1. Modernisation of Laboratory Medicine at NHS Lothian: An NPEx adopter

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

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

4. 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

5. 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

6. 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.

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

8. NPEx – lab to lab mapping

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

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

17. 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

18. 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

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

20. 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

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

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

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