new world hematology - utilizing automation, …userfiles/pdfs/6 new world hematology... · new...

© 2015 Sysmex America, Inc. All rights reserved.

New World Hematology - Utilizing Automation,

Technology, and Advanced Clinical

Parameters Efficiently in Declining Medical

Technologist Market

Gina Schneider, MT(ASCP),CA(CLS)


Long Term

Healthcare

Difficulties

© 2015 Sysmex America, Inc. All rights reserved.© 2015 Sysmex America, Inc. All rights reserved.

CAN WE MEET THE LABORATORY STAFFING SHORTAGE?

Demand for qualified lab staff far outpaces supply

19.5% Hematology techs anticipated to retire in next 5 years

MT/MLT programs closing due to lack of funding, 15%-1990

Clinical rotation placements reduced with declining staff

Nation’s labs need 7K jobs filled/yr, programs producing 6K

CMS (Centers for Medicade and Medicare Services) suggesting

nurses can perform high complexity testing

Goal: Become more creative and efficient

Clinical Laboratory News, Nov 2015


OBJECTIVES: HOW TO IMPROVE HEMATOLOGY

EFFICIENCY & PATIENT CARE

Automation vs Non-Automation

Technology

Advanced Clinical Parameters:


AUTOMATION VS NON-AUTOMATION?

Pochi-3 part,

1-10 CBC’s/Day

XP-300-3 part,

10-20 CBC’s/Day

XS-1000 AL, 5 part,

10-30 CBC’s/Day

XN-1000 BPR, 7 part,

30-75 CBC’s/Day

XN-9000 BPR, 7 part,

200+ CBC’s/Day



Hematology Automation with Cellavision

XN-3000 DI-60

Efficiency

Standardized platelet estimate tools

Standardized RBC views & tools

Problems with Manual Microscopy

• Declining availability

of medical technologists

• Labor intensive

• Not standardized

• Difficult to train

• No historical images

• Limited consultation

• Connectivity between

providers

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=0ahUKEwi-r6PXrZfOAhWE6iYKHYROCV0QjRwIBw&url=https://www.mccrone.com/transmission-electron-microscopy-tem-course&psig=AFQjCNED-FWhidnHq--qRZIg_WxcjXm5MQ&ust=1469836379157339



The Future YOU!!!

XN-3000 DI-60

-Millipore Provided as Needed


WORKFLOW ANALYSIS


HEMATOLOGY OBJECTIONS TO IMPROVE EFFICIENCY

Automation

Technology

Advanced Clinical Parameters



Rerun/Reflex Rules

Hydrodynamic Focusing &

Floating Discriminators

HGB

HCT

Technology

Flow Cytometry

WNR channel WDF channel PLT-F channel RET channel

88 μL Sample Volume

Up to 100 /hr /module

WDF Channel Scattergram - Normal Pattern

LYMPHNEUT+BASO

EO

MONO

Debris

IG

Reportable Immature Granulocytes

Multiple Myeloma with IG’s

IG – XN DIFF Abstract

Solution:

Automated Immature Granulocyte Count

C

• May be a useful complement to current infection surveillance program even when other tests are negative

• With other information may help physicians identify patients with infection sooner

O•Automated, rapid, accurate, decreases manual reviews

•Speeds information to physicians

F

• Decreased labor needed for manual slide reviews

• Could reduce cost of care when part of comprehensive infection surveillance

WNR Channel Scattergram - Normal Pattern

NRBC

WBC

BASO

Debris SFL

FS

C

WNR Channel

• Fluorescent Flow Cytometry Technology

• Maximized Efficiency

• NRBC the first time – all the time

– No additional steps

– Accurate WBC Counts in the presence of NRBCs

• Virtually eliminates interference from:

• Lyse resistant RBCs

• Lipids

Reference Ranges:

IRF 2.3-15.9 %

RetHe 28.2-36.6 pg

• CHr/Ret-He-Recommended in

guidelines for Chronic Kidney

Disease (CKD)

Decrease Blood Transfusions-RetHe

Muusze, R. et al (2009). Protocol for Transfusion Free Major OrthopaedicOperations Using RET-He. Sysmex Journal International, 19:1, 1-8.

Solution:

Automated Reticulocyte Hemoglobin

C

• More comprehensive workup of patients without access to primary care (POA)

• Less variation than acute phase reactants in patients with inflammation or infection

• Used with other information may improve care of patients on ESA / IV Iron therapy

O• Speeds information to clinicians

• Direct cellular measurement for faster indication of patient response

F• Manage cost of care for severe anemias, incl. ESA / Iron

• Potential savings from better transfusion management

Secondary Platelet Methodology

Rouleaux, RBC Fragments

IPF (Immature Platelet Fraction)

Reference

Ranges:

IPF 0.9–11.2 %

AML – Initial Run

AML – Reflex Run

Solution: Immature Platelet Fraction

C

• Use in conjunction with patient diagnosis and platelet count

• May assist in determining cause/differential diagnosis of thrombocytopenia

• Provides a direct cellular measurement of thrombopoietic activity

• May help in determining need for prophylactic transfusions

O

• Automated, rapid, inexpensive, speeds information to clinicians

• Direct measurement of immature cell production for faster indication of response to changes in therapy

F

• Could reduce time and cost of diagnosis of thrombocytopenia

• Could reduce time to assess response to changes in therapy, saving cost

• Potential savings from better transfusion management

Technology Improves Efficiency

& Patient Care

BEFORE AFTER

AC

P

IG, RET He, IPF


Automation vs Non-Automation

Technology Benefits

Advanced Clinical Parameters:

SUMMARY

new world hematology - utilizing automation, …userfiles/pdfs/6 new world hematology... · new...

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