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Using your laboratory information system (LIS) for autoverification is one of the most effective ways your lab can reduce hands-on tech time through process automation. Depending on the lab menu and patient population, 40% to 95% of results could qualify for autoverification.1,2

What is Autoverification?
Autoverification is a laboratory process. Labs define parameters for acceptable patient results generated from interfaced instruments to send to the LIS. Results that fall within the defined autoverification parameters automatically release into the electronic health record (EHR) without any additional laboratory staff review or intervention. Results that are not within the defined parameters are reviewed by a technologist before reporting.

How is Autoverification Used in a Laboratory?
With the tremendous squeeze on laboratories to continually do more with less, labs can implement process improvements that improve quality, reduce costs, and simplify processes. Autoverification is one of the key tools to achieve these goals. In most laboratories, implementing autoverification rules allows many results to forego a manual review.

How Does Autoverification Improve Laboratory Efficiency?
Result autoverification is one of the most time-saving, beneficial undertakings that a laboratory can implement. Autoverification rules provide consistent test reporting, and with dramatic improvements in turnaround time (TAT). It can also help to reduce error rates. Automatically releasing results helps improve quality, reduces costs, and simplifies processes. With autoverification rules in place, laboratory professionals spend less time manually reviewing test results and have more time to spend on other job functions that cannot be automated.

 

 

How to Set Up Autoverification
To begin autoverification rules setup, start small so the project does not become overwhelming. Below are some basic steps to follow.

  1. Select one test to begin autoverification.
  2. Review your current result approval workflow and use it to create a basic autoverification policy that fits your testing menu and volume.
  3. Determine the acceptable autoverification range. Consider the following elements:
    • Analyzer linearity
    • Analyzer auto-dilution procedures
    • Critical values
    • Delta checks
    • Quality control requirements
    • Instrument flags and how they interact within your interface
    • Rerun policy
    • Reference ranges, including age- and gender-specific
    • Calculations
    • Reflex policies
    • Integrity checks
  4. Create autoverification rules in your test system. Test the new autoverification rules on “test” patients.
  5. Create the autoverification rules in your live system and turn on autoverification rules for that one test only while still reviewing result transmissions to verify accuracy.
  6. Monitor results closely until you verify a sufficient volume of tests have properly transmitted into the EHR.
  7. Train staff throughout the process.
  8. Verify annually.

Autoverification Resources
Use the following resources to help you set up your laboratory’s autoverification procedures and processes.
CLSI standard AUTO10 – details the autoverification standards for clinical laboratory test results
CLSI standard AUTO15-Ed1 – details the autoverification standards for medical laboratory results for specific disciplines
A step-by-step process to 95% autoverification – from CAP Today  – tips to help you establish autoverification in your lab
Building and validating an autoverification system in the clinical chemistry laboratory – from Laboratory Medicine  – details on how to construct and evaluate verification rules

Conclusion
With a critical shortage of laboratory professionals, it is important to be as efficient as possible and to automate processes where you can. Autoverification rules can reduce your TAT and allow staff time to focus elsewhere. And remember, the results being released are still in your control. The rules protect any results you have flagged as needing review from inadvertently being released. You can tweak the rules as you go through the process and gain more experience.
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References

  1. Krasowski MD, Davis SR, Drees D, et al. Autoverification in a core clinical chemistry laboratory at an academic medical center. J Pathol Inform. 2014;5(1):13. doi:10.4103/2153-3539.129450.
  2. Marquardt, B. A step-by-step process to 95% autoverification. CAP Today. Published December 2015. Accessed May 2020: https://www.captodayonline.com/step-by-step-autoverification/