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Doody's Review ServiceReviewer: Shaun Grannis, MD (Indiana University Medical Center)
Description: The book describes information technology concepts as they relate to laboratory information sciences. The book covers a wide range of issues ranging from technical subjects such as computer basics and computer networks to management-related issues such as determining total cost of ownership (TCO) and ensuring security and confidentiality in the lab.
Purpose: The book is intended to help the reader become both literate and familiar with major issues related to clincal laboratory informatics as well as the major tools used in the field. An understanding of clinical laboratory informatics is critical to the development of a comprehensive Electronic Medical Records and clinical data repository. Laboratory information drives many decision support systems. Therefore, the development of robust, standardized laboratory information systems is critical to the enterprise health care information system. The authors describe general aspects of laboratory informatics, but fail to emphasize the need for information standardization, and the consequences of non-standard information. To this end, the Systematized Nomenclature of Medicine (SNOMED) encoding system and "Logical Observations, Identifier Names, and Codes" (LOINC) were reviewed but in insufficient detail.
Audience: As described in the preface, this book emerged from a laboratory informatics course for pathology residents and clinical laboratory science fellows. As a result, the material is introductory in nature but written using a sophisticated vocabulary. The authors often use clinical terms and scenarios that may be unfamiliar to those not well-versed in clinical nomenclature. Therefore, the appropriate audience for this includes medical residents, advanced allied health care professionals, and practicing health care providers with a need to learn about laboratory informatics. A majority of the authors hold professional degrees (M.D. and/or Ph.D.) and are all members of the faculty and staff of the Department of Pathology of the University of Texas Medical Branch with experience in the areas in which they write. Three of the ten authors list B.S. degrees only.
Features: The book addresses the following general areas: concept utilization, organization and management of laboratory information systems, including security considerations; technical aspects of computer systems and networks; and an overview of specific laboratory information system applications. One interesting and informative feature of the book is that it includes an entire chapter describing bar code technology. Such technology, while ubiquitous in healthcare, is infrequently described in clinical informatics literature. Further, end-of-chapter glossaries are included, which provide easy access to unfamiliar terms. One shortcoming of the book is the lack of an introductory outline at the beginning of each chapter. An outline, or chapter summary helps guide the reader through complex topics. Notably missing were references later than 1998. It appears that perhaps the book's manuscript was completed in 1998, given the lack of references after that year. Given that the field of laboratory informatics is rapidly evolving, that is a substantial shortcoming. Additionally, there was little mention of the emerging field of genomics and its relationship to laboratory informatics. Arguably, a large portion of the forseeable future of research in laboratory information sciences and clinical informatics will focus on managing and analyzing genetic information. This topic was not adequately covered. One would be careful to note that the discussion of "genetic algorithms" included in the book should not be confused with "genomics." These are two entirely separate fields of study.
Assessment: This book is appropriate for health care workers who seek a broad introduction to laboratory information sciences. Readers will also learn about information management in addition to core issues of information modelling, database design and technical computer basics. However, the book fails to discuss the role that laboratory information sciences will play in managing and analyzing the human genome. Because genomics and proteinomics are emerging as important areas for laboratory informatics research, the lack of its inclusion is a shortcoming.