Leadership Summit
Laboratory Medicine Leadership Summit
Welcome from Kath Hayden, President ACB
Welcome from Kath Hayden, President ACB
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
A warm welcome to the inaugural Laboratory Medicine Leadership Summit developed by the Association for Clinical Biochemistry and Laboratory Medicine and hosted for the first time at the IBMS Congress.
The introduction to the meeting will overview the current challenges that senior laboratory staff and managers face and highlight new developments in laboratory medicine, particularly the role laboratory medicine plays in improving patient care and the journey towards achieving Net Zero
Speakers
Kath Hayden
Blood Sciences: not AI yet but evolving
Blood Sciences: not AI yet but evolving
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
NHS Tayside and University of Dundee have developed the Intelligent Liver Function testing programme (iLFT) which, whilst not an example of Artificial Intelligence (AI), provides an example of a stepping stone on the evolution to AI within routine NHS laboratories. How can such a programme be developed from scratch? Identification and understanding of the problem that requires to be addressed (including increasing deaths from liver disease, too many LFT results to handle, complex guidelines) are explored, along with how to get the experts to agree on a possible solution.
The formation of a multidisciplinary team of subject matter experts is paramount to the approach, including laboratory experts who fully understand the complex systems required to deliver an automated approach to the problem .i.e. how to convert the expert opinion into an automated laboratory algorithm.
Laboratory infrastructure for this ideally includes automated analysers on tracking systems, and an order communications system that can handle url links for access to in depth advice. The algorithm for iLFT was applied to historic laboratory data prior to testing in a formal step-wedged clinical trial in Primary Care. Health economic analysis of such new ways of working is recommended. Once embedded in clinical practice, ongoing audit and development ensure constant evolution through human, if not machine, learning, with iLFT now approaching its fourth iteration.
Speakers
Dr Ellie Dow
NPIC’s unique scanning facility for AI testing and development
NPIC’s unique scanning facility for AI testing and development
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
Artificial intelligence (AI) has potential to revolutionize pathology diagnosis; accuracy is dependent on the training dataset. Sensitivity to input changes reduces real-world performance. Generalizable AI requires diverse data obtained from multiple sources, scanners, and staining platforms.
To address this problem, NPIC have created a unique multi-scanner facility, the NPIC AI FORGE (Facilitating Opportunities for Robust Generalisable data Emulation). This facility comprises 15 scanners from 8 vendors as follows:
Leica Biosystems (3 x GT450s, 1x AT2), Roche (DP200, and DP600), Hamamatsu (S360MD, S60, S60v2, and S20), 3DHistech (P250 Flash), Olympus (VS200), Objective Imaging (Glissando), OptraScan OS-Ultra 240, Akoya PhenotImager HT.
The NPIC AI FORGE has broad capabilities including high-capacity WSI brightfield scanning of 1x3 inch slides; 3x2 inch slides; multiple magnification capture; z-stacking across 3 instruments, and WSI fluorescence scanning. The NPIC AI FORGE can generate over 3500 WSI images per day, equating to over 5Tb of data. The NPIC AI FORGE is supported by a research image management system, and secure research data repository with 15 petabytes of backed up storage, and disaster recovery mitigations, ensuring the safety, security and longevity of all digital pathology data generated. Our PACS system presents as an easy to access online portal for rapid QC, viewing, annotation, project creation and sharing, and download.
The ability to compare multiple scanning platforms provides an opportunity to map differences between image data sets, to accurately measure the impact this has on AI specificity. We are able to accurately QC each system to specific calibration settings, ensuring robust and reliable data for AI training. Furthermore, unlike other areas of healthcare, slides can be re-scanned multiple times, which offers an opportunity develop high-quality cross-platform AI. To our knowledge, this is the only such digital pathology facility in the world.
Speakers
Dr Matthew Humphries
The Future of Laboratory Services
Consumer Driven Testing - Help or Hindrance
Consumer Driven Testing - Help or Hindrance
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
Direct to Consumer Testing (DTCT) has been expanding across the UK in recent years. This is partly due new technology becoming available, private sector appetite for profit and increasing demand from patients to take more control of their own health and fill the gap left by an increasingly rationed NHS. There are however significant issues associated with such expansion. A relative lack of regulation of products becoming available flags up potential quality issues - especially for at home point of care testing kits purchased over the internet. Test appropriateness is also questionable, with large panels of tests (2-300) being offered in some instances, which inevitably will flag up many false positive results.
The lack of interoperability with NHS databases and method differences will inevitably mean such DTCT results will not be comparable or incorporable into NHS patient records. Patients turning up to GP practices with pages of test results will impose an additional burden on the NHS at a time when it is already under huge pressure. Policy and guidance on regulation, quality, appropriateness and incorporation into patient records will be needed to ensure patient care is optimised.
Speakers
Dr Bernie Croal
Importance of Laboratory Informatics
Importance of Laboratory Informatics
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
Laboratory Medicine is exemplary in its quality management, its efficiency, its informatics and its educational attainment… within the walls of the laboratory. But in the stages of the request-report cycle that lie outside the error rates are higher and the responsibilities and accountability much less clear.
Requesting is predominantly performed by clinicians under great pressure. But we know that computerised decision support can safely help.
Viewing of reports is done with error rates that we would consider totally acceptable within the laboratory. But we are implementing clinical information systems that do not support escalation on failure to view, and there are few current trials of computerised decision support that might make some viewing by staff unnecessary.
The value and appropriate use of point of care testing is being increasingly understood. But we are still procuring systems that do not automate the transmission of reports or support remote management of devices and stocks.
Viewing of reports by patients is becoming more common in the UK. But reports are being displayed that do not help the patients to understand what they mean, despite Lab Tests Online UK having been available for many years.
The good news includes renewed work on data standards, the cross-tribal collaboration seen in parts of the NHS Virtual Wards programme and similar local initiatives, and the recognition that moving investigations upstream can help in earlier diagnosis of cancer.
The technological tools that support and can improve all of these are becoming cheaper and easier to implement. But they will not be implemented rapidly or at scale until we have a radically different approach to responsibilities.
Speakers
Professor Jonathan Kay
Results direct to patients - getting the language right
Results direct to patients - getting the language right
The Association of Clinical Biochemistry & Laboratory Medicine
Learning outcomes
This presentation will explore the adaptations needed to ensure patients can understand and utilise their results.
Background:
The move to start providing patients with direct access to their results introduces challenges around how these results are relayed. Getting the language right will be key to ensuring that these results are understood by patients, enhance self-monitoring and self-management, and prevent additional anxiety. But what is the ‘right language’?
What will happen in this session?
In this session we will consider why it is so important to get the language right, review examples of common words and phrases that may prevent understanding, cause misunderstanding or raise concerns, and discuss alternatives and potential solutions.
Speakers
Lindsey Brown
Tapping into the potential for Laboratory Information Management Systems to improve patient care
Tapping into the potential for Laboratory Information Management Systems to improve patient care
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
The laboratory information management system (LIMS) is an important repository of healthcare data. There are billions of points of diagnostic information across many healthcare domains in a typical LIMS.
The LIMS fulfils many roles in the laboratory e.g. managing and running the laboratory. However, laboratories are information generators for patient records and LIMS need to take a more active role extracting value out of all tests and ensuring that those patient records are populated with high quality, actionable and transferable information.
eGFR and AKI scoring are simple examples of where valuable information is extracted out of simple tests. This type of functionality is likely to expand and be in bigger demand. The LIMS need to support this activity.
The key to unlocking this data is structured data which is coded to recognised standards.
Speakers
Craig Webster
Our NHS, Our Net Zero – how industry and laboratories can work together
Our NHS, Our Net Zero – how industry and laboratories can work together
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
Our NHS, Our Net Zero – how industry and laboratories can work together is intended to examine how industry and laboratory teams can work together to achieve Net Zero targets in collaboration, to show how working in partnership and considering tender specifications carefully can mutually benefit everyone whilst maintaining a competitive element and deliver value.
From April 2022: all NHS procurements will include a minimum 10% net zero and social value weighting. The net zero and social value guidance for NHS procurement teams will help unlock health-specific outcomes (building on PPN 06/20).
From April 2023: for all contracts above £5 million per annum, the NHS will require suppliers to publish a carbon reduction plan for their UK Scope 1 and 2 emissions and a subset of scope 3 emissions as a minimum (aligning with PPN 06/21).
Speakers
Helen Dent
The first steps towards a sustainable laboratory; a great LEAF forward
The first steps towards a sustainable laboratory; a great LEAF forward
The Association of Clinical Biochemistry & Laboratory Medicine
Abstract
Climate change is the greatest challenge facing the planet and the healthcare sector is directly responsible for approximately 5% of the total CO2 emissions of the United Kingdom. Laboratory testing is vital and most patients interacting with healthcare will be tested. These are performed in huge numbers; the NHS processes over 1 billion tests annually in England alone. More than half of this carbon is indirectly associated with the use of consumable items, such as single-use plastics that are required for these tests.
The NHS has set an ambitious target to be completely carbon neutral by 2045. This means that it needs to vastly reduce its energy consumption and change how it works. Laboratories, who largely manage these tests, consume a lot of energy, water, and single-use plastics, and generate vast amounts of waste. Testing extends far beyond the laboratory. The whole process spans from the decision to perform the test in the first place, taking the sample, transporting it to where it will be tested, the testing itself, the interpretation and action of the results, and of course the vast amounts of waste generated along the way.
The microbiology laboratory at Lancashire Teaching Hospitals established The Microbiology Greens (The MG’s) to set about making our service more sustainable. We participated in a pilot of LEAF (Laboratory Efficiency Assessment Framework) from University College London. This provided a clear framework so that we could target our efforts on educating our team, and reducing waste and energy consumption. We also undertook a diagnostic stewardship project to reduce the processing of inappropriate samples.
Speakers
Dr Rob Shorten
