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Laboratory Services

General Information

APTT DTI Now Available at West Michigan Hospital Laboratories

Effective May 22, 2024, APTT Direct Thrombin Inhibitor (APTT DTI) will be performed at all Corewell Health West sites including Corewell Health Reference Laboratory and all regional labs (Corewell Health Big Rapids Hospital, Corewell Health Gerber Hospital, Corewell Health Grand Rapids Hospitals (Blodgett Hospital, Butterworth Hospital, Helen DeVos Children’s Hospital), Corewell Health Greenville Hospital, Corewell Health Ludington Hospital, Corewell Health Pennock Hospital, Corewell Health Reed City Hospital, Corewell Health Zeeland Hospital).

The APTT DTI is a clot based assay for monitoring the APTT in patients on direct thrombin inhibitors including Argatroban, Dabigatran, and Bivalrudin.  This testing is for inpatient use only. The reference range for this assay is analyzer specific and is listed in the lab catalog (Current reference ranges: Corewell Health Reference Laboratory 23-28 seconds and Regional laboratories 24-34 seconds) Continue Reading

Test Utilization

Influenza Testing Update: April 2024

This winter, West Michigan influenza infections peaked in February 2024 and significantly declined throughout March and April 2024. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.

 

Low Influenza
Prevalence
High Influenza
Prevalence
Recommended Order Influenza PCR (LAB3255) Influenza antigen testing (e.g. Sofia instrument)
or
Influenza PCR (LAB3255)

More detailed information can be found as published by the CDC:

Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community, and in previous lab newsletters: Influenza Diagnosis and Test Utilization

Main lab, Microbiology, Referral/Sendouts

Measles Ordering and Collecting Specimens

With several suspected cases of measles within Michigan, we thought it would be an excellent time to highlight Corewell Health West’s guidance on testing suspected patients. Specimens are sent to a reference lab for testing, which must be coordinated with local public health departments. Typically an upper-respiratory swab (throat or nasopharyngeal)  is collected for PCR testing in addition to a serum for measles IgM if collection is possible.

  • Patients should not be directed to a Corewell Health Laboratory or other healthcare facility for serum collection if patient is within 4 days after the onset of rash (with onset of rash considered to be Day 0). If Day 5 of rash or later, immunocompetent patients are no longer considered contagious and may be sent to a laboratory for a serum draw.
  • Corewell Health Providers:
    • Please reach out to Corewell Health Infection Prevention (IP) via Perfect Serve to make them aware of the situation.
    • Corewell Health Infection Prevention will contact the appropriate county.
  • Non-Corewell Health Facilities:
    • The provider’s office must coordinate with the county health department that the patient lives in to obtain permission to send measles testing.
    • Visit the following link for county health department contact information: Slide 1 (michigan.gov)
      • The county will coordinate with MDHHS for testing permission.

The preferred testing specimen is a throat or nasopharyngeal swab collected in office. Corewell Health Laboratories do not collect swabs.

For further collection and ordering instructions, please visit: Measles PCR – Laboratory Test Catalog | West

Any additional questions or concerns, please use the contact us link above or reach out to your local health department.

Chemistry, Referral/Sendouts

Hepatitis A IgG Antibody Discontinued

Effective Thursday, April 18, 2024, Corewell Health Laboratory will discontinue the send out test Hepatitis A IgG Antibody, Serum (Mayo Test ID: HAIGG). This test has been made obsolete by Mayo Clinic Laboratories. We recommend to our healthcare providers the following in-house testing:

1.Hepatitis A Total Antibody (LAB1230596): intended for the clinical laboratory diagnosis of acute or past hepatitis A virus infection in persons with signs or symptoms of hepatitis and in persons at increased risk for hepatitis A infection, to identify HAV susceptible individuals and to determine the presence of an antibody response to HAV in vaccine recipients.

2.Hepatitis A Antibody, IgM (LAB7980): intended for use as an aid in the laboratory diagnosis of an acute or recently acquired hepatitis A virus infection.

Continue Reading

Compliance & Safety, Cytology, General Information

Resolved: HPV Error 3/17/2024

This issue is resolved. It was identified as an issue within Corewell Health Epic Preference Lists. If you are still encountering issues, please reach out to Service Now. This post will be archived in 7 days.

Due to an error from our system changes that happened on Sunday, March 17, 2024, the HPV reflex on the Pap testing orderable is not reflexing appropriately based on ASCCP Guidelines.

The Cytology Laboratory (Corewell Health Reference Laboratory West) and our Digital Services teams are aware of the error and working on a solution to correct the missed HPVs that were processed this week.  As the correction may cause a slight delay in HPV results, please hold add-on requests for HPV until Friday (3/29).  If you are concerned about an HPV being missed after this date (3/29/24), please fill out an Add-On form and fax to the number on the form (Note: Pap Specimens are held for 30 days).

We apologize for any inconvenience and confusion. If you have any further questions or concerns, please use the contact us link above.