Effective Wednesday, July 30, 2025, changes to result reporting will be implemented across all Hematology Departments at Corewell Health Laboratories. These updates will help align all regions within Corewell Health Hematology Departments to provide a high-quality and standardize patient care experience.
The following are the most impactful changes for the Corewell Health West Michigan Region:
- The Immature Platelet Fraction (IPF) will continue to be performed once every 24 hours if the platelet count is <100 x10^9/L, but the IPF results will now be located within the CBC.
- The ‘immature cells’ component of the manual differential will be changed to ‘other cells’.
- The Absolute Neutrophil Count (ANC) within a CBC w/Differential order will be EITHER an Automated ANC or a Manual ANC.
- A CBC with Differential order with an automated differential will receive the automated ANC. A CBC with Differential order reflexing to a Manual Differential will receive a manual ANC.
- The RBC Morphology will no longer include Anisocytosis, Microcytosis, or Macrocytosis components.
- The RBC Morphology grading will change from “Moderate/Many” to “Present” for the following components:
- Sickle Cells
- Basophilic Stippling
- Howell Jolly Bodies
- Pappenheimer Bodies
- Toxic Granulation
- Dohle bodies
- Vacuolated Neutrophils
- Neutrophil Hypogranulation
- Giant Platelets
- The following RBC Morphology components will STILL be reported as Moderate/Many:
- Hypochromia
- Polychromasia
- Schistocytes (Few, Moderate, Many)
- Bite Cells
- Spherocytes
- Target Cells
- Teardrop Cells
- Acanthocytes
- Blister Cells
- Echinocytes
- Macro Ovalocytes
- Given the limited clinical utility and labor intensiveness of performing RBC counts, lower reportable limit for non-cerebrospinal fluid (non-CSF) body fluid red blood cell (RBC) counts will be updated to 2000 cells/uL. This means, if an RBC count on a non-CSF Body Fluid is <2000 cells/uL, Epic will report out the RBC count as <2000 cells/uL.
- CSF will continue to report out all RBCs present within the cell count.
References:
- Kjeldsberg CR, Hussong, JW: Body Fluid Analysis. ASCP Press; 2015
- Collins, l. Examination of Body Fluids: Evaluating Gross Appearance; Performing Cell Counts. Clin Lab Sci 2009;22(1):46