What is BLIS?

The Basic Laboratory Information System, BLIS, is a freeware Web-based system that can be installed in a local, district, or national laboratory. It is a tool that can help to standardize data, which improves the ability to run useful reports and can both give a realistic picture of laboratory services and assist with staff and budget planning. With enough data, BLIS can be used to track disease prevalence over time.

Features of BLIS include:

·         One-time entry of each unique patient

·         Standardization of data collected (allowable entries for specimen type, test type, patient data, reagents are set at MOH level and then entered consistently throughout a country)

·         Customization to a country’s needs

·         Ability to track lab supplies such as test kits, reagents

·         Ability to run reports as specified by a country

·         Automatic alerting of data values that may be out of range(reference ranges and panic values are set at the regional or national level)

·         Daily logs to be reviewed for data verification

·         Simple data backup

As with any properly implemented electronic record system, BLIS may be found over time to improve data accuracy and reduce costs in laboratories. Benefits already seen in labs using BLIS:

·         Reduced burden for technicians, as results are available soon after testing

·         Improved consistency of data entry

·         Ability to view patient history and track samples

·         Ability to aggregate data and analyze data patterns and trends at a regional or national level

·         Printed patient records instead of handwritten records

·         Printed daily logs that make the reports looks like the paper forms used in the laboratory


 

Overview of Manager (Admin) Interface and Features     

When you log in as an administrator, you see the Manager home page.

Description: Admin home.jpg

To switch to User view, click the Work as Technician link at the top right of the page.

 

Lab Configuration

This section allows you to choose what data are collected to track the tests, reports, and other information. Lab configuration is generally set at the country level, and may vary by country.

BLIS can be used as a tool for standardizing data collection. To implement BLIS in another lab, use the same lab configuration settings. Use Export Configuration to create a printable and exportable file.

Description: Admin lab config.jpg

Summary

This page displays information about lab, specimen types, and test types. It also lists technicians’ logins and privileges.

Description: Admin lab config.jpg

Tests

This page allows you to view and edit the tests that are performed at this facility.

Description: admin-test catalog-testtype.jpg

 

Specimen/Test Types                                 

Allows you to set the specimen and test types as appropriate for your country. Click Show to reveal and Hide to close the list. Check the box for each specimen type collected or test done at this facility, and click Submit to save.

Description: admin-tests-spec.jpg

Target TAT

Displays turnaround times for tests. To enter or change turnaround time, click Edit. The number and unit (such as “24 hours”) change to a text field and a dropdown list. Enter the desired number and choose Hours or Days. When finished, click the Submit button to save changes, or Cancel to discard changes. These options are below the list.

Description: admin-config-TAT.jpg

 

Results Interpretation

Allows you to specify the interpretation for multiple ranges of values for each test type. To view or edit an existing test’s result, choose the test type from the dropdown list and click the Search button. The current interpretation appears. Edit using the text boxes.

To add a new range to the list, click the Add Another link and enter data in the text boxes. Click the Submit button to save changes, Cancel to discard them.

Reports

Laboratory Trend Report

Generates an aggregate report of laboratory test results for a particular period for one or all lab sections. The tests listed in the report are the ones checked to include on the Specimen/Test Types page. Click Edit to make changes to the details reported. When finished, click Submit button to save changes, Preview to view the report, Cancel to discard changes.

Daily Report Settings

Allows you to set the layout of the Patient Report, Daily Log of Specimens, and Daily Log of Patients. Use the dropdown to select the report type, and click Search. Edit report settings, and add or change a logo to appear on the report. Check or uncheck boxes to show or hide patient, specimen, and test information. When finished, click the Submit button to save changes, or Cancel to discard changes. These options are below the list.

Description: admin-config-rept settings.jpg

Worksheet

Allows you to create templates for gather patient data in the lab. In lab settings where data are not entered at the point of service, the data entry staff enter patient information  and the tests ordered, then print the worksheet so that lab technicians can write test results and other data to be entered into BLIS. Select the Lab Section and Test Type and click Search to edit the report format. To edit a custom report, click Edit to the right of the report.    

Description: admin-config-worksh1.jpg

Description: admin-config-worksh2.jpg               

Inventory

Add the details of stock items.

New Stock allows you to enter a shipment: Required fields are Reagent, Lot Number, Expiry Date, Quantity Supplied, Units. To add more than one stock item you can select Add Another.

 Edit Stock allows you to edit information about a reagent; find the one to edit on the list and then click the Edit link in the far-right column. Click Submit button to save changes, Cancel to discard.

Description: admin-inventory-1.jpg

Description: admin-inventory-2.jpg

User Accounts

This page shows all the users with access to the system. It allows you to create new user accounts, edit account settings, delete accounts, and monitor account activity.

Click Add New Account to enter a new user.

Description: admin-user.jpg

Recent Activity opens a new browser page to show the user’s activity by location, specimen entry, and results. To view activity by date, enter or edit the start and end dates of the range you wish to see and click View. When you are finished, click Print or Close This Page.

Click Edit for a user to edit user account details or to reset password. User Type dictates the access the user has in the system. Reset Password allows you as administrator to enter a new password for this user. Click Submit button to save changes, Cancel to discard.

To remove a user account, click the Delete link for that user. A confirmation box appears. Click OK to complete the deletion, Cancel to keep that user’s information.

Registration Fields   

This page shows the configuration of the patient registration page. It allows you to create mandatory fields and hide the fields that are not used, per your country’s protocols. It also allows for creation of certain custom fields for Patient registration and new Specimen addition which may be needed by certain labs only.

To customize fields, click Edit to make changes: check the box to display a field, uncheck to hide. Set fields as required. After editing, click Update button below the fields to save changes, Cancel to discard.

To create new fields, choose the Add New link for which to add, and enter field name and type. Click Submit button to save changes, Cancel to discard.

Description: admin-config-regfields.jpg

Modify Language

BLIS allows you to toggle between languages. You can also choose to change the language for a few pages using this option. The pages are listed as a drop-down menu.

Select the language and category (type of page or section). Select Search button to view or edit the text. When finished, click Submit button to save changes, Cancel to discard.

Description: admin-config-lang.jpg

Setup Network

Use this procedure to add a computer other than the primary one to the network. You will also do this after a computer restart or network failure.

·         Login as Admin.

·         Click on the Setup Network option in the Lab Configuration tab.

·         Navigate to the program files for BLIS[mvd51] .

·         Double click on the file BlisSetup.html

imageDescription: BLIS-setup.jpg

Export Configuration                       

Use this feature to export all configuration settings to Microsoft Word. Clicking this link opens a new browser tab with a preview showing all preset and custom fields as well as report settings. The preview has three buttons at the top: Print, Export as Word document, and Close.

Click the Print button to open the print dialog box; Export as Word document to create a file named blisreport_[date of report].doc, which you may open or save, or Close to close this browser tab[DD2] .

Description: admin-config-exptconfig.jpg

Revert to Backup

In case of system failure, this feature allows you to revert to a previously backed-up copy of the data. Clicking the link presents the dates of the previous backups and allows you to choose which data set to load[DD3] .

Update to New Version          

This link automatically updates your version of BLIS to the current one[DD4] . It requires Internet connectivity.

 

Test Catalog

Specimen Type

This is the place to add or edit specimen types used in your laboratory[mvd55] .

Click Add New to enter a new specimen type. Required fields are Name, which is a text box for entering the name of the specimen, and Compatible Tests, which allows you to check the tests that can be performed using that specimen[DD6] . Ctrl-F opens the Find function to search for a test. You may enter a Description of the specimen type, which is optional.

Description: testcat-spec1.jpg

To edit the information about a specimen type, find the one you wish to edit on the list and then click the Edit link in the far-right column.

Description: testcat-specimen2.jpg

Click Submit button to save changes, Cancel to discard.

 

Test Type

This is the place to add or edit test types used in your laboratory.[mvd57]  It is controlled the same was as Specimen Types.

Click Add New to enter a new test type. Required fields are Name, which is a text box; Lab Section, a dropdown list that includes an option to add a new section; Measures, which are editable; and Compatible Specimens, which allows you to check one or more specimens that can be used for this test.

Optional fields include Description (text box), Clinical Data, Panel Test (a checkbox, checked for Yes), Hide Patient’s Name dropdown Yes/No), Prevalence Threshold (text box), and Target TAT (text box).

To edit the information about a test type, find the one you wish to edit on the list and then click the Edit link in the far-right column.

Click Submit button to save changes, Cancel to discard.

Description: testcat-testtype.jpg

Backup Data

The application creates a backup automatically when you select the Backup Data tab and saves it to the application file folder. Your lab may have a designated folder to which to copy the backup files.

Back up the data in BLIS weekly.

The name of the backup file is blis_backup_[username[DD8] ]_[date]-[time]/

In the Implementation section we describe making monthly backups. I don’t see a way to set a date range though. How do you get weekly vs. monthly vs. comprehensive backups?


 

Overview of Technician Interface and Features

Home

When you log in as a technician, you see this home page:

Description: Technician home.jpg               

Users with Admin rights can click the Work as Manager link in the top right corner to switch to Admin view.

Users with Technician rights and not Manager rights see the profile page. You can edit your profile to add or change email, phone, and language. Username cannot be changed.

Description: User home.jpg

Click on the Change Password link to change your password.

Description: User chg pwd.jpg

 

Registration

This page allows you to add new patients to the system and to look up existing patients based on name, patient ID, or number.

To add a new patient: Click the Search button without entering any search criteria. The Add New Patient link appears[DD9] . Click the link and wait for a dialog box to appear on your screen. Fill in the blank fields and check the appropriate elements. Elements with asterisks * are mandatory. Click on Submit to save, or Cancel to discard changes and return to patient look-up page.

Description: New Pt screen.jpg

Patient Look-Up

Once a patient has been registered, you can use the Registration page to view or edit patient profiles. You can also register a specimen the patient has provided for a particular test.

Click on the drop-down list and select patient name, ID, or number. Type in the blank space the patient name, ID, or number you have selected. Enter all the information you have for that patient.

To add or edit a specimen record: Find the patient as above, then click the Register Specimen link to the right of the patient name. Fill in the blank fields and check the appropriate elements. Elements with asterisks * are mandatory. Click on Submit to save, or Cancel to discard changes and return to patient look-up page. Add Another Specimen allows you to add another one for this patient.

Description: specimen registration.jpg

 

Results

Single Specimen Results
This option allows you to add results for a patient based on the specimens provided.

Click on the drop-down list and select patient name, ID, or number. Type in the field at least X[DD10]  characters to search.

Description: results-single specimen.jpg

To add or edit a specimen record: Find the patient as above and then click the Enter Results link to the right of the patient name. Fill in the blank fields and check the appropriate elements. Click on Submit to save, or Cancel to discard changes.

Description: results-spec-pt page.jpg

Batch Results
This option allows you to add results for a particular Test Type.

Description: results -batch.jpg

Select a test for which to find results. Set a date range, then click Search. The results appear without patient names [DD11] . Click on Submit [DD12] to save, or Cancel to discard changes.

Verify Results
This option allows you to verify the result based on the test type. It shows the list of results for all patients whose results have not been verified. You can modify the results and enter remarks before verifying the results.

Description: results -verify.jpg

Select a Test Type and click Search. All test results for that test appear. Look over the test results for accuracy. Edit the results as appropriate. When you are finished, click on Verify, or Cancel to discard changes. Choosing Verify opens a confirmation dialog box. Click OK to mark results as verified, Cancel to discard changes.


Control Results
Select a test for which to find results. Choose the result to find, then click Submit[DD13] ..

Description: results-control.jpg
Worksheet

This option generates a worksheet based on the Lab Section and Test Type. In lab settings where data are not entered at the point of service, the data entry staff enter patient information  and the tests ordered, then print the worksheet so that lab technicians can write test results and other data to be entered into BLIS.  Custom worksheet which can be created by Admins using Lab Configuration > Tests > Reports > Worksheet.

You can create a blank worksheet by choosing the Keep Blank option and specifying the number of rows you need. Click Submit to create the worksheet.

Description: result-worksheet.jpg

After generating the worksheet, you can click on a column heading to sort the table by that field. You can then Print in portrait (default) or landscape view, Export as a Word Document, or Close the page. If you choose Export, the default option is to open the Word document. You can choose to print or save it from Word.

 

Search

This page allows you to search for a patient by name, number, or ID. You can enter a partial name or ID (at least X characters[DD14] ) to generates a list of matches.

Description: search.jpg

Click View Profile to view the patient’s profile and test history.

From the test history section, click Details for specimen information. From there you can choose Get Report for a specimen report; Track Actions to view a log of actions on that specimen, or Enter Results to enter the specimen analysis results. You can also generate a report from the test history section on the profile page by clicking the Report link.

 From the profile page you can also Register New Specimen, Update Profile, or Print Patient Report.

Inventory

Current Inventory

This link displays the reagent quantities currently in stock. It is not editable. To edit the list, click Update Stock.

Description: inventory-update.jpg
Update Stock

Click Update Stock to edit the quantities of reagents in stock. Update stock as you acquire new reagents by adding the reagent name, quantity received[DD15] , receiver name, and remarks. Click[DD16]  Submit to save changes.

Backup Data

When you click, a new page opens in your browser while data are backed up automatically. The file is saved as blis_backup_[username[DD17] ]_[date]-[time] in the BLIS directory.

Copy this folder to your hard disk as backup or save as otherwise directed by your country’s data backup protocol.

Reports

Any user (Technician or Manager) can generate reports[DD18] .

Daily Reports

The Patient Report and Daily Log should be run every day [DD19] 

Patient Report

Search for the patient by Patient Name, Patient Number, or Patient ID[DD20] . Click the Search button to start search. Select the patient you want from the list if more than one patient matches your search criteria. Click View Report to see all data for that patient, or Select Tests to see tests ordered and the results for that patient.

You can edit the report to show activity within a date range, include pending tests for which results are not available, set printing information, or export to Word using the controls at the top of the page.

Patient Report page.                                                                              

Description: patient-report.jpg

Daily Log

Set the date range to reflect the log to print[DD21] . You can run a report of the day’s activity by patients seen (by clicking Patient Records), or by tests run (by clicking Test Records). If you choose Test Records, You can choose to run a log for one lab section or for one type of test. The default settings are test records, all sections, and all tests. The report opens in a new browser tab and has Print and Export controls at the top of the page.

Aggregate Reports

After running an aggregate report, press Ctrl-S to open the Save As dialog box. The default location for saving reports is your Downloads folder on the C: drive. Navigate to the folder where you want to save the reports.

Prevalence Rate

Gives the prevalence of a particular laboratory test result [mvd522] based on the number of tests done and the results. Set a date range to view infection graph and prevalence rates. Click Submit to run the report, which will open in a new browser tab.

You can also view the trends of the laboratory test results for the defined period, as a graph, by clicking the Trends option after the report is displayed.

Counts

Generates a report for a particular time period of the number of tests, specimens, or doctor statistics. Set a date range and choose Test Count, Specimen Count, or Doctor Statistics to run the desired report. The report opens in a new browser tab[DD23] .

Turnaround Time

Allows you to see actual turnaround times between test order and completion[DD24]  for all or specific tests. Set a date range and choose whether to include Impending Tests. The default is completed tests only. The report opens in a new browser tab. It also generates a graph of the statistics.

Infection Report

Allows you to generate reports of infections by patient age and gender[DD25] . Set a date range and select one Lab Section, or all sections to see all test results. The report opens in a new browser tab. It also provides an option to create a Word document of the generated report.

Overview of Director Interface and Features

When you log in as the Director, following is the home page you see.

Description: C:\Users\Naomi\Pictures\1.PNG

 

 

Lab Configurations

This module allows you to add/view/modify configurations for different labs.

Clicking on the Lab Configuration tab lists the different facilities that have been previously added.

Description: C:\Users\Naomi\Pictures\2.PNG

 

The configuration details along with the options for viewing and editing the lab configuration are displayed.

Description: C:\Users\Naomi\Pictures\3.PNG

 

 

Tests

This option gives you the option to view the various types of tests and specimens in the lab along with the target turn-around time and preliminary interpretation of lab results for the specific facility.

 

Specimen/Test Type

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Specimen_Test Types - Director.png

 

Target TAT

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Target TAT - Director.png

 

 

Reports

This helps the user to view lab results in various formats for different class of data along with the option to modify report configurations.

 

 Infection Report

 

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Infection Report - Dir.png

 

 

Daily Report Settings

 

 

Description: C:\Users\Naomi\Pictures\6.PNG

 

Worksheet

Using this option the user can create customized worksheets as shows below.

Description: C:\Users\Naomi\Pictures\222.PNG

Lab Managers

This option enables the user to view the various lab managers along with an option to add new managers and edit details for existing ones.

Description: C:\Users\Naomi\Pictures\7.PNG

Description: C:\Users\Naomi\Pictures\8.PNG

 

 

Test Catalog

This enables the user to link lab characteristics/elements which are logically the same for different labs but are referenced by different names for the different labs. This helps the user to create a common country level name for the lab element.

Specimen Types

To associate logically same specimen types referenced by different name in the various labs in order to create a unique country level name for the specimen.

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Specimen Types Association.png

 

Test Types

To associate logically same test types referenced by different name in the various labs in order to create a unique country level name for the test.

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Test Types Association.png

 

Lab Sections

To associate logically same lab sections referenced by different name in the various labs in order to create a unique country level name for the lab section.

 

 

 

Description: C:\Users\Naomi\Pictures\11.PNG

 

Measures

To associate logically same lab measure units referenced by different name in the various labs in order to create a unique country level name for the lab measures.

Description: C:\Users\Naomi\Pictures\12.PNG

 

Reports

This enables the user to modify report generation settings along with the option to view aggregate statistics based on the various lab records.

Reports Settings

This enables the user to modify reports generation settings.

Infection Report

This enables the user to modify settings for infection report.

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Infection Report Settings.png

 

Aggregate Reports

This enables the user to view different aggregate statistics based on the various lab records.

 

Prevalence Rate

This enables the user to track the prevalence rate for various infections for different facilities together or separately.

 

Description: C:\Users\Naomi\Pictures\13.PNG

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Prevalence Rate.png

 

 

 

Turnaround Time

This enables the user to view turnaround time for various lab tests for different facilities together or separately.

Description: C:\Users\Naomi\Pictures\15.PNG

Description: C:\Users\Naomi\Downloads\BLIS Screenshots\BLIS Screenshots\Turnaround Time.png

 

Infection Report

This displays the aggregate results for lab reports for various infections.

Description: C:\Users\Naomi\Pictures\16.PNG

Inventory

This enables the user to track inventory of lab reagents for different labs together or separately.

Description: C:\Users\Naomi\Pictures\18.PNG

 

Appendix

Installation

If using a server and router, plug in the router first.

·         Set up and turn on the server PC and its monitor.

·         Navigate to the BLIS home page and select Download[DD26] 

·         Save the files to your hard drive.

·         Open the BLIS folder on the desktop and double click on BLIS.exe. Wait for a dialog box to appear on the screen. Choose Yes from the two options. The application will be installed automatically and the full login screen will appear.

·         This completes installation for a single computer.

For networked computers, we recommend setting a static IP address for the network.

·         Ensure that the computer is on the network.

·         Copy the file BlisSetup.html to the computer

·         Double click BlisSetup.html to install BLIS on the networked computer.

·         Wait for the login screen. If the full screen with username, password, and login does not appear, check the URL on the server and make sure they are the same.

 


 [mvd51]Should this file location be specified or might it differ in each facility?

 [DD2]Can you import the settings into (another instance of) BLIS? Or would you just look at the Word doc and have to configure by hand?

 [DD3] [DD3]
Note that the page needs updating – radio buttons are there but the options aren’t clear.

 

 [DD4]There is no Continue/Cancel option – should there be?

 

 [mvd55]If specimen types are defined at a national level, is this functionality still available to lab managers?

 [DD6]What are the presets?

Do these come from the Configuration/Test/Spec Type data?

 [mvd57]If test types are defined at a national level, is this functionality still available to lab managers?

 [DD8]Lab name?

 [DD9]This link should be on the main Registration page. It needs to be very visible/obvious.

Add screenshot and edit this paragraph when the screen is updated.

 [DD10]What’s the minimum #? It looks like 1

 [DD11]Is this deliberate or just based on the worksheet that’s used in the beta version?

 [DD12]I got errors when I clicked Submit

 [DD13]I’m getting error messages – what should the technician see?

 [DD14]What’s minimum # characters for search?

 [DD15]Currently the screen says “Qty signed OUT” indicating use of reagent, not acquisition of more.

 [DD16] On a regular skd or when new reagents arrive? “Consult local/national protocol”?

 [DD17]Lab name instead of user name? I can’t quite tell from my saved rept.

 [DD18]Is this true? It seems to be so from the structure of the Help page

 [DD19]At start or close of business?

 [DD20]What is the difference between pt # and ID? Lab assigned vs. national ID?

 [DD21]If you set a range of more than one day, do reports print on a new page per day?

 [mvd522]This returns the prevalence of certain laboratory results, not infections.  Laboratory reports are not diagnostic independent of a clinician interpretation.

 [DD23]Add guidance for when to use this report

 [DD24] [DD24]Add guidance for when to use this report

 [DD25]Add guidance for when to use this report

 [DD26]What file would a new lab download - would they have made prior arrangements so they can select their location?