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The use of the Reflection computer program for facilitating report formulation in the medical microbiology laboratory
  1. M Viagappan,
  2. S Howard
  1. Microbiology Department, University Hospital Lewisham, Lewisham High Street, London SE13 6LH, UK
  2. Business Development, 2nd Floor Mulberry House, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK

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    There are several different computer systems in use in UK medical microbiology laboratories. Rule bases can be built into the system for the automatic release of comments or antibiotic sensitivities on laboratory reports in predetermined situations to aid manual amendment. The time consuming nature of data entry has already been highlighted.1 We describe a method to facilitate data entry and report amendment.

    Within our hospital, all result entry and reporting is performed through the pathology management system APEX (ACT Medisys Ltd, Newbury, Berkshire, UK). Most of the data input on to this system is via dumb terminals that attach to the server through the hospital network. In addition, there are presently two PCs within the department also attached to the hospital network running either Windows 95 or NT. By utilising the terminal emulation software Reflection (WRQ/Wickhill, Guildford, Surrey, UK), these PCs are able to replicate all the functionality achieved from a terminal on a windows based PC platform. However, because Reflection is a software component, it can incorporate features unavailable to a terminal.

    A toolbar programme within the Reflection programme can be used to facilitate report amendment. This enables a toolbar to be created with icons on which a frequently used string of keystrokes can be recorded then played back by clicking on the icon. The computer can therefore be used like a tape recorder by recording keystrokes instead of sound. Figure 1 demonstrates the creation of an icon.

    The method can be used to assist various functions, such as comment entry or amending antibiotic sensitivities. For example, to enter a comment:

    • Icon 1 = to arrive at the comment entry point = five keystrokes.

    • Icon 2 = comment “contaminated urine sample, please send a repeat” = 44 keystrokes.

    • Icon 3 = to return to the main menu = five key strokes.

    In this example 54 keystrokes have been reduced to three.

    Different toolbars can be created for each group of samples—for example, sputum, urine, etc.

    Figure 1 shows three toolbars open simultaneously, thus allowing toolbars to be used together. Customised toolbars can be saved on to disc, allowing them to be used on different machines, or for different users to have their own customised disc.

    An important feature of a UK microbiology laboratory is the input of the medical microbiologist in laboratory supervision and report authorisation. Report amendment can be time consuming but can make a report more user friendly for the clinician and facilitate clinical care. The toolbar programme can assist this process.

    The program can also be used by technical staff. A further advantage of this program is that it can be used as an adjunct to most computer systems. A hospital in which there is an integrated network can therefore incorporate the use of Reflection without having to change its current computer system.

    This program may assist in more effective time management for hospital microbiologists, an increasingly important factor if their time is to be deployed in the most effective way.

    The Reflection package is produced by WRQ (UK distributors: Wickhill Ltd, Bradstone Brook, Christmas Hill, Shalford, Guildford, Surrey GU4 8HR. Tel: +44 01483 466 500).

    Figure 1

    The Reflection toolbar program has the facility to record both text and function keystrokes and allow these to be played back. The “string to transmit” box shows the letters and function keys being recorded.

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