July 30, 2012 | posted in: Articles, Autoverification | by

What is Autoverification?

Autoverification uses rules established by laboratory management to filter data prior to release to clients. Rules are established using parameters such as instrument flags or pre-determined values and can be applied at the instrument level, through use of middleware, or at the LIS level.

Definitions of Autoverification

Below are two industry definitions for autoverification:

  • “The end process of a set of rules or Algorithms, invoked by specific instrument data, ranges and/or flags, that trigger an action by the LIS.”1
    • Release of results to the user
    • Hold results for intervention
    • “Reflex” to additional testing while releasing results
  • According to CAP: “The process by which the computer (LIS or instrument system) performs initial verification of results.”2

How Autoverification Works

Examining an autoverification example illustrates how rules can be applied through the use of middleware. In one laboratory, the following rule was applied to all feline platelet data coming from a multi-species hematology analyzer:

If PLT<200, then a Blood Smear Review is required

Clinical pathologists, in conjunction with the company’s chief medical officer, wanted to change this rule to have blood smears reviewed for platelets only when there was not a clump flag received from the instrument. The new rule:

If PLT<200 AND PLTCLMP=0, then a Blood Smear Review is required

Within days the rule was changed on the server by laboratory management, and the new rule was implemented.

Advantages of Middleware

The use of middleware to apply autoverification rules has several advantages over applying them at the instrument or LIS level. Middleware allows for much greater flexibility than instrument rules, which are often limited to ranges and flags. Middleware can be programmed to use information from the instrument, but can also be customized to apply Boolean logic…something that most instruments cannot do without review of results by a technician.

Adjusting the rules in a middleware program is also a fairly simple process. Rules can be refined and updated as often as desired by laboratory management. This is a great advantage over rules applied at the LIS level where changes often involve complex programming and implementation by the company IT department.


1. Duca, Dale J.: “Autoverification in a Laboratory Information System”;Laboratory Medicine; 1;23;21-25

2. CAP;General Checklist; GEN.43360

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