A heterodyne interferometer for angle metrology.

We have developed a compact, high-resolution, angle measurement instrument based on a heterodyne interferometer. Common-path heterodyne interferometer metrology is used to measure displacements of a reflective target surface. In the interferometer set up, an optical mask is used to sample the laser beam reflecting back from four areas on a target surface. From the relative displacement measurements of the target surface areas, we can simultaneously determine angular rotations around two orthogonal axes in a plane perpendicular to the measurement beam propagation direction. The device is used in a testbed for a tracking telescope system where pitch and yaw angle measurements of a flat mirror are performed. Angle noise measurement of the device shows 0.1 nrad/square root of Hz at 1 Hz, at a working distance of 1 m. The operation range and nonlinearity of the device when used with a flat mirror is approximately +/-0.15 mrad, and 3 microrad rms, respectively.

A longitudinal view of laboratory re-engineering in a community hospital group.

Starting with a traditional community hospital laboratory system in one medium-sized and two small community hospitals and with a modest plan for reorganization, the CHS laboratories have embarked on a successful 6-year run of re-engineering.

Plexiform neurofibromatosis involving the uterine cervix, endometrium, myometrium, and ovary.

BACKGROUND: Neurofibromatosis involving the female genital tract is unusual. The vulva appears to be most frequently affected, with only rare reports of vaginal, cervical, and ovarian involvement in patients with known von Recklinghausen's disease. CASE: We present a case of diffuse neurofibromatosis involving the cervix, endometrium, myometrium, ovarian cortex, and serosa in a patient with uncontrollable pelvic pain, diagnosed initially as endometriosis. No gross pathology was appreciated, and the histologic features of the small lesions were consistent with plexiform neurofibromas. CONCLUSION: The case presented is an example of diffuse involvement of the female genital tract by neurofibromatosis in a patient without a family history of von Recklinghausen's disease and without other clinical manifestations of the disease.

Software regression testing and quality assurance.

Inadequacy and inefficiency of manual validation and regression testing present major problems for users of clinical laboratory information systems (LIS). This article examines the history of LIS regression testing, typical examples of related problems, and possible approaches to improving system QA through partial or complete automation of the process.

The clinical laboratory is in the information business.

Clinical laboratories have always been in the information business. More than ever, this perspective is essential to deal logically with the many current pressures and anticipated changes in laboratory management. Current pressures for test turn-around and report flexibility are readily explained based on the spatial and temporal factors in the information content of a result. A long term trend is apparent toward easier to manage testing systems more often distributed to the point of care. Combined with the trend toward larger and more integrated delivery systems, this increases the need for information management in the laboratory, both to control production of data at many sites and to collect, route, and archive results for each patient. One potential outcome of this trend appears is dispersion of essentially all central hospital laboratory operations to the bedside, the ward based laboratory, or an outside reference lab. These changes will mesh well with the re-design of nursing and ward care jobs underway in the hospital industry which emphasizes cross training of ward personnel and rapid access to services for patient evaluation and monitoring. More than ever, information management will be synonymous with laboratory management.

A clinical laboratory information systems survey. A challenge for the decade.

In 1990, the College of American Pathologists Informatics Committee surveyed 14,785 laboratorians for their experiences with a clinical laboratory information system. A 16.25% response rate was achieved, representing 2402 questionnaires that were analyzed. Despite the perceived satisfaction of the clinical laboratory information system users with more expensive systems, no economy of scale was demonstrated with increasing system cost through either laboratory staff reduction or increased number of specimens per day. The strongest predictors of system satisfaction were (1) vendor success measured by number of installations and (2) a selection process that involved the pathologist/laboratory director and included a formal request for proposal. The need for integration of clinical laboratory information systems with hospital information systems, as well as the universal adoption of standard productivity terminology, including work load units, was evident.

What's right and what's wrong with laboratory information system requests for proposals.

Using a formal request for proposal (RFP) has been widely promoted as an essential phase of laboratory information system (LIS) selection and acquisition. Recently, stories of system or project failure--despite adherence to the RFP procedure--have increased. Case reports suggest that the RFP itself may sometimes hinder, rather than facilitate, the system selection process. As with any tool, the RFP has strengths and weaknesses, either of which may predominate depending on how the tool is used. Laboratories should be aware of alternatives to the formal RFP and should view the RFP as part of an integrated process of system evaluation and selection.

The ins and outs of laboratory information systems. Combining the hospital and reference laboratory.

Regulatory and reimbursement pressure on laboratory and hospital organizations have led to diversified or hybrid combinations of hospital inpatient, outpatient, and reference laboratory operations. Laboratory information system (LIS) requirements to integrate these operations become more complex than for either operation alone, because inpatient and reference operations have different and sometime conflicting priorities. Careful attention to LIS requirements is necessary to implement hybrid laboratory operations systems successfully.

Putting bar codes to work for improved patient care.

Healthcare bar code applications have developed more slowly than industrial or supermarket bar codes, but they are beginning to gain acceptance. Clinical laboratories that use bar code systems have already improved productivity and, more importantly, patient care through reduction of human clerical errors in identifying laboratory samples. Soon, integration of proven technology should expand the benefits of automatic ID to a broader range of healthcare applications.

Implementing information systems.

Effective implementation and system selection are equally important for a successful information system. Many new challenges exist in laboratory management and information system operations. Philosophy, strategy, and selected details of system implementation are presented in the context of practical examples of implementation issues.