Lab Matters Winter 2019 | Page 23

GLOBAL HEALTH Zambia’s National LIS Advances Laboratory Efficiency, Data Availability by Clement Phiri, laboratory technical advisor, Global Health; Kasimona Sichela, dashboard developer/data manager, Global Health; Elias Munshya, LIS support officer, Global Health; Reshma Kakkar, manager, Global Health Informatics; Rachelle Jones, senior specialist, Global Health Informatics; Sadaf Chaudhry, manager, Global Health With support from APHL, Zambia officially launched its national laboratory information system (LIS) in 2014 after a year of implementation at the largest hospital in the country, University Teaching Hospital. Designed to exchange data among public sector laboratories nationwide, the LIS was inaugurated by the Minister of Health. Since 2014, Zambia has rolled out LIS to 13 more facilities, ranging from sections that conduct HIV viral load testing only (9 facilities) to full scale LIS implementation covering Hematology, Biochemistry, Immunology, Serology and Bacteriology sections (4 facilities). These laboratories have welcomed the benefits of the LIS, including reduction in turnaround time for HIV test results from weeks to days, improvements in specimen tracking, and secure results/records storage and retrieval. In addition, an electronic test orders and results transmission application that enables remote test request entry, specimen tracking and final result transmission has been installed at several health facilities. This application has contributed to enhanced barcoded sample tracking and rapid return of results to care providers. All 13 laboratories are pursuing accreditation as part of the Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) program. Three applied for the Southern Africa Development Committee Accreditation Scheme (SADCAS) accreditation audit in 2018, and all were accredited to the ISO 15189 Standard by SADCAS. PublicHealthLabs @APHL Dr. Hamankwa Mantina, deputy head of Pathology and Microbiology disusses the LIS setup with (from l to r) Charles Nyambe, deputy director, Laboratory Services, CDC Country Director Dr. Lawrence Marum, the Hon. Minister of Health Dr. Joseph Kasonde and Dr. Victor Mudenda, head, Pathology and Microbiology. Photo: Zambia Daily Mail To improve knowledge and decision making at the Ministry of Health (MOH), APHL assisted with development of an MOH centralized laboratory data repository that captures data from all LIS nationwide on an almost real-time basis. This open source repository, termed Open Laboratory Data Repository (OpenLDR), allows the MOH to conduct analyses, generate reports and integrate data from other healthcare systems, for example, electronic medical records (EMRs). Monthly reports include information on LIS performance and statistics for HIV viral load and EID testing for information on progress and trends. The OpenLDR also helps to identify gaps in the data management cascade such as the need for a unique national patient identifier to enable longitudinal monitoring of HIV viral load tests for patients on anti- retroviral testing. APHL Zambia seeks to be innovative especially with use of laboratory data. In 2018, the team began developing data visualization tools and dashboards using data from the central repository. The team is also exploring data integration possibilities with other health systems to enable seamless linkage between clinics and laboratories. n Winter 2019 LAB MATTERS 21