In order to prevent Biotin interferences several endocrine oriented tests have been updated, see test information below.
Internal Medicine
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
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
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.
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:
TEST INFORMATION
Test name | Epic code | Interface EMR Code | CPT Code |
Influenza PCR | LAB3255 | 11594 | 87502 |
Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
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.
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.
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.
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.
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)