Microbiology, Test Spotlight, Test Utilization

Stool Ova & Parasite Exam: New Order Criteria

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

 

September 15, 2021 by
Advanced Technology Laboratory, Education & Training, General Information, Immunochemistry, Microbiology, Test Utilization

Reminder: COVID Orders and Scheduling

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:

COVID-19 Lab Information

COVID-19 General Information

COVID-19 Screening and Testing

August 27, 2021 by
Chemistry, Compliance & Safety, General Information

Update: Salicylate Results Reporting

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

August 2, 2021 by
Hemostasis/Coagulation

Update: PT/INR Resulting Change

The Spectrum Health Laboratory Coagulation Department announces the following changes occurring on 6.29.21 because of new instrumentation:

• New coagulation instrumentation will go-live on 6.29.21.

• This new instrumentation will align the Spectrum Health Regional Laboratory (in GR) with current Regional/Blodgett reportable upper limit for Protime/INR results.

• The current Protime (PT) upper limit of 120 seconds will change to 90 seconds. Any result that is greater than 90 seconds, will be reported as >90 seconds.

• The current INR upper limit of 12.0 will change to 8.0. Any result that is greater than 8.0 will be reported as >8.0.

Any questions can be directed to the Spectrum Health Regional Laboratory Coagulation Department using the Contact Us link above.

TEST INFORMATION 

PT/INR (Protime with INR): Epic Code #LAB320 | Interface code #10059 | CPT #85610

June 29, 2021 by
Hemostasis/Coagulation

New Test: Factor VIII Chromogenic Assay

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

June 28, 2021 by
Compliance & Safety, General Information

Pathology Narratives Release Hold Removed for Weekends and Holidays

Effective July 1, 2021, Pathology and Radiology Result Narratives will no longer be held on weekends and holidays. All finalized result narratives will be released at 6 a.m. and 12 p.m. daily. This adjustment aligns with the 21st Century Cures Act and corresponding CMS mandate to allow data to flow freely and securely between providers, payers, and patients.

Of note, patients may be able to see results in MyChart prior to a provider seeing the results. Ordering providers should consider discussing potential outcomes with patients to prepare patients for results. Results should only be held if releasing the result puts the patient at risk of physical harm, or the patient requests the information not be shared.

More information related to the 21st Century Cures Act and established interoperability requirements can be found on the Information Governance Insite page (Internal). Contact Information Governance at InformationGovernance@spectrumhealth.org with any questions or use the Contact Us link above.

June 23, 2021 by