(Use the search window above to look up lab tests)

 

News from Children's Healthcare of Atlanta Laboratories

 

It is Children’s policy, approved by the system-wide Lab Stewardship Committee, that “free” testing, defined as a test for which the performing referral lab does not charge the hospital, patient’s insurance, or patient, CANNOT be sent out on CHOA inpatients, unless the test is:

  1. a clinical test performed in a laboratory under its CLIA license, AND
  2. not available elsewhere, AND
  3. equally and readily available to ALL CHOA patients under an institutional account.  

Orders for tests that do not meet these criteria must be collected in the outpatient setting in which CHOA lab serves as a “pass-through” to the receiving referral lab. CHOA will charge a standard phlebotomy processing free if a CHOA phlebotomist collects the specimen.  Please direct any questions to Dr. Elizabeth Weinzierl at 404-785-4552 or elizabeth.weinzierl2@choa.org. The policy can be found here on the Careforce website:
 
Laboratory Policy 23079.5108: Reference Lab Testing Rules, Exceptions and Algorithms
 
April 2024:
 
  • Thromboelastographs: In May 2024, orders for thromboelastographs will be changed to an order set to accommodate a new and simultaneously offered tests on the new TEG 6s instruments. See below.  
    • Real-time graphs will be available via new TEG manager software which is available through the web browser or via the Citrix portal.
    • With the addition of the TEG 6s, the following orders will also be discontinued: 
      • Thromboelastograph-On Pump Citrated 
      • TEG if on Heparin RX/contamination 
Staff in impacted groups will receive training between Thursday, May 2, and Friday, May 17,2024.
For quesitons, please contact Ahmed Aljudi, MD.
 
New TEG Order set:
 
  • Differences between the current TEG 5000 instrument and the new TEG 6s instrument:
    • The new TEG 6s instruments will have different reference ranges from the current TEG 5000 instruments for each of the results it generates, but the numeric values for each result are clinically similar in meaning. 
      • For example, an R time of 16 minutes has the same clinical meaning for the patient regardless of whether it is generated by the TEG 5000 instrument or the new TEG 6s instrument.
    • Please see the differences in technical ranges between the two instruments below
Analytes TEG 5000 technical range TEG 6s technical range
R (reaction) time to fibrin formation 0 - 120 min 0.4 - 17* min
K (kinetic) time to fibrin cross-linkage 0 - 120 min 0.5 - 5.0 min
Angle (cross-link rate)of clot formation 0 - 90 degrees 39 - 83 degrees
MA (Maximum Amplitude) of clot formation 0 - 90 mm 40 - 75 mm
G value clot strength   <not currently done by TEG 6s with current cartridge>
EPL (Estimated % Lysis) of clot   <not currently done by TEG 6s with current cartridge>>
LY30 of clot (Heparinase) 0 - 100% <not currently done by TEG 6s with current cartridge>


Changes to Existing Lab Tests
 
  • Replaced tests (requires physicians to update affected personal preference lists): Several tests have been replaced due to change in reference lab (Mayo to ARUP initiative) or replacement of the lab test by the reference lab with a new test. Please update any affected personal preference lists. If the test is not replaced, the order will not cross to the lab system and consequently may not be seen by phlebotomists for collection.
Test REPLACED   Test Code  New or Existing Replacement Epic Order   Test Code  Date of Change 
CULTURE LEGIONELLA  CULEGI  Legionella spp PCR LEGPCR  4/18/2024 
Non-Urgent Care Locations ONLY:*

Pinworm Prep		 PINWM Pinworm Microscopic Exam PINWA 4/25/2024 
HIV-1 RNA Quantitative PCR HIVQN HIV-1 RNA Quantitative NAAT HIV1Q Expected:
4/30/2024 
Factor 8 Assay Low LF8 Factor 8 Assay Low Level Quantitation LFACT8 Expected:
May 2024 
*PLEASE NOTE: Urgent Care locations will continue to order PINWM for Pinworm prep.
 
  • Updated tests: The following tests have minor changes to one or more of the following: order questions, process instructions, reference links, display names, results, etc. If these tests have defaulted selections for order questions in personal preference lists, they may need to be updated to prevent errors.
Test Name  Test Code  Date of Change  Elements Changed 
Autoimmune Encephalopathy Eval CSF >=18y  ENCEC      4/1/24  Results updated by the reference laboratory (Mayo) with a new result for IFA notes.. 
Thromboelastograph (TEG 5000) TEG  Expected May 2024  Updates to display name, order questions and process instructions. Will only be available via order set (see above) as of the go-live date. 
TEG 5000 if NOT on Heparin RX or contamination  TEGNH  Expected May 2024  Updates to display name, order questions and process instructions. Will only be available via order set (see above) as of the go-live date. 
Culture Stool Vibrio (IC Lab)  CUVIB Expected May 2024  Updates to display name and performing laboratory

 
  • New tests: 
Test Name  Test Code  Date Added  Comments 
Thromboelastograph (TEG 6s)  TEG6S  Expected May 2024  New test - see announcement above. 

 
  • Tests inactivated without replacement:
Test Name  Test Code  Date Inactivated  Reason 
Thromboelastograph-On Pump Citrated  TEGOP  Expected May 2024  See announcement above. 
TEG if on Heparin RX/contamination  TEGHEP  Expected May 2024  See announcement above. 
 

The lab continues to optimize additional lab tests not listed in this update with minor changes which do not require personal preference lists to be updated. Thank you for your patience. The lab also is working toward making all lab test orders available in all locations. If an inpatient lab test order is not available for your outpatient, submit a Solution Center ticket to the Laboratory Information System (LIS) team. Contact Alexis Carter, MD, with questions.

(Use the search window above to look up lab tests)

 

News from Children's Healthcare of Atlanta Laboratories

 

It is Children’s policy, approved by the system-wide Lab Stewardship Committee, that “free” testing, defined as a test for which the performing referral lab does not charge the hospital, patient’s insurance, or patient, CANNOT be sent out on CHOA inpatients, unless the test is:

  1. a clinical test performed in a laboratory under its CLIA license, AND
  2. not available elsewhere, AND
  3. equally and readily available to ALL CHOA patients under an institutional account.  

Orders for tests that do not meet these criteria must be collected in the outpatient setting in which CHOA lab serves as a “pass-through” to the receiving referral lab. CHOA will charge a standard phlebotomy processing free if a CHOA phlebotomist collects the specimen.  Please direct any questions to Dr. Elizabeth Weinzierl at 404-785-4552 or elizabeth.weinzierl2@choa.org. The policy can be found here on the Careforce website:
 
Laboratory Policy 23079.5108: Reference Lab Testing Rules, Exceptions and Algorithms
 
April 2024:
 
  • Thromboelastographs: In May 2024, orders for thromboelastographs will be changed to an order set to accommodate a new and simultaneously offered tests on the new TEG 6s instruments. See below.  
    • Real-time graphs will be available via new TEG manager software which is available through the web browser or via the Citrix portal.
    • With the addition of the TEG 6s, the following orders will also be discontinued: 
      • Thromboelastograph-On Pump Citrated 
      • TEG if on Heparin RX/contamination 
Staff in impacted groups will receive training between Thursday, May 2, and Friday, May 17,2024.
For quesitons, please contact Ahmed Aljudi, MD.
 
New TEG Order set:
 
  • Differences between the current TEG 5000 instrument and the new TEG 6s instrument:
    • The new TEG 6s instruments will have different reference ranges from the current TEG 5000 instruments for each of the results it generates, but the numeric values for each result are clinically similar in meaning. 
      • For example, an R time of 16 minutes has the same clinical meaning for the patient regardless of whether it is generated by the TEG 5000 instrument or the new TEG 6s instrument.
    • Please see the differences in technical ranges between the two instruments below
Analytes TEG 5000 technical range TEG 6s technical range
R (reaction) time to fibrin formation 0 - 120 min 0.4 - 17* min
K (kinetic) time to fibrin cross-linkage 0 - 120 min 0.5 - 5.0 min
Angle (cross-link rate)of clot formation 0 - 90 degrees 39 - 83 degrees
MA (Maximum Amplitude) of clot formation 0 - 90 mm 40 - 75 mm
G value clot strength   <not currently done by TEG 6s with current cartridge>
EPL (Estimated % Lysis) of clot   <not currently done by TEG 6s with current cartridge>>
LY30 of clot (Heparinase) 0 - 100% <not currently done by TEG 6s with current cartridge>


Changes to Existing Lab Tests
 
  • Replaced tests (requires physicians to update affected personal preference lists): Several tests have been replaced due to change in reference lab (Mayo to ARUP initiative) or replacement of the lab test by the reference lab with a new test. Please update any affected personal preference lists. If the test is not replaced, the order will not cross to the lab system and consequently may not be seen by phlebotomists for collection.
Test REPLACED   Test Code  New or Existing Replacement Epic Order   Test Code  Date of Change 
CULTURE LEGIONELLA  CULEGI  Legionella spp PCR LEGPCR  4/18/2024 
Non-Urgent Care Locations ONLY:*

Pinworm Prep		 PINWM Pinworm Microscopic Exam PINWA 4/25/2024 
HIV-1 RNA Quantitative PCR HIVQN HIV-1 RNA Quantitative NAAT HIV1Q Expected:
4/30/2024 
Factor 8 Assay Low LF8 Factor 8 Assay Low Level Quantitation LFACT8 Expected:
May 2024 
*PLEASE NOTE: Urgent Care locations will continue to order PINWM for Pinworm prep.
 
  • Updated tests: The following tests have minor changes to one or more of the following: order questions, process instructions, reference links, display names, results, etc. If these tests have defaulted selections for order questions in personal preference lists, they may need to be updated to prevent errors.
Test Name  Test Code  Date of Change  Elements Changed 
Autoimmune Encephalopathy Eval CSF >=18y  ENCEC      4/1/24  Results updated by the reference laboratory (Mayo) with a new result for IFA notes.. 
Thromboelastograph (TEG 5000) TEG  Expected May 2024  Updates to display name, order questions and process instructions. Will only be available via order set (see above) as of the go-live date. 
TEG 5000 if NOT on Heparin RX or contamination  TEGNH  Expected May 2024  Updates to display name, order questions and process instructions. Will only be available via order set (see above) as of the go-live date. 
Culture Stool Vibrio (IC Lab)  CUVIB Expected May 2024  Updates to display name and performing laboratory

 
  • New tests: 
Test Name  Test Code  Date Added  Comments 
Thromboelastograph (TEG 6s)  TEG6S  Expected May 2024  New test - see announcement above. 

 
  • Tests inactivated without replacement:
Test Name  Test Code  Date Inactivated  Reason 
Thromboelastograph-On Pump Citrated  TEGOP  Expected May 2024  See announcement above. 
TEG if on Heparin RX/contamination  TEGHEP  Expected May 2024  See announcement above. 
 

The lab continues to optimize additional lab tests not listed in this update with minor changes which do not require personal preference lists to be updated. Thank you for your patience. The lab also is working toward making all lab test orders available in all locations. If an inpatient lab test order is not available for your outpatient, submit a Solution Center ticket to the Laboratory Information System (LIS) team. Contact Alexis Carter, MD, with questions.

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