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Middleware and the Clinical Hematology Laboratory


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Practice Modeling - Mayo

Slide 8

February 2009

I want to share with you our experience here at Mayo Clinic, again using those four major decision points.  We instituted middleware in 1996 and I pulled some old data prior to that to show what we were doing.  I know that sounds like eons ago, but at that point in time the instrument was auto-verifying using its internal software at a 40% rate; we were scanning and releasing without doing a manual differential in 20% of cases; and when we took a hard look at our manual differentials, 30% of all cases that we did or 3/4 of the manual differentials really had no or only minimal clinically significant abnormalities.  Now, let’s look at 2008:  we see an auto-verify rate at the instrument together with middleware at 82%; an 8% scan and release rate; 2% manual differentials with normal to minimal abnormalities and an 8% manual differential rate for clinically significant abnormalities.  This clearly shows a significant change in the lab’s workflow after the successful implementation of middleware.  And that change is coming primarily from those middle two boxes of scan and release and manual counts showing no or minimal abnormalities.  What was the impact of this change?  Within 3 months of implementation, we had decreased our FTEs and improved our turnaround times within the laboratory.

Practice Modeling - Mayo


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