Effective December 6, 2021, Spectrum Health Reference Laboratory (SHRL) Coagulation department will go live with a new lot of Prothrombin Time (Protime/PT) reagents. The reference range for the PT will be adjusted to reflect this reagent lot change and align with our Regional Laboratories. The new reference range will be 9.5 – 12.0 seconds. There will be no change to the INR ranges.
| Test | Current Reference Range | New Reference Range |
| Prothrombin Time (PT) | 9.7 – 12.6 seconds | 9.5 – 12.0 seconds |
Effective immediately, Thyroglobulin Antibody will be performed at Spectrum Health Reference Laboratory (SHRL, Grand Rapids, MI) and will no longer be a sendout to Mayo Clinical Laboratories. Collection instructions and other information may have changed, please visit the lab catalog for more information.
Thyroglobulin Tumor Marker will continue to be a sendout. If a Thyroglobulin Antibody is ordered with a Thyroglobulin Tumor Marker, then the Thyroglobulin Antibody will automatically be canceled as Mayo Clinic Laboratories will perform the Thyroglobulin Antibody as well as the Tumor Marker.
For questions and inquiries, please use the “Contact Us” link above.
New test: Thyroglobulin Antibody [LAB1230840]
Former test: Thyroglobulin Antibody, Serum [LAB1230457]
Mentioned Test: Thyroglobulin, Tumor Marker, Serum [LAB864]
Spectrum Health Lab has noticed an increase in outpatient orders for Respiratory Pathogens by Film Array [LAB3359]. This may be due to a shortage of supplies for some Point of Care (POC) testing platforms. Film Array is typically used for emergency and high acuity patients and therefore has a high cost that may not be covered by most patients’ insurance. To lesson out of pocket costs for your patients, please order the below for RSV, COVID, or Flu testing.
In continued pursuit of alignment, regional market hospital labs have adopted the Sysmex-Siemens automated urinalysis system. This advanced platform elevates analytical control and automation, eliminates manual steps previously required from former systems, and offers the latest in digital particle imagery. Combined with exceptional service engineer support, this system represents a notable step forward in urinalysis performance.
On Tuesday October 26, 2021, a new lot of aPTT reagent will go live for the Spectrum Health Laboratory Information System starting at 10:00 AM.
• The aPTT therapeutic range for ADULT patients on continuous heparin infusions will be updated to reflect the new reagents. The therapeutic range, for most indications, will be changed from 37 to 52 seconds to a new range of 42 to 57 seconds. UFH anti-Xa therapeutic ranges will remain unchanged (0.3 to 0.7 units/mL). All ADULT nomograms will be adjusted to reflect the new therapeutic ranges.
• For PEDIATRIC patients, aPTT nomograms will no longer be used in this population. Only the unfractionated heparin (UFH) anti-Xa nomograms will remain for PEDIATRIC patients, again with no changes made to their current UFH anti-Xa nomograms.
The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus have also impacted the transmission of other respiratory viruses. Influenza is typically prevalent during the winter months (December through March), however, influenza cases were essentially non-existent during the 2020-2021 season and influenza is not currently circulating in our community.
In the absence of circulating influenza activity, it is recommended to use the most sensitive diagnostic test in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is not appropriate at this time. 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
| Low Influenza prevalence |
High influenza prevalence |
|
| Recommended order | Influenza PCR (LAB3255) | Influenza Rapid Antigen (LAB2111530) or Influenza PCR (LAB3255) |
| Test name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
Effective September 15, 2021, Spectrum Health’s Epic will contain new ask-at-order questions to help improve clinical decision support and appropriate utilization of stool ova and parasite (O&P) testing. O&P testing may be used to diagnose several parasitic infections, though the staining of stool smears and their microscopic review is very labor intensive for laboratories. Historically, O&P testing has been widely ordered for patients with diarrhea, however, there are now other testing options able to detect the most common pathogens associated with community-acquired diarrhea. While Enteric Pathogens PCR and Giardia/Cryptosporidium testing is more appropriate for the identification of common bacterial/viral and parasitic pathogens, respectively, O&P testing should be reserved for patients with specific exposure or immune status criteria.
The Pharmacy and Infectious Disease Stewardship Committee has endorsed the following order criteria for O&P testing. If any of these criteria are met, then then order can be placed.
♦ Past foreign residence or recent foreign travel followed by at least 2 weeks of diarrhea.
♦ Immunocompromised status.
♦ Unexplained microcytic anemia or peripheral eosinophilia.
♦ Unique exposure (daycare, MSM, waterborne outbreak, etc.)
Note: If no criteria are met, cancel the order and consider Giardia/Cryptosporidium Screen (LAB258) or Enteric Pathogens PCR testing (LAB3618).
Please direct question to the Contact Us link above.
TEST INFORMATION
Ova and Parasites, Complete – Epic: #LAB9550, Interface Code #50033, CPT #87328, 87329, 87177, 87209
Enteric Pathogens by PCR – Epic #LAB3618, Interface Code #55078, CPT #87506
Giardia/Cryptosporidium Screen – Epic #LAB258, Interface Code #50025, CPT #87329, 87328
Effective July 1, 2021, Spectrum Health no longer offers patient self-screening through MyChart or telephonic COVID screening appointments to patients. Patients will need an order from their provider prior to scheduling a COVID-19 test. Patients should be symptomatic or have a recent exposure, all other visit types should go through Michigan.gov (travel, athletic, or return to work or school, etc.)
If the patient does not have a provider, they may utilize the SHNow On Demand Visit via MyChart or find testing site options on Michigan.gov.
Once the order is placed, patients may schedule an appointment through MyChart or calling the Covid Hotline (for paper orders).
For more information:
The following information was updated in the Spectrum Health Laboratory Catalog.
Effective Wednesday, August 18, 2021, to align with Clinical and Laboratory Standards Institute (CLSI) guidelines, the Salicylate lower limit of reporting will increase from 0.3 mg/dL to 2.0 mg/dL.
Note: The therapeutic range for Salicylate is 2.0 – 10.0 mg/dL and this test is best utilized for assessment of Salicylate toxicity.
TEST INFORMATION
Salicylate Level – Test Codes: Epic #LAB34, Interface #10245, CPT #80329