Autoverification
Autoverification is a process for automatically verifying test results based on a predetermined set of rules established by the laboratory. Autoverification improves operational efficiency by eliminating the need for a medical laboratory scientist to approve each test result before they are released to the laboratory information system for reporting. Besides more effective use of personnel, autoverification improves turnaround time and reduces reporting errors.
In autoverification, patient results generated by an instrument interfaced to a laboratory information system are compared by computer software against laboratory-defined acceptance parameters. If results fall within these parameters, they are automatically released for reporting with no additional human intervention. Results that fall outside of these defined parameters are reviewed by a medical laboratory scientist prior to reporting.
Software rules for autoverification may reside in either the laboratory information system or in middleware. Several parameters are included in autoverification rules including instrument flags, serum interference indices, delta check, need for manual dilution, analytical measurement range (AMR), reference range, and critical range.
The following criteria must be met before a result is autoverified:
- quality control is acceptable
- Results fall within the specified autoverification range
- Results pass delta check limits
- No instrument flags are present
Common reasons that a result is not autoverified include specimen error (clot, bubble, short sample), need for manual dilution, instrument error, interference index flag, and value outside the AMR.
One issue that complicates chemistry autoverification is the presence of method interferences. The LIS must be able to capture all instrument error flags and use them to prevent autoverification.
College of American Pathologist’s general lab checklist has several questions regarding autoverification. These concern monitoring quality control, suspension of autoverification, rules-based checking, rules validation, and medical director oversight. CAP requires that the medical director sign a policy approving the use of autoverification procedures.
