Advice Needed Regarding GEM 100 Result Documentation

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I am reaching out to ask for your thoughts on a process we currently have in place for our GEM 100 analyzers.

Currently, staff document patient results on a paper log sheet in addition to the results being transmitted electronically. I review these logs weekly at a minimum to verify that the results recorded by staff match what is present in RALS and our EMR. The staff have requested that we discontinue the paper documentation process since the results are already being captured electronically.
My hesitation stems from concerns about potential interface failures or result transmission issues. For example, if a critical result such as a value greater than 400 did not successfully transmit, I appreciate having the paper documentation as a secondary verification source. Additionally, our IQCP currently includes paper documentation and routine review as part of the risk mitigation process.
How does your facility handle this situation? Do you rely solely on the electronic record, or do you maintain a secondary documentation process? With our relatively new Cath Lab staff, I am somewhat reluctant to remove an established safeguard without understanding how others have addressed this challenge.
I would greatly appreciate any thoughts, experiences, or recommendations you would be willing to share.
Thank you for taking the time to help.

6 Replies

We avoid paper results logs as much as possible. We try to only keep that for manual tests.  For downtimes, we have downtime result logs that they can utilize if needed.

We also avoid paper logs as much as possible. All of our interfaced devices have the ability to store results on the device itself, which we can refer back to in the event of an interface issue. The GEM Hemochron 100 stores patient, LQC, and EQC results in the instrument database. I'm wondering if that would give you what you need as far as backup documentation.

I also avoid manual logs as much as possible and only use the electronic.
As to your concerns about transmission and  interface problems: the Gem 100s have log thats very easy to navigate. If needed, it is not difficult to look up a test result on the meter itself- With your concerns, I would list out the circumstances the fully electronic system would fall short and see if meter-specific look-back process could resolve it.

We avoid paper logs with our Hemochron Signature Elite, using electronic transmission only.  Any transmission issues can easily be seen/resolved in RALS utilizing the flagged results list.  If there are interface issues, patient results and QC can easily be retrieved from the instrument.  

Manual logs are like a bandaid on a deep cut, they might make you feel better to cover it but it's not actually helping :) How often are you having to go back and fix an issue using the paper logs? I'd start there and see how often this happens, and if there is a better potential mitigation strategy or strategies. If there's better mitigation, like some suggestions above, then maybe it's time to cut out the manual paperwork and update your IQCP.

Thank you guys.  I appreciate the input.  The logs do make me feel better however, we have other items that we don't keep manual logs for that are interfaced.  

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Melva Anderson
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