to the international standards and if it can cater the whole MRI needs there is a possibility after a successful piloting ,  sustainability and cost factor also has to be considered.

2015

HIMS- Maharagama

Staff not enough MLTs cannot attend to system due to heavy work load and they did not like minor staff entering data to the system.

Since this is the government recommended system and it is fully developed according to the international standards and its piloted and implemented in 17 hospitals around the island and  its more sustainable.  Some suggestions at different forums to wait till proper staff recruited. Director was informed in writing with the proposal again and expecting advices on the future plan.

2016- June

A meeting with Dr. (Mrs) Champika Wickramasinghe , Director Information visited MRI on 29th June 2016 to solve the issues related to network and MLIMS

Since the existing network is almost 10 years old, Network upgrading was prioritized for 2016, and MLIMS will be planned for 2017 for a comprehensive unique MLIMS for MRI after network upgrading finished.

Network proposal was submitted towards November 2016 with the help of the Health Information Unit , MOH but delayed to work out to finish it by 2016 and it was taken to 2017 and .

Afterward, the letter number HP/HI/P/11/2016 dated 01.12.2016 by the Director General of Health Services (Annexure 2) advised to consider the laboratory module of HIMS already implemented at National Cancer Institute Maharagama (in addition TH Peradeniya and many other hospitals). When I contacted Dr. Nishan Siriwardena as stated in the above letter, he stated that the system itself was designed to cater the needs of MRI and NCI Maharagama initially in 2011-2013 by gathering inputs from previous MO-HI, Dr Uditha Perera and the system is now much improved than before with interfacing many automated machines.

 

None of the above attempts were successful due to several reasons. 

  1. Lack of reliable network at MRI. The currently available network is about 10 years old and for most of the hardware the suppliers have announced “End of Life” .It is expected to be sorted out with the support of the Director -Information, Ministry of Health from HSDP funds during this year and the process is already started.
  2. Insufficient staff to attend network related issues immediately: Only two supportive staff to handle network (nearly 130 network terminals) and all hardware maintenance (nearly 100 desktops, 20 Laptops, 50 printers) at MRI. Therefore, recruitment of proper staff to HIMU for sustained smooth function of the network is very much essential.
  3. Administrative commitment:  Since there was frequent changing of the administration at MRI in the recent past the administrative commitment was not in a favorable position. For a succesful implementation the administrative commitment is needed in the following ways,

             i.      Fully supportive attitude for implementation of the system- The administration should facilitate the working group to make it happen. 

            ii.      Making sure a sustainable internet service with reliable fast access (also important for customization of the system remotely whenever necessary).

            iii.      Making sure a sustainable network with support for proper network maintenance.

            iv.      Staff motivation to use the automated system and encourage them.

            v.      Appointment of competent TEC comprising Medical expertise, Medical officers-Health Informatics, software expertise at MOH and other government agencies like ICTA  etc. to have more diverse inputs for sustainability. 

 

In all the hospitals with currently running information management systems there are adequate staff.

At MRI currently only one Medical Officer I/C and one health care assistant (සෞඛ්‍‍යකාර්‍යසහායක) ‍ are available permanently. We are performing following duties with lot of difficulties,

  1. Network maintenance- Creating users and giving privileges according to staff categories and managing users using firewall, supervision of smooth running of the MRI network by the health care assistant
  2. Hardware maintenance – supervision of smooth running of hardware functions and repaire the faulty computers by the health care assistant
  3. Preparation and planning , design, customizing of the available automated LIMS  to cater MRI needs
  4. Maintenance of Library information Management System.
  5. Creating users and giving privileges according to staff categories and managing users using firewall, supervision of smooth running of the LGN2 system
  6. Attending TEC, providing specs etc
  7. Conducting  research
  8. Maintenance of the communication  and files for future communications