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Developing software for management applications.

Developing software for management applications

In August 1982, the microcomputer we had sought out to improve department operations finally arrived in the laboratory. Trailing behind it was a dilemma: Should we write our own programs or purchase commercial software?

We obtained the Apple II Plus with disk drive as part of our annual purchase of chemistry controls, so some software was already provided--preprogrammed disks for quality control calculations. In addition, the laboratory spent $1,000 for a CRT, a printer, and another disk drive.

It wasn't difficult to adapt the QC packages and use them with other manufacturers' reagents as well. Such programs probably constitute the largest class of laboratory software; most of their calculations and equations are standard. But this still left the microcomputer to collect dust on the supervisor's desk for 90 per cent of the day. We wanted to get much more out of it than that.

Our two divisional laboratories use out 690-bed medical center's computer system only for test order entry, and we have no dedicated laboratory minicomputer. That left it up to the microcomputer to simplify everyday management. Specifically, collecting statistics and compiling records are two of our most tedious and time-consuming management tasks. Most supervisors would concur on the drudgery of preparing time cards and assembling CAP workload statistics for monthly reports, for example.

Given the right programs, the microcomputer would lighten this burden. A look through computer and clinical lab publications revealed a number of vendors with software for compiling CAP statistics, analyzing quality control, and calculating productivity. Laboratorians can also design their own data formats, within limits, on electronic spreadsheets. These programs are replete with calculating functions that can be combined in endless permutations.

Even though commercial sources offered programs that might well have served our needs, we turned to our medical center's computer experts for two key reasons. First, few of our staff members had the know-how to select commercial programs in this highly competitive market, or the time to become wise computer consumers. Second, we didn't want to change our report formats extensively to meet the constraints of a "canned' program.

The laboratory manager and supervisors were satisfied with the manual reporting and recording formats developed over the years. We wanted software that would immediately reflect administrative operation. So we opted, at least for the near term, to use inhouse services.

After much deliberation, we chose the computer's first practical use: helping the laboratory secretary complete the biweekly payroll. In just one of the two divisional labs, it took five hours to complete 120 to 130 time cards.

Putting together the payroll would be a snap if everyone worked 9 to 5, Monday to Friday. But clinical laboratories don't operate that way. Our secretary had to calculate overtime by shift, premium pay, and shift differentials, and keep track of employees' personal time. Many employees also are on multiple or overlapping shifts, or work in more than one cost center of the lab.

With experience, manual processing of time cards becomes less troublesome. But if the secretary is sick or on vacation, there's no guarantee that someone else will be able to process the cards efficiently.

In March 1983, we called on the medical center's software specialist to assist with the program design. Four weeks after we outlined our specifications, he gave us a completed disk. A trial run removed some of the bugs, and the program was ready for use.

Ten months later, the secretary had reduced the time spent preparing time cards by as much as an hour and a half each pay period. The big pluses for laboratory management are that the calculation of time cards is uniform (Figure I) and that anyone, regardless of experience, can handle the payroll when the secretary isn't there.

With the payroll program in operation, we moved on to our next project: creating software to calculate CAP workload statistics. Instead of spending several hundred dollars for a ready-made CAP program, we again turned to the fixed-cost services of our data processing department.

An easy-to-use program would cut preparation time for the monthly workload report. We also wanted to consolidate records kept on countless pieces of paper into a single disk.

The latter was a particularly irritating problem because the administration, medical staff, and planning department frequently called for our statistics. We like to maintain five years' worth of data, but doing it on paper carries a high risk of misplacing some records, no matter how much care is taken. We intended to change over to disks before suffering an irreplaceable loss.

Less than a month after outlining our needs to the software designer, we had a completed program. Now when we're asked for a workload report, we simply enter the disk in the microcomputer, retrieve the data needed, and print it immediately (see Figure II).

These early programs of ours, including one on productivity (Figure III), differed from spread-sheet programs in that we only had to respond to screen prompts and "fill in the blanks.'

By mid-1984, we asked our in-house software programmers to develop two packages dealing with budgets: cost accounting of direct costs for lab tests and variance analysis for operating expense budgets. Concurrently, our assistant manager and two supervisors were working with a Lotus 1-2-3 spreadsheet program to achieve the same objectives.

Our supervisors succeeded in using the Lotus program for budget variance analysis. But we employed in-house designed software for test cost accounting mainly because the programmers had made it easier for us to work with the algorithms used in the calculations.

The variance analysis program for budgets helps explain how well the laboratory is performing under prospective payment. Each month we receive an operating report from the data processing department that compiles operating expenses by invoices paid. Section supervisors use the program to record monthly expenses from invoices, standing orders, storeroom requisitions, etc., and match the totals against revenue during the same period.

Since the hospital financial reports sometimes include paid invoices that are not for the current month, the program segregates these unfavorable variances to minimize distortion in the budget. This gives administration a much clearer picture of laboratory spending patterns.

The test cost accounting program has been used to determine whether it is more cost-effective to perform new tests in-house or send them out to reference laboratories.

What were the advantages of our early software choice? Economical use of the fixed-cost services of the data processing department and its custom software served our needs best at the beginning. Within a short period of time, however, laboratory management quickly adapted to more versatile commercial spreadsheet software, leaving only the more complex programs to our in-house designers.

Operationally, we have brought microcomputers into our work flow with little disruption of existing time-tested administrative procedures.

Table: Figure II A customized breakdown of workload

The monthly report records test volume and CAP workload units for the medical center's main Fitzgerald laboratory (FITZ) by section, including a separate listing of work that the lab performs for the smaller Misericordia laboratory (MIS). Inpatient, outpatient, and quality control procedures are totaled first. CAP units for quality control are listed separately, and the final column tallies total CAP units. At the bottom, the report also provides a comparison of the current FITZ in-house workload with that of the preceding month and year.

Table: Figure III A program to measure monthly productivity

This monthly report lists laboratory sections with their accounting codes, followed by total CAP workload units, minutes worked, and calculated productivity.

Photo: Figure I Processing time cards on a payroll program

This excerpt from the two-week payroll record shows hours worked, including overtime, in one cost center of the lab.
COPYRIGHT 1987 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1987 Gale, Cengage Learning. All rights reserved.

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Author:Murphy, Robert J.; Mautz, Lynn A.
Publication:Medical Laboratory Observer
Date:Oct 1, 1987
Previous Article:Why, when, and how to hire a laboratory consultant.
Next Article:Determining linearity on a microcomputer.

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