It is impossible to imagine diagnostic laboratories without molecular techniques. During the past decades molecular techniques have made it possible to show small quantities of DNA or RNA in microbiological, clinical chemical-and-genetic-pathology laboratories. In the world of microbiology PCR, real-time amplification, characterization and sequencing are well and truly established. We can now show each fragment of DNA or RNA of a micro-organism and we can show it quantitatively. The best known examples from clinical practice are for instance HIV-1, Hepatitis B virus (HBV) and Hepatitis C virus (HCV) quantitative PCR for monitoring disease activity.
In recent years, more automated systems has become available that allow automated isolation of nucleic acids (DNA and RNA).In addition, there are several real-time detection systems on the market; in the Netherlands the systems of LifeTechnologies (such as ABI7500) and Roche Diagnostics (LC480) are routinely used. Pipetting robots are being implemented more frequently which provide a bridge between isolation and detection.
Even in the presence of a combination of fully automated isolation-pipetting and detection systems, this equipment must still be linked to a LIS (laboratory information system) to translate and transfer data to electronic patient files (SPD). The communication between these automated systems has been a challenge for our Laboratory of Clinical Virology. This is mainly because these systems come from different manufacturers and are not designed to communicate with each other.
Our motto is: "the only limitation is your imagination". We want to work paperless and from one single application to another and with an easy visual inspection. All information needs to be accessible on monitors and all data should be visual approachable. Our dynamic way of working allows for constant improvements and the application needs therefore to be easy adjustable. Our "workflow" is guiding which is why we have named our project “Flow Groningen” or Flow G. Our approach is that everything we want, can be done.
FlowG is our first application and already other microbiology laboratories and diagnostic companies have shown interest. FlowG is currently in the process of developing new applications, such as FlowS (for sequencing) and FlowQ (for quality).
In the Isolation module, work list(s) are read from our LIS system called ISMED. The requests are subsequently processed on the working lists and can be transferred to an isolation list.
Upon loading the isolation list positive and negative controls are automatically added by FlowG.
During parsing of the SDS-file, the internal, positive and negative controls are analyzed. The table below shows the results in a deprecated check. In case the controls, after analyzing by the Amplification plot or multicomponent plot, are not found to be good or in case they are rejected, they can still be overruled.