PRIVATE LABS AND THE GOVERNMENT

We would like to take this opportunity to thank you for your support during our dispute with the government over the future of private outpatient laboratories. We are hopeful that current discussions will ensure our ability to provide you with ongoing services.

TESTS ORDERED ON NON-MDS METRO REQUISITIONS

MDS Metro Laboratory Services has been expanding its test menu to meet the needs of our patients and physicians, and we are now capable of performing many tests that were previously sent to other facilities. Effective immediately, any requests we receive for tests that are offered by MDS Metro Laboratory Services will be tested at our facilities, regardless of the requisition used to indicate the request. We will continue to forward specimens to other facilities only for tests not performed at MDS Metro Laboratory Services. For your (and your patients') convenience, you can request that copies of the results obtained at MDS Metro be forwarded to other facilities by writing the name of the facility in the "copy to" box of the MDS Metro requisition. These changes reflect our continuing efforts to offer the most comprehensive laboratory medicine service possible to you and your patients.

REMINDER ABOUT NOTIFYING MICROBIOLOGY LAB OF CYSTIC FIBROSIS PATIENTS

It is important to identify on the requisition that a patient has cystic fibrosis when ordering sputum or throat cultures. With cystic fibrosis patients it is of particular importance to identify the presence of Burkholderia (Pseudomonas) cepacia in sputum and throat cultures. Therefore, when the laboratory is informed that the specimen belongs to a cystic fibrosis patient, a special culture plate can be added to optimize the detection of B. cepacia.

MDS METRO ACHIEVES CAP ACCREDITATION

MDS Metro received word this week that it has once again achieved a full two-year accreditation from the College of American Pathologists (CAP). We are proud of the fact that MDS Metro is the only lab in the province to hold both CAP and BC Diagnostic Accreditation certificates.

COMPUTER NETWORK FOR LAB RESULT REPORTING ANNOUNCED

On January 18, 1999, MDS Metro and BC Biomedical Laboratories signed a joint agreement to enter cyberspace by initiating a new electronic network designed to communicate results directly to physicians' office computers. The first stage of this exciting venture will be to conduct a trial of electronic ordering and result return with 50 physicians. This trial will lead to a full "province-wide" roll out later in the year.

NEW MDS METRO POLICY FOR MISLABELED PATIENT SPECIMENS

At MDS Metro we are concerned for the well being of your patients and the correct identification of patient specimens is of paramount importance. Beginning February 15, 1999 we will be instituting a new policy for dealing with the situation of receiving a specimen and requisition from a physician's office where the names do not match. When a specimen and requisition are received where the names do not match, our staff will contact the physician's office. If you inform us that the name written on the specimen is incorrect, and you want us to process and report the specimen under a different patient name, we will ask the ordering physician to complete a special form which we will fax to you and ask that you return it by fax to us as soon as possible. If we do not receive this form within 24 hours the specimen will not be processed. We thank you for your co-operation in ensuring the correct testing and reporting for your patients. A copy of the fax letter we will be using is included with this newsletter.

NEW TOTAL T3 REFERENCE RANGE

A new method for Total T3 has been established. The reference range for adult men and women is 0.7 – 2.1 nmol/L. The Total T3 is generally used to confirm unusual cases of hyperthyroidism in which the TSH and T4 (or FT4) are not characteristic.

HELICOBACTER PYLORI: NEW STOOL TEST TO BE EVALUATED IN COMPARISON TO THE 13CO2 UREA BREATH TEST (UBT)

MDS Metro Laboratory Services has been providing a non-radioactive UBT for laboratory diagnosis of Helicobacter pylori infection since October 1, 1998. The UBT is considered to be a gold standard for both diagnosis and assessment of eradication after therapy, and the test has been well accepted since its introduction.

Because of the importance of H. pylori in peptic ulcer disease and gastritis, a variety of tests are being developed for the laboratory diagnosis of this infection. One promising new test is an enzyme immunoassay (EIA) for detection of the antigens of the organism in stool samples. Preliminary studies of this test indicate that it may be reliable for detection of H. pylori.

We plan to evaluate the performance of the stool EIA test in comparison to the UBT. The stool EIA will be offered free of charge to patients referred for a UBT, or physicians can request that the test be performed when ordering a UBT. Patients can participate in the evaluation simply by providing a stool sample at the time they come in for the UBT.

We will discuss the results of the evaluation of the stool EIA test in a subsequent Lab Medicine Bulletin, and we would very much appreciate your participation in the evaluation.

For more information about the UBT or the stool EIA, contact an MDS Metro medical microbiologist.

To contact an MDS Metro Microbiologist, use the following telephone numbers:

Mainland

Michael Kelly MD PhD FRCPC 604-412-4435
Susan Roman MD CCFP FRCPC 604-412-4519
Sylvie Champagne MD FRCPC 604-412-4409

or

Burnaby Switchboard 604-431-5005
                      1-800-663-9422

Vancouver Island

Keith Brown MB FRCPC FRCPath 250-881-3109

Dear Physician:

We have received a specimen and a requisition from your office where the names do not match. At MDS Metro, we are concerned for the well being of your patients and the correct identification of patient specimens is of paramount importance. Please complete this form and return it by fax to us at __________within 24 hours. If this form is not received by us within 24 hours, the specimen will be rejected and no testing performed. We thank you for your cooperation in ensuring the correct testing and reporting for your patients.

I, Dr. ___________________________________________hereby state that the specimen

(Print Doctor's Full Name)

labelled ____________________________________________is actually the specimen of

(Fill in labelled patient name)

___________________________________.

(Fill in patient's full name)

I accept responsibility for this mislabelling of the specimen that occurred in my office and authorize MDS Metro Laboratory Services to bill MSP and report results under the name

of ___________________________________.

(Fill in patient's full name again)

______________________________    _____________________________

Doctor's Signature                   MDS Metro Staff Member

_____________________________    ______________________________

Date                                 Title of MDS Metro Staff Member

                                   ______________________________

                                     Date