Should Electronic Medical Records Be an Alternative to Reference Intervals for Interpretation of Laboratory Results in Geriatric Subjects?

Abstract

Reliable reference intervals (RI) and clinical decision limits (CDL) are indispensable for correct interpretations of laboratory results. The problem becomes more evident in geriatric population as these people are often affected by comorbidities, polypharmacy, and atypical disease presentations. With the advent of electronic medical records (EMR) and its wide availability, it becomes a possibility that, some baseline lab and clinical data would always be available which could be used as references, especially, in geriatric people, to evaluate them for chronic diseases. For the meaningful usage of EMR, the records need to be harmonized and available to the health care providers. These records can then be used to differentiate clinically relevant changes in lab investigations over periods of time. Hence, we need to define the percentage differences per unit periods of time or personalized CDL rather than absolute values based on population-based RI especially in the geriatric population. However, issues regarding security and ownership of EMR need to be well defined to prevent unwanted breaches in privacy.