PowerPoint Presentation · Tests offered via NPEx 6-TGN Levetiracetam Level Adalimumab Methanol...
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Transcript of PowerPoint Presentation · Tests offered via NPEx 6-TGN Levetiracetam Level Adalimumab Methanol...
Title
Modernisation of Laboratory Medicine at City Assays: An
NPEx adopter.
By:
Noman Manzoor
Pathology Informatics and Epidemiology manager
Sandwell and West Birmingham Hospitals NHS Trust
Introduction
Introduction
• SWBH Pathology offers comprehensive services including specialist Biochemistry, Immunology, Haematology, Microbiology, Histopathology, Toxicology and Blood transfusion.
• The Specialist Clinical Biochemistry Services are used by laboratories throughout the country and include pioneering work in Toxicology and Pharmacogenomics.
• Modern and proactive IT is absolutely essential to good Pathology and we have dedicated Pathology IT department to help end users with any issues.
Blood Sciences NPEx Lead in SWBH
Journey to NPEx
• Started early 2015.
• Ended in April 2016.
• Wasn’t a smooth ride.
• Lack of support from LIMS supplier but excellent support from X-labs.
• Took good 8-10 months to have LIMS supplier on board.
• Testing took few weeks.
• Testing with Great Western Hospital Swindon, Russell’s Hall Hospital Dudley and Heartlands Hospital Birmingham.
Post go Live
• We have a dedicated specialist Biochemistry team to look after NPEx.
• Training provided to staff in postal reception.
• SOPs were amended to reflect the change in receiving the requests from other hospitals and sending out the requests to other hospitals.
• NPEx test repertoire was setup.
• Advertised in monthly Pathology news and also in national conferences.
• All service users were notified via email regarding the availability of NPEx in SWBH labs for referral work.
Tests offered via NPEx6-TGN Levetiracetam Level
Adalimumab Methanol measurement
Alpha Carotene Olanzapine measurement
Amitriptyline and nortriptyline measurement Phenobarbitone
Beta Carotene Plasma Aluminium
Blood Arsenic Serum Caffeine
Blood Cadmium Serum chromium
Blood Chromium Serum Cobalt
Blood Cobalt Serum Copper
Blood Lead Serum Erythropoietin Level
Blood Manganese Serum Selenium
Blood Mercury Serum Zinc
Clozapine Sodium Valproate
Diuretic Screen Tobramycin
Ethanol (alcohol) Quantitation Toxicology Screen (LC-QTOF-MS / time-of-flight)
Ethylene Glycol TPMT
Fructosamine TPMT Genotype
Gamma-Hydroxy-Butyrate UGT1A1*28 polymorphism
Infliximab Vit E/cholesterol Ratio
Lamotrigine Vitamin A
Vitamin D Measurement
Tests offered via NPEx Urine Assays
24 hour urine citrate output measurement Gamma-Hydroxy-Butyrate
24 hour urine copper output measurement Measurement of urine copper/creatinine ratio
24 hour urine oxalate output measurement Methanol measurement
24 hour Urine Volume Random Urine Citrate
24 hour Urine Zinc Excretion Random Urine oxalate measurement
25 hour urine copper output measurement Toxicology Screen (LC-QTOF-MS / time-of-flight)
25 hour Urine Zinc Excretion Urine Arsenic
26 hour urine copper output measurement Urine Cadmium
26 hour Urine Zinc Excretion Urine Chromium
Diuretic Screen Urine Cobalt
Ethanol (alcohol) Quantitation Urine Drugs of Abuse Screen
Tests offered via NPEx Other Assays
Calculus/Stone Analysis
Calprotectin
Dried Faecal Elastase
Faecal Pancreatic Elastase
Users of our service connected via NPEx
Organisation HospitalCambridge University Hospitals NHS FT Addenbrooke's Hospital
Central Manchester University Hospitals NHS Foundation Trust Manchester Royal Infirmary
Epsom and St Helier University Hospitals NHS TrustSt Helier Hospital
Epsom Hospital
Hampshire Hospitals NHS Foundation Trust North Hampshire Hospital
Pennine Acute Hospitals NHS Trust
Fairfield General Hospital
North Manchester General Hospital
Royal Oldham Hospital
Salford Royal NHS Foundation Trust Salford Royal
Sherwood Forest Hospitals NHS Foundation Trust King's Mill Hospital
Southwest Pathology ServicesMusgrove Park Hospital
Yeovil District Hospital
The Dudley Group of Hospitals NHS Foundation Trust Russells Hall Hospital
The Royal Bolton Hospitals NHS Foundation Trust Royal Bolton Hospital
University Hospitals South Manchester NHS Trust Wythenshawe Hospital
Number of requests per month
0
2
4
6
8
10
12
0
200
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1200
Co
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ect
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Lab
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Re
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SWBH - NPEx Requests & Connected Laboratories
Live Labs Connected
Requests
To date: 9,890 requests processed using NPEx
Potential number of requests in future
0
500
1000
1500
2000
2500
3000
3500
Live Sites In Testing Initial Contact Made All (Total)
Mo
nth
ly R
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Development Phase
Monthly NPEx Requests (Current & Potential)
Process for setting up new users
• Majority of laboratories contacted us to set them up in initial stages
• XLABs facilitated many introductions via email between us and interested parties
• NPEx site catalogue provides full lists of laboratories and tests and we utilised this to promote our services and provide up-to-date contact details
Process for setting up new users
• The NPEx Test Catalogue makes it quick and simple for referring labs to map their orderable and reportable codes against those of the performing labs with most fields auto-populating
• We found it useful to have our own catalogue containing NPExcatalogue names in additional to local LIMS test configuration details (test type/units/reportable decimal places) which we could filter by assay and email specific test configuration tables to service users…
Order Item.NPEx Catalogue
Name (Orderable)
NPEx SNOMED concept ID (Oderable)
NPEX Specimen
Type.
NPEx Global Name (Reportable)
SNOMED Concept ID (Reportable)
Reportable - Test Type
(Numerical/Interpretive/Free TXT)
Reportable - UnitsReportable - Decimal
Places
6-TGN6-thioguanine
nucleotide level845251000000105 BLOOD
6-methylmercaptopurine
nucleotide measurement
845271000000101 Numericalpmol
6MMPN/8x10^8 cells
0
6-thioguanine nucleotide level
845251000000105 Numericalpmol 6-
TGN/8x10^8 cells0
Process for setting up new users
• With all new referring labs we run through a brief test script and document all testing in a pro forma (evidence for UKAS)…
Loads of SCREENSHOTS!!!
Future Development
• Looking to expand our NPEx service to other disciplines such as Microbiology
• Reporting of UK NEQAS General Chemistry EQA schemes using NPEx
