Cytogenetics expert joins PAML

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Cytogenetics expert joins PAML Powered By Docstoc
					                                                                                                                 VOLUME 8, ISSUE 1           SPRING 2008



PAML receives Microsoft
Dynamics™ Pinnacle Award
                                             Cytogenetics expert joins PAML
for healthcare leadership                    Dr. Julie Biggerstaff
                                             knows chromosomes.
                                             Her expertise in
PAML has been honored by Microsoft®
                                             constitutional and
with a Pinnacle Award for outstanding
                                             cancer cytogenetics
business achievement. The company
                                             and FISH (fluorescent
was selected for the award because of
                                             in situ hybridization)
its extraordinary success with Microsoft’s
                                             probe development
Customer Relationship Management
                                             and validation is
(CRM) products.
                                             nationally recognized
     PAML received formal recognition for
                                             and she has published
its Pinnacle Award for Healthcare Industry
                                             numerous scientific
Leadership at Convergence 2008,                                          Julie Biggerstaff, PhD, FACMG displays a computer program she uses
                                             articles and abstracts
Microsoft’s annual customer conference                                   for chromosome diagnosis.
                                             using her clinical
which was held in March in Orlando,
                                             proficiency in the field of human
Florida.                                                                                          chromosome-based abnormalities.
                                             cytogenetics.
     Established in 1997, the Pinnacle                                                                An important part of cytogenetic
                                                 During her career, cytogenetics—
Awards are presented yearly and                                                                   diagnostic testing, FISH can be
                                             the study of normal and abnormal
recognize Microsoft Dynamics™                                                                     used to detect structural changes in
                                             chromosomes—has evolved into an
customers who have achieved notable                                                               chromosomes. A gene segment in a
                                             integral diagnostic and prognostic
accomplishments with their applications.                                                          chromosome can be made to “light
                                             tool in various branches of medicine
     PAML has implemented a                                                                       up” or fluoresce when it is bound to a
                                             (e.g. oncology, obstetrics, pediatrics,
comprehensive Microsoft-centric solution                                                          specially labeled DNA probe. Genetic
                                             cardiology and neurology).
environment—referred to as CRM at                                                                 changes in many cancers can be
                                                 There are now many disorders
PAML—to drive exceptional service                                                                 detected using this method.
                                             that can be diagnosed by examining
awareness and improvement, and has                                                                cGH (competitive genomic) micro-array
                                             a person’s chromosomes. Newer
effectively promoted its value to the                                                             is also entering clinical use in genetic
                                             techniques developed since the
industry.                                                                                         diagnostics and is used to detect the
                                             1990’s allow for increased resolution
     Rosalee Allan, senior vice president                                                         same type of aberrations with higher
                                             of chromosome analysis, permitting
and COO for PAML, has provided
                                             differentiation of a greater number of                                                continued on page 8
leadership for implementing and
extending CRM within the organization.
As she saw the impact of CRM, she and           IN THIS ISSUE
her colleagues recognized that they could       Pinnacle Award.................................. 1    Patient safety initiatives ................... 5
incorporate more and more business              Cytogenetics expert .......................... 1      Turnaround time reports ................... 6
processes into the system to automate           MountainStar joint venture ............... 2          Viral activity reports ......................... 6
their end-to-end workflow. This, in turn,       Outreach Advantage ........................ 2         Results reporting .............................. 7
has resulted in the ability to identify         LCMS test menu ............................... 3      New/Updated Tests ........................... 7
trends more rapidly, target improvement         Sonny Varadan ................................. 4     Hospital Services portal .................... 7
efforts and speed up service response.          Notification changes ........................ 4       Monitoring/tracking software ........... 8
“It has become the heartbeat of our             Interfaced Tests................................. 4
organization,” said Allan. v
                                 Outreach Advantage launched                                                  ®



                                                       New division offers technology toolkit designed
                                                       to enhance laboratory competitiveness
                                                       PAML, Johnston is a laboratory industry          and technology partners are excited
                                                       veteran and has been at the forefront of         about Outreach Advantage and we
                                                       information technology—from guiding              believe it will fuel hospital and regional-
                                                       connectivity strategy and strategic              based outreach programs throughout the
                                                       planning, to being an integral part of           country,” concluded Johnston.
                                                       launching several laboratory-technology              PAML has entered into a letter
                                                       products.                                        of intent with ARUP Laboratories
                                                            “Outreach Advantage is a proven             to market the Outreach Advantage
    Mark Johnston displays the new Outreach            set of products and services that will           products through their sales and service
    Advantage logo and company’s web site.             strengthen the competitive position and          organization. PAML has also secured an
                                                       enhance the operational efficiency of            exclusive sales distribution agreement
    In January 2008, PAML announced                    every laboratory that                                               with Maplewood
    the creation of a new and independent              chooses to deploy the        OA Mobile—an integrated                Software to market and
    operating division named Outreach                  unique technologies,”        route planning, scheduling,            sell the ScheduleLabs
    Advantage® to commercialize a unique               said Mark Johnston. “We dispatch and specimen tracking application to automate
    collection of information technologies to          are excited we can offer     system.                                scheduling, credentialing
    support and expand laboratory outreach             these innovative products OA Connect—a comprehensive and competency
    programs.                                          and services to the          integration platform to connect verification activities in
        The Outreach Advantage suite                   laboratory community         laboratory information systems laboratory departments.
                                                                                    to EMR systems and web
    of products and services developed                 through our direct sales                                              “We are excited about
                                                                                    products.
    by PAML provides the platform for                  efforts and distribution                                            the opportunity to help
    hospital-based and regional laboratories           partners.”                   OA CRM—an advanced end-                laboratories across the
                                                                                    to-end workflow and business
    to excel in the outreach marketplace.                  “Each of the                                                    country enhance their
                                                                                    analytics tool that consolidates,
    The laboratory-customized technology               Outreach Advantage           communicates and documents outreach programs and
    toolkit includes an automated logistics            products and services        marketing, sales and client            we believe the systems
    platform, a robust connectivity platform           has been deployed,           service activities and patterns.       we have built to support
    with normalized EMR and web portal                 tested and proven                                                   PAML’s operations and
    interfaces, and a customer relationship            in daily laboratory operations. The              joint ventures will help other laboratories
    management and sales force automation              combination of the key pre and post-             increase their success,” said Dr. Tom
    system.                                            analytic functions into an integrated            Tiffany, president and CEO of PAML.
        Mark Johnston will serve as chief              technology suite is unique in the industry           For more information on Outreach
    executive officer of Outreach Advantage.           and will greatly improve outreach                Advantage, go to our web site at
    Formerly chief information officer of              laboratory effectiveness. Our distribution       www.outreachadvantage.com. v



                 PAML forms new joint venture with MountainStar in Utah
      PAML and MountainStar, a premier healthcare system in Idaho              Our goal is to provide a turn-key program that will enable a
      and Utah, have entered into an agreement to enhance laboratory           competitive offering to physicians in their local communities.”
      outreach services in the Salt Lake City region. MountainStar is a            Named “MountainStar Clinical Laboratories,” the LLC will
      division of Hospital Corporation of America (HCA), the nation’s          combine the high-quality laboratory testing capabilities at two
      leading provider of healthcare services.                                 hospitals within the MountainStar family—St. Mark’s Hospital and
          “The partnership with MountainStar is an important milestone         Lakeview Hospital—with the esoteric testing and lab outreach
      for PAML in the continued expansion of our laboratory joint              support services offered by PAML. The rapid turn around times
      ventures with leading hospital systems,” said Dr. Tom Tiffany,           delivered by MountainStar hospital-based laboratories and
      president and CEO of PAML. “We are confident that our partner            advanced physician connectivity, logistics and client service support
      health systems will realize the benefits of working in a collaborative   products for which PAML is well-known will enhance the delivery
      fashion to expand laboratory outreach businesses.                        of laboratory services available to physicians in Utah. v
2
LCMS test menu expanding
Advances in mass
spectrometry, combined                                                                             Methylmalonic
with the separation
power of liquid or gas
chromatography, has
                                                                                                   Acid (MMA)
revolutionized the way
laboratories do clinical                                                                           The laboratory analysis of
chemistry analysis.                                                                                methylmalonic acid occupies a
Innovative preparation                                                                             growing place in the assessment
methods together with                                                                              of a patient’s welfare.
highly accurate analytic
                                                                                                   This important organic acid
systems are making
mass spectrometry                                                                                  provides significant insight into
ideal for solving                                                                                  an individual’s Vitamin B12
complex medical issues.                                                                            utilization. Vitamin B12 is an
    PAML’s mass                                                                                    essential vitamin in the body
spectrometry
                                                                                                   and is important for nerve
laboratory utilizes both Clinton Roe, Toxicology Technician, checking specimens being tested
gas chromatography                                                                                 health. One of its essential
                             on PAML’s new LC/MS/MS system.
(GC) and liquid                                                                                    functions is as a cofactor in
chromatography (LC)                             would be difficult, if not impossible, with        the enzymatic conversion of
coupled with mass spectrometers for             other forms of chromatography. The                 methylmalonic acid to succinic
testing purposes. Each testing platform         sample to be analyzed is introduced                acid. A deficiency, or lack of,
gives strength to specific types of tests.      in small volume to the stream of liquid
                                                                                                   vitamin B12 leads to elevated
We currently have ten different mass            mobile phase and is retarded by specific
spectrometers in-house, including six           chemical or physical interactions with             levels of methylmalonic acid.
GC/MS systems, one                                                 the stationary phase            Consequently, the measurement
LC/MS system, and three Assays currently on the                    in the column. The              of methylmalonic acid has been
LC/MS/MS systems. All          LC/MS/MS platform include:          amount of retardation           used effectively as an indicator
systems serve different        • Methylmalonic Acid                depends on the nature           of vitamin B12 deficiency.
applications and               • Sirolimus                         of the analyte, stationary
purposes.                                                          phase and mobile phase
                                                                                                   Symptoms of neuropathy such
    While gas                  Additional LC/MS/MS assays in                                       as numbness and tingling in the
                                                                   composition.
chromatography has long development for 2008 include:               LCMSMS is starting             hands and feet are common
been a routine analytical • Fentenyl                               to play a key role in           with vitamin B12 deficiency.
tool and the workhorse         • ETG & ETS
                                                                   uncovering early disease
in mass spectrometry,          • Mycophenolic acid
                                                                   markers. By analyzing
liquid chromatography          • Vitamin A
                                                                   down to the molecular
coupled with tandem            • Vitamin D
                                                                   structure of a compound      PAML” according to David Michaelsen,
mass spectrometry is           • Keppra (Levitiracetam)
                                                                   or protein, biological       general manager of toxicology,
quickly becoming the                                               systems can be studied       “because it opens doors into the future
powerful hybrid analytical method. The          to better understand their effect on our        of healthcare where disease can be
rapid pace of developments in liquid            health. Advancements in the area of             identified before it gains ill effects on
chromatography and the advent of                LCMSMS analysis is starting to make a           your life.”
new interfacing technology are quickly          significant impact in the treatment and             One example of enhanced sensitivity
making LC/MS/MS a methodology of                prevention of cancer, cardiopulmonary           in testing is Ethyl Glucuronide (ETG) and
choice at PAML because of increased             disease, diabetes and strokes.                  Ethyl Sulfate (ETS). Both are alcohol
sensitivity, lower detection limits, and the        PAML’s toxicology division is               metabolites used to identify use up to 36
ability to analyze a much wider range           increasing its usage of tandem mass             hours after consumption. A regular urine
of components with relatively short run         spectrometry for the identification of          alcohol test only identifies use in the last
times.                                          drugs and other molecules because               8 hours. These biomarkers allow a longer
    High performance liquid                     of its ability to measure low level             window for analysis helping drug rehab
chromatography has the capacity to              concentrations. “Staying on the leading         and compliance monitoring programs to
attain separations and analyses that            edge of technology is important to              assure alcohol abstinence. v
                                                                                                                                               3
    Patient safety initiatives supported
    PAML takes patient safety as seriously         hospital patient databases.
    as hospitals do. We are acutely aware          If incorrect demographics
    that laboratory employees play a crucial       are submitted with test
    role in protecting patients -- primarily       orders, PAML requires
    through the accuracy of our testing, but       written authorization to
    also through the systems for collecting        invalidate the results. Once
    specimens, laboratory processing, and          the results are invalidated,
    reporting of results.                          a new order is created
        PAML supports the Joint                    with the correct patient
    Commission’s Patient Safety Goals and          information. Even though
    reviews their initiatives on an annual         this safeguard meets
    basis. Two initiatives we are focusing on      with resistance at times,
    relative to our hospital clients include:      the written authorization
        • Improving the accuracy of                protects the patient.             Hyacinth Dezenobia, Accessioning and Jolette Miller, Technical
           patient identification.                      PAML has invested a          QA and Safety Manager, discuss two patient identifier system.
        • Improving the effectiveness              significant amount of money
           of communication among                  in sophisticated specimen tracking                       immediately. Additionally, all
           healthcare providers.                   systems, which we view as the hub of                     communications require a
                                                   our patient safety processes. Through                    confirmation by the receiver.
    Improving the accuracy of patient
                                                   the use of bar coding, hardware, and                  One particular area that PAML
    identification
                                                   software designed on-site, PAML has              monitors closely is timely notification of
         A critical patient safety issue
                                                   developed a system that ensures the              clients when testing can’t be completed.
    within the laboratory is ensuring
                                                   correct identification of some 11,000            If samples have been compromised in
    optimal specimen identification during
                                                   patient specimens processed per day.             the drawing or transportation process
    laboratory operations so results are
    released for the correct patient. Key to       Improving the effectiveness of                   and are not viable for testing when they
    this initiative is requiring two patient       communication                                    arrive at PAML, we have implemented a
    identifiers throughout the process of               Failures in communication represent         series of procedures for quick resolution
    delivering healthcare. As part of our          the most common cause of medical                 of the problem. Prior to notification,
    mandate on this                                                      errors. Inadequate         PAML makes a rigorous effort to
    initiative, PAML                                                     “hand-off’” between        determine if like samples are available
    requests two patient
                                  National Patient Safety two different                             at our laboratory or the client’s facility
    identifiers when                   Awareness Week                    healthcare providers       to replace the compromised specimen.
                                                                                                    Otherwise, we usually ask to have the
    receiving specimens.                 March 2-8, 2008                 often results in
         One of PAML’s                                                   poorly documented          specimens re-drawn to ensure patient
    most frequently                     “To err is human,                or lost information.       safety.
    documented patient          to cover up is unforgivable,                 As you hand a            Improving our processes
    identification                    and to fail to learn               specimen and orders              The initiatives mentioned in this
    errors is the receipt               is inexcusable.”                 over to us, and as           article are just two of numerous patient
    of inadequately                      Sir Liam Donaldson              we hand the results          safety initiatives PAML has undertaken.
    identified specimens.                                                back to you, PAML            Since the Joint Commission made its
    To correct this error, we initiate an           has several clearly defined procedures in         patient safety standards effective in
    electronic work order (referred to              place to address this initiative, including:      July 2001, we have made significant
    as a CRM case) immediately after                   • Any verbal exchange of test                  improvements in fulfilling our patient
    determining that the specimen arrived                 orders or critical lab results              safety goals. While risk can never be
    without the proper identifiers. As a CRM              require that the receiver write or          totally eliminated, we know that safer
    case, it becomes a top priority for our               type the information, read it               healthcare is possible.
    Resolution Center staff and fast-tracks               back, and receive confirmation                  Collaborating with our clients and
    through a problem-solving model.                      from the person who gave the                partners to identify patient safety risks,
        On occasion, patients with identical              information.                                then working together with them to
    names are not scrutinized closely                  • All critical test results and values         adopt new protocols and procedures
    enough when tests are being ordered                   requiring urgent notification are           to improve safety is one of PAML’s top
    through physician group EMRs or from                  communicated to clients                     priorities. v
4
Interfaced Tests
___________________
The following is a list of tests that have been
                                                            Sonny Varadan promoted
                                                            to Chief Information Officer
interfaced from FOCUS Diagnostics.
29170   ANTIADRENAL ANTIBODY SCREEN           ADREAB
29175   OVARIAN ANTIBODY SCREEN               OVAB
42417   EEE AB IFA                            ARBO
40161   STREPTOCOCCUS, GP B, AG DETECTION     BAGP                                              PAML recently announced the promotion of
40235   CANDIDA ALBICANS ANTIGEN DETECTION    CAAGAB                                            Sonny Varadan to chief information officer
41431   IgA FIBRONECTIN AGGREGATES, ELISA     FIBRON
                                                                                                (CIO) from his previous role as IT Director.
40277   S. CEREVISIAE IgG AND IgA, ELISA      IBDDP
60921   T. GONDII IgG                         TGONCF
                                                                                                In his new position, Varadan will be a key player
20125   CANDIDA AB ELISA                      CANAGM                                            in providing strategic direction for technology
20172   HEPATITIS E VIRUS (HEV) IgM, ELISA    HEPEM                                             initiatives, including all core business systems
20193   EPIDERMAL (SKIN) ANTIBODY, IFA        EPIDAB
                                                                                                development. The promotion comes at a time
20255   PM-Scl ANTIBODY, ID                   POLYMY
20775   21-HYDROXYLASE ANTIBODY               21OHAB
                                                                                                when PAML is seeing strong demand for its
21004   MAG ANTIBODY, DUAL ELISA (SERUM)      MAGMAB                                            network intelligence solutions.
24310   HEP D TOTAL                           HEPDAB                                               “Sonny has an excellent understanding of
40200   NEISSERIA GONORRHOEAE AB CF           GONAB
                                                                                                business and information technology,” said
40205   BRUCELLA IFA                          BRUAPB
40245   TRYPANOSOMA CRUZI AB PANEL IFA        CHAGAS
                                                                                                Dr. Tom Tiffany, president and CEO of PAML.
40305   COLORODO TICK IGG                     COTICK                                            “He takes the time to meet with departments
40330   COXSACKIE A PNL                       COXAB6
                                                                                                and to understand systems and how IT
40340   CRYPTOCOCCUS ANTIBODY, IFA (SERUM)    CRYPAB
40350   CYSTICERCUS ANTIBODY, ELISA (SERUM)   CYSTAB
                                                                                                implementation can fit as a business case.
41881   B. HENSELAE IgG SCREEN                BARGM         He has been a driving force in the expansion of our information technology
40915   SCHISTO IGG ELISA SERUM               SCHAB         during his time here at PAML. Sonny understands how important information
40995   FRANCISELLA TULARENSIS ANTIBODY, DA   FTULAB
                                                            technology is to our organization and our joint venture partnerships. He brings a
41000   TYPH AB PNL IFA                       SLEVCF
41055   WIDAL (SALMONELLA) AGGLUTININS, DA    SALMAG
                                                            combination of vision and pragmatism to his new role, so the IT solutions he and
41090   HIV 2 ANTIBODY, IBL                   HIV2WB        his department develop together are not only innovative, but also very beneficial to
41091   HIV 2 ANTIBODY, IBL                   HIV2AB        our growth,” added Tiffany.
41253   RABIES ANTIBODY, ELISA                RABAB
                                                                A certified expert in project management, Varadan brings a wealth of
42050   TOXIC SHOCK AB MAID                   TSABP
43160   HERPESVIRUS 6 (HHV-6) DNA, PCR        HHV6PC
                                                            knowledge and experience in team building, quality assurance, analytics, software
43500   CHLAM PNEUMONIAE DNA PCR              CHPPPC        design, systems engineering and applications development to his position.
45050   CMV DNA, QUANTITATION, PCR            CMEGDN            Varadan holds a bachelor’s degree in corporate secretaryship from the
46050   GIARDIA IGG IGM IGA                   GIAAGM
                                                            University of Madras (India), post graduate diploma in Computer Science and
47000   BARTONELLA DNA, PCR                   BARPCR
47900   BK VIRUS DNA, QUANT PCR               BKPCR         master’s degree in business administration from Indiana State University. v
51183   AFB MTB PCR                           AFBPCR
51523   ANTIFUNGAL LEVEL, ITRACON, HPLC       ITRAC
51590   5-FLUROCYTOSINE LEVEL, BA             FUNAB




                                                        Notification changes implemented
60340   CRYPTOCOCCUS ANTIBODY, IFA (CSF)      CRYPSF
60350   CYSTICERCUS ANTIBODY, ELISA (CSF)     CYSAB
60428   WEST NILE AB PNL, ELISA (CSF)         WNVCSF
81030   CHLAMYDIA PNEUMONIAE CULTURE          CHLPC
81055   CLOST. DIFFICILE CYTOTOXIN NEUT       CDIFAB
82000
40766
        CYCLOSPORA DETECTION, FM
        STREP PNEU IgG, pre
                                              CYCDET
                                              PNABPP
                                                        Database Alert renamed                          changes are made by one of our referral
                                                                                                        laboratories, PAML will send out a Test
25045   Toxic Shock Syndrome Toxin Panel      TSSTP
                                                        to Test Change Alert                            Change Alert on an ‘as-needed’ basis.
29958   Interferon Beta G                     INFBEG
                                                                                                            Many clients have requested more
40417   EEE PANEL                             EEEAB
40895   SLE AB PNL                            SLEVAB
                                                        As a result of client feedback, PAML            lead time between notification of test
60417   EAST EQUINE ENCEPH AB, IFA (CSF)      EEECSF    has made changes in the way it notifies         changes and the actual “go-live” date.
61045   WEE IGG IGM IFA CSF                   WEEGMC    clients about significant test changes and      In response to this request, PAML has
23015   HBV QUAL DNA PCR                      HBDQ      new test offerings.                             created an internal calendar which
40170   S. PNEUMONIAE AG DETECTION, LA        SPNAGD
                                                             Previously, all notifications were         will increase the amount of advanced
40540   HHV 6 PNL IFA                         HEV6GM
                                                        sent out in a document called PAML              notification for changes and new test
  If you wish to receive the results for these tests    Database Alert. This document has been          offerings. Our goal is to give you as
  through your interface, please follow your internal   re-named to PAML Test Change Alert.             much notice as is possible.
  procedures to activate new tests. If you are               The Test Change Alert will continue            Interface Maintenance Bulletins will
  interfaced through INHS, please contact them          to be sent to clients on a monthly basis—       continue to be sent in conjunction with
  directly. Should you have specific questions                                                          the Test Change Alert when they are
                                                        around the 3rd week of the month—
  regarding any of the above tests, please feel free
                                                        unless there are no changes to report.          appropriate, and our clients will also
  to contact Juliette Wyatt at PAML Ext. 8829 or
  e-mail her at jwyatt@paml.com.                        It is sent by e-mail and also posted on         continue to receive Test Updates when
                                                        the PAML web site. If any significant           they are published. v
                                                                                                                                                    5
    New turnaround time
    reports available
    Next to accuracy, speed is essential in lab       TAT reports facilitate
    work. Identifying variables that speed or     identification of testing
    slow turnaround times (TAT) is important      delays and allow both PAML
    to not only PAML but our clients as           and our clients to scrutinize
    well. Identifying the key variables, and      areas that are causing
                                                                                  Angela Grote, PAML IT Help Desk Supervisor, sets new clients up
    sharing the variables with clients, allows    problems. Corrective actions with secure log-in services to access TAT reports online.
    both PAML and our client’s laboratory         may include changing
    personnel to improve TAT performance          ordering patterns, adding staff, revising       meet or exceed the published TAT on all
    by modifying the variables that can be        the protocol for last-minute stats,             tests 95 percent of the time. In addition,
    manipulated at each facility.                 increasing test runs, replacing outdated        PAML compares their TAT with the
        Taking a more proactive approach,         equipment and bringing send-out tests           published TAT of other national reference
    PAML has recently developed a new             in-house to name just a few. “This is a         testing laboratories to ensure that PAML
    procedure for gathering and reporting         classic example of how data can help            is competitive in the marketplace.
    turnaround time data. The procedure           focus improvements,” said Bill Remillard,           PAML also offers a client-specific TAT
    makes it possible for us to analyze a         PAML’s technical site director. “The first      report when requested by a client. This
    deeper range of descriptive statistics and    report we pulled in November 2007               report will look at all of the tests ordered
    produce more thorough reports. One            indicated seven tests which missed our          by a client for a specific time frame.
    new report, the Esoteric TAT Report,          goal of 95 percent reported within the          Once the report is generated, both PAML
    is generated on a monthly basis and           published TAT. The January, 2008 report         and our client can analyze the data.
    reflects the TAT for high volume esoteric     saw this number improve to only five tests          To request a TAT report, talk with
    testing, as well as providing clients with    missing the goal.”                              your marketing representative or go to
    testing schedules, monthly test volumes,          PAML is firmly committed to                 our web site at www.paml.com to view
    averages, percentage of turnaround            improving turnaround time without               reports on-line. TAT reports are located
    times met, and the turnaround time at         compromising the benchmark standards            within the Hospital Services portal, which
    the 95th percentile.                          of quality and accuracy. Our goal is to         is accessed from the Home Page. v




                                                           Viral activity reports now
                                                           located on PAML web site
                                                             admissions due to respiratory         site at www.paml.com under the
                                                              diseases. The number of              Virology heading.
                                                               confirmed viral cases is                These reports are timely indicators
                                                               considered only a small             of public health conditions and confirm
                                                            portion of the true level of           what viruses are circulating throughout
                                                  illness in a community, but it serves as         the region. The reports can also identify
                                                  an indicator of how pervasive a virus is.        early warning signs of a viral outbreak,
                                                      PAML collects summary counts                 giving hospitals advance notice to
    The respiratory syncytial virus (RSV) is      of positive laboratory specimens and             prepare for an increased number of
    recognized as the single most frequent        compiles the data into two weekly                patients.
    lower respiratory tract pathogen in           reports designed to provide a picture of             This knowledge can also lead to
    infants and young children in the             the viral activity in the region during any      the improvement of medical diagnosis
    United States. RSV infections present         given week of the year. The two reports,         and treatment, especially for the more
    seasonal incidence, primarily starting        Rotavirus and Enterovirus Weekly                 severe cases. Identifying viral strains
    in the fall and peaking in the winter         Report and the Weekly Respiratory                each season can also guide decisions
    —which parallels an increase in hospital      Report, are posted on the PAML web               regarding antiviral treatment. v
6
Results reporting streamlined
PAML receives approximately 11,000                     printout, write the result on a
specimens daily and performs over four                 hard copy worksheet, or type
million lab tests annually. With lab work              data into an application.
volumes of this magnitude coming in                    Receptionists no longer have to
and going out each day, it would be                    jot the telephoned results down
impossible to deliver results as quickly               and make sure they reach the
and accurately as needed without utilizing             appropriate healthcare provider.
valuable information technologies that                 Medical Records employees are
                                                                                             Shannon Reich, Lab Technician, is running centaurs and
allow for automation and connectivity                  happy because they don’t have
                                                                                             releasing patients results.
with our clients.                                      to scan in as many lab reports as
    Interface technology has enabled                   in the past. Nurses are happy because             hospital clients—has become a stream-
PAML to route test results from our                    they can either see the results on their          lined process, all done electronically.
laboratory directly into a hospital or                 computer or receive a hard copy of the                This time and cost-saving technology
healthcare provider’s computer system                  lab results.                                      has made a significant impact on patient
or printer as soon as the results are                       While PAML does the bulk of our              care as well. Rapid access to a patient’s
available. In addition, many of our                    testing in our parent                                                lab results can reduce a
laboratory instruments are also interfaced             laboratory, we do            Additional benefits                     patient’s length of stay,
with our laboratory information system                 utilize other reference      • Redundant entry is                    an important goal under
(LIS), allowing many test results to be                laboratories for a small         substantially reduced.              prospective payment
sent to clients in real-time. Our interface            percentage of our esoteric • Demographic information                 plans.
                                                                                        is immediately available.
capabilities have decreased the number                 testing. Interfacing with • Lost, delayed or misplaced                  Healthcare providers
of paper reports by 80 percent, reduced                our testing partners has         reports are eliminated.             are moving aggressively
the incidence of clerical errors and                   significantly improved our • Add-on and cancelled tests              to paperless processes,
decreased turnaround time substantially.               efficiency, productivity         can be tracked.                     especially with the rising
In many cases, reporting time has been                 and turnaround time on • Billing is accurate and revenue number of electronic
                                                                                        for add-on tests is not lost.
cut from days down to minutes.                         these tests. What used to                                            medical records (EMR)
    Interface technology has been a big                be a cumbersome process of transferring           systems being implemented.
boost for hospital employees as well.                  esoteric test results from the reference          As technology changes, PAML will
Laboratory technologists are happy                     lab’s report to our reporting system—             continue to look for new and more
because they no longer have to read                    involving tedious manual entry into a             efficient ways increase connectivity with
the result from a screen or instrument                 computer before sending it on to our              our clients. v


New/Updated Tests
_______________________                                            Hospital Services portal provides
DESCRIPTION                              FLEXICODE   EFFECT.IVE
                                                                   internet access to reports and resources
Lipid Profile & LPA2 (PLAC)              LIPID2      09/18/07      By now, many of you have met with your PAML marketing representative
Lipid Profile & LPA2 (PLAC)              PLACA2      09/18/07      for a demonstration of PAML’s new hospital portal. Accessible from any
Autoimmune Profile (reflexive)           AIP         11/27/07      computer with internet capabilities, the hospital portal is designed to make it
Chromatin Autoantbodies                  CHROMP      11/27/07      easy for you to obtain pertinent laboratory information online. While this new
Connective Tissue Disease (Reflexive)    CTD         11/27/07      portal offers many advantages, the greatest benefit is that the information is
Ribosomal P Autoantibody                 RIBPMP      11/27/07      available to you when you have the time to review it.
Celiac Profile, Pediatric Basic          CELPED      12/19/07          As you may have noticed, some client-specific reports that are available
HSV 1 Type-specific IgG Ab               HSV1G       12/19/07      within the portal are stored in a secure environment requiring a user name
HSV 2 Type-specific IgG Ab               HSV2G       12/19/07      and password. These reports include Client Specific Fees, CRM Report,
Lamotrigine                              LAMI        12/19/07      Electronic Bill, Test Utilization Report, Manifest, PAML Inquiry and Reprint
Methylmalonic Acid Serum (Quant)         MMAMS       12/19/07      Labels and Supply Orders. You must create a secure personalized account
Varicella Zoster Antibody, IgG and IgM   VZAGM       12/19/07      in order to access these reports. Ask your marketing representative about
Varicella Zoster Antibody, IgM           VZVM        12/19/07      setting up an account if you don’t have access to these reports. These reports
Zonisamide                               ZONI        12/19/07      stay in the folder on a running 12 month cycle.
Ethyl Glucuronide, Urine                 ETGU        02/05/08          To access the portal, go to the PAML web site at www.paml.com and click
Transplant Immune Cell Func Assay        TICFA       02/26/08      on Hospital Services—located on the left-hand side under Featured Areas.
Rubeola, Mumps, Rubella IgG Abs          MMRG        03/11/08      If you would like a demonstration, call your marketing representative.v
                                                                                                                                                         7
    New monitoring and message tracking             Cytogenetics expert
    software increases problem-solving capabilities
                                                                continued from page 1


                                                                                                              resolution, throughput and automation.
                                                                                                                  As technical director for PAML
                                                                                                              and its joint ventures, Dr. Biggerstaff
                                                                                                              will concentrate on expanding the
                                                                                                              laboratory’s genetic testing menu
                                                                                                              through the use of such advanced
                                                                                                              technologies. Staying at the forefront of
                                                                                                              development and implementation of new
                                                                                                              test methods like FISH and micro-array
                                                                                                              for both congenital and hematologic/
                                                                                                              oncologic disorders is her primary goal.
                                                                                                              She will also provide leadership in the
    IT Team responsible for new monitoring and message tracking software include front row (left to right):   development of standards of practice
    Nancy Bossler, Sean Montgomery. Back row: Matt Altermatt, Jon Tolley, Shaun Elliott, Ted Shaver.
                                                                                                              and genetic-related client and physician
    Not pictured - Keith Lokken.
                                                                                                              education activities.
    Delivering high-performing interface                   This means that the computer interface                 “We are at a point as a society where
    environments is a critical component                   between PAML and the client has been               genetics will be no longer considered
    in PAML’s success. Acutely aware that                  disconnected for some reason. Reasons              esoteric diagnostic testing, but an
    the day-to-day operations of interfacing               for a disconnection could be computer              important component to public health
    with our clients must be seamless and                  failure, power outage, or a software               and of everyday clinical medicine,”
    automatic, we continually look for new                 anomaly.                                           said Dr. Biggerstaff. “Appropriate use
    ways to expand our interface capabilities.                  This new program also monitors a              of evidenced-based genetic diagnosis
        One of the latest upgrades                         client’s level of activity and alerts the          has huge potential to change the way
    in technology, functionality and                       IT group when there is a noticeable dip            medicine is currently practiced.”
    supportability is the implementation                   in activity that is not normal. When an                One particular area of interest which
    of two new PAML designed and built                     unusual dip occurs, it usually signifies           has developed from her knowledge and
    software programs: IE Alerter and                      that there is a problem with connectivity.         experience in cytogenetics is in the field
                                                           For example, if PAML hasn’t received a             of genetic counseling. Throughout the
    IE Tracker.
                                                           message from Client A for “x” amount               years, she has seen how traumatic it
        IE Alerter is designed to monitor all
                                                           of time, a notification will go out to the         is for families to deal with the impact
    interfaces and integration engines, and
                                                                                                              of a genetic disorder. Dr. Biggerstaff’s
    alerts our IT group—and subsequently                   IT Help Desk requesting them to check
                                                                                                              compassion for those dealing with the
    our clients—of any potential issues.                   Client A’s interface to be sure we are
                                                                                                              possibility and burden of a genetic
    The new program facilitates quick                      getting the orders they are trying to send.
                                                                                                              disorder, as well as having to sort through
    resolution of issues, usually before the                    Clients always receive notification if a
                                                                                                              the scientific jargon and translate it
    client is aware that a problem existed.                problem is detected that will affect them.
                                                                                                              into practical information, has left an
        More often than not, an issue arises               Notifications are made by e-mail or by
                                                                                                              indelible mark on her. The expansion of
    when ‘the connection’ has been lost.                   telephone. Alert Notifications can go out
                                                                                                              PAML’s genetic counseling, consultation
                                                           24/7 with escalation notifications going
                                                                                                              services and educational resources will
                                                           out to PAML managers if the alerts are
                                                                                                              also be part of her focus as technical
                                                           not acted upon.                                    director.
                                                                IE Tracker tracks all incoming and                Dr. Biggerstaff received a doctorate
                                                           outgoing Interface messages, including             in human genetics from the Graduate
                                                           all orders and results that go through             School of Biomedical Sciences at the
          Esoteric Essentials is a publication of          the Integration Engines. It is used to
      Pathology Associates Medical Laboratories                                                               University of Texas and is board certified
                                                           help trouble shoot and debug issues                in clinical cytogenetics by the American
         .O.
         P Box 2687 • 110 West Cliff Avenue
                    Spokane, WA 99204                      that arise with the Interface messages.            Board of Medical Genetics. She is
          Phone ......................... 509.755.8600     Code translations, message routing, and            a member of the Genetics Advisory
          T Free ...................... 800.541.7891
           oll                                             message delivery can all be tracked using          Committee for the Washington State
          Fax ............................. 509.755.8687   this tool. When an issue arises with a             Department of Health. Dr. Biggerstaff is
          Web site .................... www.paml.com       specific order or result, IE Tracker is the        also a consultant laboratory director to
          Please send comments/questions to                first place our information technology
                      jnerud@paml.com
                                                                                                              Signature Genomic Laboratories, LLC,
                                                           team goes to diagnose the problem. v               as part of her role at PAML. v
8

				
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