SLIDE 1 An Advanced Consultation System for Hospital Laboratories:
Steven Hinrichs, MD, Director, Nebraska Public Health Laboratory Ann Fruhling, PhD, Assistant Professor, UNO Anthony Sambol, M.A., SM (NRM), Assistant Director, NPHL Josh Rowland, MBA, MT(ASCP), State Training Coord., NPHL
STATPack TM
SLIDE 2
Washington Washington Minnesota Minnesota Nebraska Nebraska Michigan Michigan
National Laboratory System- State Lab Demonstration Projects, 2001
SLIDE 3 Nebraska LDP Project goals
– Clinical Laboratories, Infection Control, ED
- Internet Connectivity
- Provide consultation and training
– Expertise on testing methodology – On-site training – Distance consultations
SLIDE 4 NE-LDP: Obstacles and Challenges
– Most labs connected only by phone
– Large geographical area similar – “Distance” barriers for rapid testing – “Distance” barriers for consultation
– Many hospitals without Internet connection in the laboratory
SLIDE 5 86 Hospital Laboratories
10 3
NPHL Level-B/C Laboratory 4 Full-time Health Departments Nebraska, Summer 2001: No true “Network” – 86 hospital labs, six “service areas” and four full-time county health departments.
SLIDE 6 Created
“Laboratory Needs
Assessment Tool” addressing:
- Communication- how
- Technology- what
- Education
- Protocols
- Contacts
SLIDE 7 Laboratory Capacity in Nebraska 86 Hospital Laboratories
A (n =14) 15% B (n =7) 7% A- (n =21) 22% Basic Capacity (n=44) 51% Collect and refer ID, no BSC ID and BSC Advanced ID
State-wide Assessment Results:
SLIDE 8
LRN Level-A Laboratory Training, Fall, 2002
11 Sessions, 7 Locations, 104 Laboratorians, 74 out of 86 Hospitals
SLIDE 9 Pre-Training Post-Training
Yersinia pestis Francisella tularensis Brucella spp. Bacillus anthracis
100% 79% 100% 64% 100% 71% 100% 71% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Level-A Laboratories Familiar with Cultural and Morphological Characteristics of Select Agents
Training impact seen:
SLIDE 10 NE-LN Basic Capacity Laboratories
10 3
NE-LN Level-A Laboratories NE-LN Level-B Laboratories NPHL Confirmatory Laboratory Training, supplies, protocols for Smallpox rule-out testing, 2002 & 2004
SLIDE 11
CONNECTING TO THE LABORATORY ELECTRONICALLY NHHSS Focus Area E: HAN
SLIDE 12 Hospital Laboratories in Nebraska with Computer Connectivity
2001 (23)
5
26% Hospital Laboratories had Connectivity pre 9/11/2001
86 Hospitals 93 Counties
SLIDE 13 Hospital Laboratories in Nebraska with Computer Connectivity
2001 (23) 2002 (51) 2004 (81) 2005 (1)- fax only
5 4 5 5
99% Hospital Laboratories have Internet Connectivity in 2005
85 Hospitals in 73 Counties
SLIDE 14
www.nphl.org
SLIDE 15
Enhanced Communications & Diagnostic Capabilities
STATPackTM
SLIDE 16
STATPack™ Secure Telecommunications Application Terminal Package
SLIDE 17
Strategic Planning Session
SLIDE 18
STATPackTM Hardware- Prototype
SLIDE 19
STATPackTM Hardware- Phase 1
SLIDE 20
Bio-image Capture Unit
SLIDE 21
STATPackTM Hardware-Phase 2
STATPackTM with Macroscopic Image
SLIDE 22
STATPackTM with Microscope Image
SLIDE 23
Hospital Lab STATPackTM Home Page
SLIDE 24 Scenario 1:
A laboratory has an unusual organism growing
- n culture and would like consultation from the
NPHL.
Sending Messages and Images to the NPHL
SLIDE 25
Capture Image - Macroscopic
SLIDE 26
Sending an Image to the NPHL
SLIDE 27
Capturing a Microscopic Image
SLIDE 28
Image Display Window
SLIDE 29
Sending an Image to the NPHL
SLIDE 30
NPHL STATPackTM Home Page
SLIDE 31
NPHL Message History
SLIDE 32
Retrieving a Message from a Lab
SLIDE 33
Retrieving a Message from a Lab
SLIDE 34
Retrieving a Message from a Lab
SLIDE 35
Scenario 2:
The NPHL identifies a specimen that is of suspicious nature and determines that labs should be notified of their concern.
Send Message to Laboratory Sites from the NPHL
SLIDE 36
Sending a Message to Selected Laboratory Sites from the NPHL
SLIDE 37
Sending a Microscopic Image
SLIDE 38
Hospital Laboratory: Message History
SLIDE 39
Messages History-
Expanded Detail Window
SLIDE 40 Scenario 3
Hospital microbiologist encounters an highly suspect
- rganism on specimen culture or Gram stain.
Emergency Contact to the NPHL
SLIDE 41
Emergency Contact Page
SLIDE 42
- Image History
- Electronic Textbook
- Remote LabCam access
- Server (NPHL) System Administration Services
– Electronic Consultation Management – Email Contact Information Management – Emergency Contact Information Management – System Status/Availability Information
- Hospital Laboratory STATPack™ Status
– System Status/Availability – Electronic Textbook – STATPackTM Information
Other Features:
SLIDE 43 Phase 1-STATPack Units (7): NRI Funding Phase 2 -STATPack Units (3): APHL/CDC PPLIP- UNL Veterinary, NDA Food and NHHSS Water Phase 3-STATPack Units (10): HRSA funding
3
SLIDE 44 Ne-LN Basic Capacity Laboratories
10 3
Ne-LN Level-A Laboratories Ne-LN Level-B Laboratories NPHL
Complete networking of the Ne-LN; a 500 mile wide laboratory network
SLIDE 45
SPHLs in the Central Plains States
SLIDE 46
SLIDE 47
STATPackTM System Team
SLIDE 48
STATPackTM System Team
SLIDE 49 Steven Hinrichs, MD Ann Fruhling, PhD Tony Sambol, MA, SM(ASCP) University of Nebraska at Omaha Nebraska Public Health Lab Peter Kiewit Institute UNMC 1110 S. 67th Street 986495 Nebraska Medical Center Omaha, NE 68182-0500 Omaha, NE 68198-6495 402.554.4968 402.559.7203 afruhling@mail.unomaha.edu shinrich@unmc.edu asambol@unmc.edu
Contact information:
