IMPLEMENTATION OF AN APPLICATION-BASED ALERTING SYSTEM FOR CRITICAL BIOCHEMICAL, MICROBIOLOGICAL AND CYTOLOGICAL LABORATORY VALUES IN RESPIRATORY MEDICINE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Timely identification and communication of critical laboratory values are essential for patient safety in respiratory medicine, where rapid clinical deterioration is common. Conventional manual reporting systems are often associated with delay and inefficiency, and mobile-based alert systems have emerged as a potential solution to improve real-time communication and clinical response. Aim: To evaluate the effectiveness of a mobile-based clinical alert system (CritiCall) in improving the detection and communication of critical laboratory values in patients admitted under respiratory medicine. Methods: This prospective observational study was conducted over 12 months and included 144 patients admitted under respiratory medicine. Conventional Electronic Medical Record (EMR)-based communication was compared with an integrated EMR + application-based alert system. Data were collected on demographic characteristics, comorbidities, alert type (biochemical, microbiological, arterial blood gas [ABG], cytological), alert timing, and patient outcome. The chi square test, Pearson’s correlation, ANOVA, and logistic regression were used for statistical analysis; p<0.05 was considered significant. Results: The cohort was predominantly elderly with a high burden of comorbidities. Notification within 15 minutes was achieved in 82.0% of patients in the EMR + App group compared with 43.4% in the EMR group. Disease-specific alert patterns were observed, with ABG abnormalities predominating in COPD and interstitial lung disease and microbiological alerts predominating in pneumonia and bronchiectasis. Discharge rates were higher and deaths fewer in the application group. Alert burden correlated significantly with ICU admission in the EMR + App group (r=0.278, p=0.013) but not in the EMR-only group (r=0.028, p=0.832); however, logistic regression did not show an independent effect of the alert system on ICU admission (adjusted OR 1.879, 95% CI 0.758–4.658, p=0.173). Conclusion: The mobile-based clinical alert system significantly improved the timeliness of critical-value notification and increased the number of critical alerts recorded across several clinical categories in respiratory medicine patients. Its integration into clinical practice may enhance patient safety by facilitating more timely communication of critical laboratory values.