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Aotea News - February 2014

Editorial

Welcome to the first edition of our e-newsletter for 2014.

This edition’s articles include:
- new option of emailed laboratory results
- changes to specimen labelling requirements
- ability to amend electronic test orders (eLab)
- 3DHBs laboratory services contract
- Thyroid Fine Needle Aspirates

We hope you find this newsletter timely and relevant, and as always your feedback is welcome.

Emailed Results

Knowing that NZ Post intend to reduce mail deliveries, and to improve result security, we have been working on alternative methods for delivery of patient results for those who rely on printed reports.

From March we will introduce a secure email option for reporting of laboratory results to referrers using a password protected PDF.

Over the next month Aotea Pathology will contact those referrers currently only receiving printed reports regarding this new reporting option.

Patients will also be able to receive copies of their laboratory results via email.

Upcoming Changes to Specimen Labelling Requirements

From March our laboratory accreditation mandates us to make changes to our specimen labelling requirements. All specimens will require both the first name and last name, plus NHI or date of birth (i.e. two identifiers required on the specimen). Alternatively the NHI and date of birth could be used. These details on the specimen must also match the request form.

A poster showing the specimen labelling requirements can be downloaded here: http://www.apath.co.nz/sites/default/files/Specimen%20Labelling%20Form.pdf

Amending eLab requests

We are pleased to announce that you can now amend an elab request.  This means that you will be able to add to, delete or change an elab request any time before the patient presents at an Aotea Pathology collection centre for testing; or for surgery-collected specimens any time before the specimen is received at Aotea Pathology.

Initially the eLab amend function will only be available for doctors. HealthLink is currently working to enable the amend function for nurses ordering on behalf of doctors.

A reminder when adding a copy doctor to an eLab request, please ensure that this information is not typed into the clinical details field - it is very likely to get missed in this field.

3DHBs Laboratory Contracts

In 2013 the 3 DHB regions (CCDHB, HVDHB & Wairarapa) developed a long term strategy for the provision of laboratory services in their regions. The Strategy included opportunities for greater integration of hospital and community referred services. The current contracts for community-referred laboratory services expire in October 2015.
 
A request for expressions of interest (EOI) in community-referred laboratory services was issued 16 October 2013.
 
As the 3 DHBs received broader proposals seeking to integrate hospital and community referred laboratory services, the 3 DHBs are currently clarifying options around the involvement of hospital laboratories in the next phase. The DHB Chief Operating Officers will be leading the work to identify these options over the next month, which will form the basis of advice to the Chief Executives and Boards. Once the Boards have made a decision on this, detailed proposals will be sought from the shortlisted respondents for laboratory services across the three DHBs, with successful provider confirmation by November 2014.
 
Aotea Pathology is keen to remain a key provider of laboratory services in the region. We will keep you updated on developments.

House Call Requests for Fasting Lipids and Glucose Tests

At Aotea Pathology we are aligning our practice with the body of evidence showing that a non fasting lipid profile can be substituted for a fasting test in most situations.  We no longer take fasting lipid levels or glucose tests from patients requiring a house call unless it is clinically indicated on the request form.  Glucose testing in most situations has been replaced by the HbA1c test.

For more information on fasting/non fasting testing for the lipid profile please refer to the bpac November 2013 edition. Read more here: http://www.bpac.org.nz/BT/2013/November/lipid-testing.aspx

Thyroid Fine Needle Aspirates (FNAs)

In the past we have undertaken many freehand fine needle aspiration examinations of thyroid lumps. However current standard of care is moving away from recommending freehand FNA in the workup of thyroid masses.

Many thyroid lumps are multiple and significant pathology does not necessarily reside in the largest (or most easily palpated) nodule. It is therefore important to combine fine needle aspiration with concurrent ultrasound examination, firstly to identify the lesions of most concern\risk and secondly to ensure that these are properly sampled.

Patients requiring cytologic workup of thyroid masses should therefore be referred to your radiology provider or endocrinologist in the first instance.
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