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.
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Pediatrics
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 INFORMATION
| Test name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
Effective July 1, 2021, the Coagulation Department within the Spectrum Health Regional Laboratory will go live with an in-house, bovine based, Chromogenic Factor VIII assay.
This assay, a photometric determination of Factor VIII activity, is useful for monitoring coagulation factor replacement therapy of selected extended half-life coagulation factor replacements and Emicizumab therapy, a recombinant, monoclonal antibody that restores the function of the missing activated factor VIII by bridging FIXa and FX. The action of Emicizumab interferes with all APTT clot based and human chromogenic based assays, leading to an overestimation of Factor VIII activity. As such, the bovine based Chromogenic Factor VIII assay is recommended. The Chromogenic Factor VIII activity also assists in the diagnosis of hemophilia A using a 2-stage assay, particularly when the 1-stage clot based assay is normal.
For questions about this test, please refer to the laboratory catalog or use the Contact Us link above.
TEST INFORMATION
Chromogenic Factor VIII Activity – Epic Code: LAB1230831 | Interface Code: 1230831 | CPT: 85240
If you are collecting COVID-19 swabs in your office or clinic, please order and collect using the saline swab kits (“liquid media” or “wet collection”) instead of the tube with no liquid media (“dry collection”).
• Liquid media swab kits will provide a faster turn-around time.
• Dry collection kits supplies are low.
Please refer to the COVID-19 PCR test in the Lab Catalog for the most up-to-date information on COVID-19 collection.
Self-collected vaginal swabs may be used for testing as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.
NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.
Effective December 9, 2020, the following insect allergen components will be available:
◊ Allergen Honey Bee Component Panel – EPIC #LAB1230747, Interface #1230747, CPT 86008
◊ Allergen Common Wasp (Yellow Jacket) Component Panel – EPIC #LAB1230752, Interface #1230752, CPT 86008
◊ Allergen Paper Wasp Component rPol d 5 – EPIC #LAB1230754, Interface #1230754, CPT 86008
◊ Cross-reactive Carbohydrate Determinant (CCD) – EPIC #LAB1230755, Interface #1230755, CPT 86008
Effective March 4th, 2020, Thrombin Time will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Coagulation Laboratory and will include a new reference range (please see link in Test Information below).
Thrombin Time is suitable for monitoring fibrinolysis therapy, screening for disorders of fibrin formation and in cases of suspected fibrinogen deficiency states. It is also useful for the differentiation between a heparin induced prolongation of the thrombin time and fibrin formation disorders.
For questions around this test, please contact the Coagulation Department at 616-267-2740.
TEST INFORMATION
Thrombin Time – Epic Code: #LAB11230581, Interface Code: #11230581, CPT: #85670
Education & Training, General Information, Test Utilization
Appropriate Thyroid Peroxidase Antibody Ordering
The most conclusive evidence for using thyroid peroxidase antibody (TPO) is predictive in nature when evaluating possible subclinical hypothyroidism. If this test is positive, hypothyroidism occurs at a rate of 4.3% per year versus 2.6% per year when the antibody is negative. While this scenario does not cover all clinical indications for ordering TPO, there is no definitive evidence that repeat TPO testing provides additional information.1
Based on this information the ordering of TPO within Spectrum Health is being modified. If the test is ordered more than once on a patient, a screen will appear in EPIC indicating the following: “This test should typically only be resulted once per lifetime. The duplicate checking indicates that this patient has already had this testing performed. Please see chart review for results.” This is not a “hard stop” but providers will need to click “Continue” to proceed with the order.