Browsing Tag

Internal Medicine

Advanced Technology Laboratory, Cytogenetics

Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes

Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:

• Prader-Willi/Angelman (15q11-q13) by FISH

Recommended test is Angelman/Prader-Willi mPCR

Smith Magenis (17p11) by FISH

• Williams (7q11,23) by FISH

If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.

Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory. Continue Reading

General Information, Test Spotlight

Influenza Testing Update: April 2022

West Michigan influenza infections peaked mid-March 2022 and have been declining in the weeks that followed. 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 Rapid Antigen (LAB2111530)
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

 

TEST INFORMATION

Test name Epic code Interface EMR Code CPT Code
 Influenza PCR  LAB3255 11594 87502
 Influenza Rapid Antigen  LAB2111530 11208 87804 x4
Chemistry, Test Spotlight

Reminder: Folate Test and Fasting

Folate (aka Folic Acid) is a test that requires the patient to be fasting in order for the results be accurate. Results are falsely elevated if the patient is not fasting.  Spectrum Health Laboratories recently updated our system to hard stop a test from being collected if the patient is not fasting. Please remind your patients to fast 8 hours prior to having their blood drawn.

Spectrum Health Laboratories recommends:

• No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc.

• Take normal dosages of medications unless the provider has instructed otherwise.

Click here for a list of tests the require or recommend fasting. Continue Reading

Education & Training, General Information, Test Spotlight, Test Utilization

Webinar: Managing Rhinitis Patients and the Role of Specific IgE Testing

LIVE Webinar –Managing Rhinitis Patients and the Role of Specific IgE Testing, available at Spectrum Health!

Featuring Guest Speaker Scott Duhaime, MPAS, PA-C

Please join us for a 30-minute webinar on the importance of the primary care providers’ role in regard to managing patients suffering with symptoms consistent with rhinitis—itchy watery eyes, runny nose, and congestion.

We are offering two training webinars for all providers and clinical staff on March 24th.

The goal of this webinar is to address:

♦ Importance of ruling in and ruling out allergies

♦ Debunking misconceptions around managing rhinitis

♦ Simplified patient care management

♦ Qualified referral

Continue Reading

Chemistry, Education & Training, Main lab

Test Update: AST and ALT

Go Live Date delayed to 3/3/2022

Go-Live Date: 3/2/2022

Due to new instrumentation at Spectrum Health Blodgett Hospital Laboratory (BIRL) and to standardize across the Spectrum Health system, we will be adopting new tests for AST and ALT. The difference between our current test and this new test is the addition of the co-factor pyridoxal phosphate (Vitamin B6). The new test is the recommended test of the International Federation of Clinical Chemistry and ultimately will provide our patient population more accurate AST and ALT results. We did not adopt the new test in the past because it came with logistical and stability issues that made its use in the lab difficult. The new instrumentation we obtained has solved some of these concerns.

Historically, if patients had a Vitamin B6 deficiency, their AST and ALT levels may have been falsely lower than the true values. This decrease was due to the lack of endogenous co-factor causing a slower reaction rate when we tested the patient sample. After we implement the new test across the system, you may notice an increase in your patient’s AST and ALT results. This increase may be evidence that your patient had some degree of Vitamin B6 deficiency. If you were trending results, we recommend you establish a new baseline with the new test versions. The lab has been changed slightly in EPIC to prevent trending between the two test versions, since the results may not be able to be correlated if your patient had a Vitamin B6 deficiency. Continue Reading

Compliance & Safety, Education & Training, General Information

Appropriate Labeling for Shared Specimen – COVID-19 & FLU AB PCR

To provide efficient and safe testing for patient specimens, please review the following information when sending COVID-19 PCR and Influenza A/B PCR testing in the same encounter to Spectrum Health Laboratories.

Two labels will be available for this testing. Labels must be fixed so that

• The test and patient information are shown
• The barcode may be easily scanned by Lab staff or instruments

When this is not done correctly, Laboratory staff removes the labels and re-fixes or re-prints it, which obstructs workflow, causes delays, and could result in patient information being peeled off. With patient safety and efficient testing being two of the Lab’s top priorities, it is vital that specimens arrive in such a way as to best accomplish both. Continue Reading

Molecular Diagnostics

Cystic Fibrosis (CF) Carrier Screen Discontinued

Effective February 1, 2022, the Cystic Fibrosis (CF) Carrier Screen test, which includes the 23 common variants for cystic fibrosis recommended by ACOG/ACMG, will be discontinued as an orderable test at Spectrum Health Laboratory.

The recommended replacement test is the Cystic Fibrosis Mutation Analysis (Test ID: CFP) offered by Mayo Clinic Laboratories, a 106-variant panel which includes the recommended 23 common variants.

Continue Reading

Chemistry, Immunochemistry, Main lab

Supply Update: Mono Kit Replacement

Spectrum Health and Spectrum Health Medical Group (SHMG) Supply Chain Update:

AbbottTM has discontinued their Mono Test Kit. The identified replacement product is from Cardinal HealthTM. This product is already in use in some spaces throughout Spectrum Health. Please see ITM number for the replacement product below and update your ordering processes accordingly.

Discontinued Product: ITM-1002651 Kit Test Mono CLIA Waived (Abbott 92407)

Replacement Product: ITM-1049839 Test Mono II Rapid (Cardinal Health CH1145) Continue Reading