Modernisation of Laboratory Medicine at NHS Lothian: An NPEx adopter

Topics: NPEx – lab to lab mapping Implementation Operational issues Future challenges

NPEx – lab to lab mapping Performing lab locates test in NPEx catalogue:

NPEx – lab to lab mapping Performing Lab links test to NPEx global code: - all reportable tests linked in a 1:1 relationship Lothian NPEx Profile Code Test Code Orderable Code Reportable Code Global Test Name PBORG BORG Urine organic acid level

NPEx – lab to lab mapping Requesting Lab links test to NPEx global code: -profile code not necessary... Lothian perform NPEx Grampian request Orderable Code Reportable Code Global Test Name PBORG BORG Urine organic acid level PORG-A ORG-A

NPEx – lab to lab mapping Requesting Lab orders test in LIMS: Equivalent linked test ordered in performing lab & results file back into requesting lab LIMS.

NPEx – lab to lab mapping Establishing agreement: Decimal Places Units of Measurement Reference Ranges Specimen Types* Result comments

NPEx – lab to lab mapping

NPEx – lab to lab mapping Performing lab test order set-up: Glasgow performing NPEx Profile Code Test Code Orderable Code Reportable Code Global Test Name n/a 25OHD2 25-Hydroxy Vit D2 25OHD3 25-Hydroxy Vit D3 25OHDT 25-Hydroxy Vit D2, D3 & Total

NPEx – lab to lab mapping Test to test: Glasgow performing NPEx Lothian Request Orderable Code Reportable Code Global Test Name 25OHD2 25-Hydroxy Vit D2 BVITD2 25OHD3 25-Hydroxy Vit D3 BVITD3 25OHDT 25-Hydroxy Vit D2, D3 & Total BVITDT

NPEx – lab to lab mapping Performing lab profile order set-up: Glasgow performing NPEx Profile Code Test Code Orderable Code Reportable Code Global Test Name VITDT 25OHD2 25-Hydroxy Vit D2 25OHD3 25-Hydroxy Vit D3 25OHDT 25-Hydroxy Vit D2, D3 & Total

NPEx – lab to lab mapping Profile to profile: Glasgow performing NPEx Lothian Request Orderable Code Reportable Code Global Test Name VITDT 25OHD2 25-Hydroxy Vit D2 BVTD2 BVITD2 25OHD3 25-Hydroxy Vit D3 BVITD3 25OHDT 25-Hydroxy Vit D2, D3 & Total BVITDT

NPEx – lab to lab mapping Profile to profile – Reflex order: Glasgow performing NPEx Lothian Request Orderable Code Reportable Code Global Test Name VITDT 25OHD2 25-Hydroxy Vit D2 n/a BVITD2 25OHD3 25-Hydroxy Vit D3 BVITD3 25OHDT 25-Hydroxy Vit D2, D3 & Total BVTD2 BVITDT

NPEx – lab to lab mapping Performing lab test & profile order set-up: Glasgow performing NPEx Profile Code Test Code Orderable Code Reportable Code Global Test Name VITDT 25OHD2 VITDT/ 25-Hydroxy Vit D2 25OHD3 25-Hydroxy Vit D3 25OHDT 25-Hydroxy Vit D2, D3 & Total

NPEx – lab to lab mapping Profile to profile, test to test: Glasgow performing NPEx Lothian Request Orderable Code Reportable Code Global Test Name VITDT/ 25OHD2 25-Hydroxy Vit D2 BVTD2/ BVITD2 25OHD3 25-Hydroxy Vit D3 BVITD3 25OHDT 25-Hydroxy Vit D2, D3 & Total BVITDT

NPEx – lab to lab mapping Configuration: Hospital sites User roles Shipping manifest

Implementation: preparation Establish send-away test list and frequency Prioritise test builds Assess operational impact & resources Current practice vs best practice with NPEx Consolidate practice, codes, etc Timetable Keep staff & users up to date of coming changes

Implementation: Interface Field matching: Demographic matching/MDS Clinical detail field Result field Comment fields Requesting lab number Order number Order trigger Resending results Active running

Implementation: Roles Project management System administrators Test configuration Testing Operational input Clinical input Training Multi-site, multi-discipline

Operational Issues Control of ordering; OComms  NPEX direct? User roles & responsibilities Message error handling & notification Contingencies, system helpdesk Sample issue handling Documentation – validation, SOPs, training logs Oversight and responsibility Billing

Operational Issues Validation and Reporting Queues, RBA Amended reports Up/Down-stream impact GPOC Hospital OC Reporting format changes Results audit

Future challenges Non-blood science disciplines Requestor sending preliminary results forward Filtering unwanted requests to NPEx Additional information; PO numbers

Contact: Matt.Noel@nhslothian.scot.nhs.uk