Oregon State Society of American Medical Technologists FALL/ WINTER 2013 VOLUME 30 NUMBER 2

Transcription

1 Oregon State Society of American Medical Technologists FALL/ WINTER 2013 VOLUME 30 NUMBER 2

2 Marilyn Albertsen, MT - President Audrienne Whitley, MT- Secretary Edna Anderson, MT- Treasurer Term expires Dec 31, 2014 Term expires Dec 31, 2014 Term expires Dec 31, Hwy Salt Creek Rd 1397 Redwood St NW Astoria, OR Dallas, OR Salem, OR (503) (503) (503) bayberry428@gmail.com audmelwhit@aol.com ema46@comcast.net William Dettwyler, MT Susan M Beard, MT Louise Isbell, RMA Board Member/ Co-Editor Board Member/ Co-Editor Board Member Term expires Dec 31, 2014 Term expires Dec 31, 2015 Term expires Dec 31, Sunnyview Rd NE 569 Eagle Feather St NW 198A W Woodside St Salem, OR Salem, OR Grants Pass, OR (503) (503) (541) wdettwcpt@aol.com beard74@earthlink.net ldisbell@gmail.com Ken Hawker, MT Western District Councilor hawkerke@aruplab.com Kim Cheuvront, PhD National AMT Judiciary Councilor kimcheuront@fghi.com 2 P a g e

3 LEGISLATIVE REPORT William K. Dettwyler Legislative Chair Clinical laboratories and also anatomical Pathology labs are still much in the news, especially on a national scale where money is involved. Within the last two years our two largest national labs have paid to the state of California over 290 million dollars. This year there is another large scale lawsuit that involves a few East Coast and Midwest states with at least one of these labs. On the government s regulatory issue we see very ominous signs that there may be a large scale drive to evaluate all lab services which would allow the government to lower prices and again reduce lab fee schedule allowances, but on a much greater reduction than previous years. Government analysts feel that the Laboratory industry has been able to perform testing more affordable than in 1984 when the Medicare fee schedule was developed. Some of this may be true because of a lean process that was applied to every facility but they don t realize that the automated equipments and labor costs have also increased. Laboratories were getting cost of living adjustment yearly, but that stopped and was replaced with an annual reduction. This is due to the Labs being the cash cow that CMS has been milking to dryness. Last year anatomic pathology got taken to the cleaners when they reduced payments on the technical component of the most prevalent AP code (88305) by 52%. Last June 30, 2012, the Grandfather Clause expired which has hit small hospitals hard by having to now pay the pathology departments for that technical portion. Previously, certain Pathology Labs were able to bill Medicare directly for the global charge. Molecular Pathology coding and reimbursement issues have been a source of embarrassment for the government and a financial disaster for laboratories this year. Many were not paid for 6 months and then some that were getting paid were getting much lower pay than last year. Also the number of denials were much higher and many of the codes had no listed allowance and now near end of the year CMS is finally coming out with some allowances. In previous years most new lab codes were cross walked to present codes, while in 2012 CMS decided to gap fill most of their new 2013 codes. This ended up being a nightmare and a colossal failure. Laboratories were not getting paid and not being informed how to bill and payers were also unsure how to proceed. This has caused at least one new molecular laboratory to fold up their 100+ million dollars operation and shut it down with a great loss. Many laboratories have had severe financial difficulties due to mismanagement by the government. Whistleblower suits are becoming very prevalent. Laboratories need to be very discrete and honest in their business operations and dealings to prevent such large scale lawsuits. It also tarnished the honest Labs when a few bad apples set a bad example. TABLE OF CONTENTS ORSSAMT Officers 2 Legislative Report 3 President s Message 4 District Councillor s Message 5-6 Notes from the Editors 7 National News 8 Articles Lab in Marketplace ISBT 9 10 Vitamin D 12 3 P a g e

4 PRESIDENT S MESSAGE Summer is at an end and the children are back in school. It is time to get actively involved in your State Society. Start by voting on your choice of Officers for the year You are never too young or old to get involved. Take a minute to vote. Please let us know what topics you are interested in hearing more about. The Oregon Spring Seminar has 32 speakers, so let us hear from you. Come to the beach (Newport) in May. There is much to see and do for the whole family. You can even bring your pets, as the hotel is pet friendly, just ask. And finally, I ve requested Proclamations signed by the Governor of Oregon for the National Medical Assistant Week. So look for a copy to download from our site in the near future. Due to several state societies (OHIO, OKLAHOMA, OREGON) having similar initials, we decided to make Oregon easier to identify. We are now ORSSAMT. Marilyn Albertsen ORSSAMT President 4 P a g e

5 Western District Councillor s Message FALL 2013 The Steaming days of summer are slowly beginning to give way to the more moderate days of fall. Here in the west many have been pummeled by drought and horrific wild fires this year. Many of our AMT family have been challenged by life changing personal and family issues. Sometimes, the shares stress of these events make it difficult to focus on other things in life. As I sit down to write this message I am thinking of many of you that have shared with me the drama and trauma of life. I want you to know that I understand the need to prioritize your time and attention in areas other than AMT. Please know that you and your contributions to your local state society are noticed and deeply appreciated. There are many things about AMT that I would like to share with you in this message. As I left the National Meeting in Pittsburg I was impressed by the dynamic energy and positive attitude of our Western District members that were able to attend. I would like to thank our Western District members for your support of my candidacy for the AMT National Board of Directors. As I am sure you probably know, I was not elected, but I don t feel that I lost. I knew I would be a winner however the election turned out. I am honored to continue serving as District Councilor for the greatest District in the entire nation. Speaking of the National Board of Directors, the newest are Christopher Seay and Peggy Oiler. Jeannie Hobson (CASSAMT) was reelected for full three year term. The BOD officers remain the same as last year. The newest member of the AMTIE Board is Dorothy Mimi Roush (formerly of Arizona) and Charles Baker. Marty Hinkle (RMSSAMT) has moved from the AMTIE Board to serve as Chair of the Scientific Committee. Our Western District state were once again well represented at the Wednesday night Awards Convocation. Those receiving recognition were: DeAlmeida, RMA, RPT, AHI (CA)- Medallion of Merit; Sujanalatha DeAlmeida, Ken Hawker, MT (UT), Fred Morley, MT (AZ) and Sheryl Rounsivill, RMA, RPT, CMAS, AHI (CA)-Exceptional

6 Merit; Jeri Bond RMA, AHI (CO)- Pillar Award; Jennifer Dillard, RMA (CO) and Patrick Watkins, RMA (UT)- Distinguished Achievement Award; Barbara Garrido, RMA (CO) and Barbara Ware, MT (NM)-Silver Service; Roxanne Erskine, MT (WA)- O.C. Skip Skinner Uniformed Services Award; Michelle A. Stone, RMA student (CO)- Norm Fankel Outstanding Student; Henry Oh, Editor (NM)- 3 rd place Journal; Dr. Teresita Hacuman, Editor (CA)-1 st place Newsletter. Six of our state societies earned Honor Roll status this past year- AZSSAMT, CASSAMT, NVSSAMT, NMSSAMT, RMSSAMT and UTSSAMT. A student highlight at the meeting in Pittsburg was the first annual Student Bowl. This was birthed by an idea from our CASSAMT society with Dr. Teresita Hacuman and Sujanalatha DeAlmeida serving as midwives for the event. We are hoping to see this in an expanded format at the 2014 National Meeting in Chicago. Several states responded to the North Carolina storyboard challenge. These were judged by the North Carolina delegation and the top awards went to Oregon-1 st place and California-2 nd place. There are many new things taking place in our national office. By now you should be finding a bi-monthly newsletter about significant events involving AMT. If you are not receiving these blasts please take the time to go online at and verify that your correct address is listed under your person profile. A second news item involves the every expanding array of on-line educational products available on the national web site. Rather than my listing them here I would encourage you to take time to navigate the web site and see all that it has to offer. Many members have commented on the sometimes difficulty of navigating the AMT website. Our national staff members have heard these comments and are diligently working to upgrade the site and provide a much more user friendly format. Finally, it is not too early to begin planning to attend the next year s national meeting at the Drake Hotel in Chicago, July 6-10, We will be celebrating AMT s 75 th anniversary. The hotel rates have been announced at $125 per night. This will be followed by a family vacation trip to the beautiful state of Hawaii, June 21-26, We will be the only people at the resort for the time of our meeting. The rates of $169 per night will be honored for three days prior and three days after the meeting for those who want an extended vacation. As always, I am honored to send you this message as your Western District Councillor. Ken Hawker, MT-AMT Western District Councillor 6 P a g e

7 Notes from the Editors Desk Autumn is now here and just recently the NWMLS was held in Lynnwood, Washington and the attendance was good, but certainly not what it could be. The programs were excellent but could have used a lot more attendees. Looking forward to the spring state meeting in Newport, to be held on May the 16 & 17 at the Hallmark on the Pacific Coast. We are looking forward to and encouraging our members to attend this Spring Meeting that goes back years and years, I can remember attending in the late 50 s. This is only one of the two times in the year that we can meet and network with our friends while making new acquaintances or renewing old ones. We strongly encourage you to make the effort and come join us for this Spring Blast. Congratulations to Edna Anderson Golden Microscope Award from the National Convention last July held at Pittsburg, PA. We are so proud of you!!! Please congratulate her for her finest work and her achievements. It is an honor to be working with her, and be associated with her as part of the ORSSAMT. Also we thank the judges for choosing our state to win the 1 st place for the Storyboard. Thank you all for your efforts in making this possible. Sincerely, Susan M. Beard, MT-AMT MicroScoop Co-Editor William K. Dettwyler MT-AMT MicroScoop Co-Editor 7 P a g e

8 EDNA M. ANDERSON -AWARDED ORDER OF THE GOLDEN MICROSCOPE The highest honor bestowed by AMT for outstanding organizational and professional contributions in the field of Medical Technology and to AMT, recognizing consistent superior performance throughout the years. Edna was certified in She is the current Executive Councillor and a past Western District Councillor. She is our Treasurer on the AMT Oregon State Society board of directors. She served as past president and secretary and also served as past Chair of Oregon seminars committees and member of the planning committee and registration Chair for the Northwest Medical Laboratory Symposium for 17 years ( was instrumental in starting the Symposium, a 5 state, joint AMT/ASCLS/(ASMT) meeting). She served in leadership positions for Northwest American Red Cross, and served in many national committees over the years. She also assisted in writing AMT manuals and wrote Councillor s Messages for the AMT publications in the Western District, and has attended the AMT National Convention for 30 years. She also provided leadership training seminars at state, regional, and national meetings. Her honors include Distinguished Achievement, Exceptional Merit, Becky Award, Silver Service, Pillar Award, and Technologist of the year. She has been a recipient of the Charles E. Martin award 3 times at the state level, which recognition is the highest award given in the State of Oregon. She is now retired and living in Salem, Oregon. DELEGATE CORNER Thank you for sending me as Oregon s RMA delegate this year to AMT s 2013 Convention in Pittsburg, PA. It was a very busy tim e for all. Many good sessions to select from. One of the sessions that I went was Mutations. It was very enlightening for me as I had never, so to speak, connected the dots as to why mutation happened or what caused them. Definition: A mutation is a permanent change in the DNA sequence of a gene. This can change our growth, our development and the body system functions. Gene mutation occurs in two different ways. They can be inherited from our parents or they can be acquired in our lifetime by a virus which alters the RNA sequence. Even X-rays can disturb the molecules of your DNA. Just to name a few of the things it can alter is Cystic Fibrosis, Hurler Syndrome and Down syndrome. They are caused by a nonsense mutation which is a premature stop codon in a DNA sequence. To me all of this is very complicated and complex sequence of events in the structure of our gene pool. Myostatin is a gene which limits muscle growth. Scientist are hoping to use the inhibitors to treat diseases like MS, Muscle Dystrophy. Even miscarriages can be traced back to your chromosome and genes that are affected. Basically any disease or differences in one another leads back to our DNA, our protein and chromosomes and genes creating changes. I will stop but to me it explains so much. I hope it opens your mind to the quest to know more and your heart to understand and accept each others physical and mental differences. I h ope more of you can attend next year to enjoy the fellowship of our AMT family. They are the GREATEST. Sincerely, Louise Isbell, RMA 8 P a g e

9 THE SAFETY CORNER Where is the Laboratory heading in the marketplace? Submitted by William K. Dettwyler, MT Questions and Answers on Laboratory Safety The Safety Lady has graciously given us permission to reprint here some of the questions that are asked by lab personnel. Terri Jo Gile as many of you know lives in Florida and will be retiring soon and her column will then be replaced by one from Dan Scungio as Dan the Safety Man. Question: Is there a regulation stating that eyewash can or cannot be plumbed to a dirty sink (used for disposal of body fluids)? Her answer was: Many emergency eyewash stations are located at dirty sinks in laboratories. Often, that is the location nearest to corrosive chemical in the department. Because of this, it is important to keep the safety caps on the eyewash at all times and to perform weekly cleaning. Question: Do caps from tubes need to be thrown in the biohazard waste? Also, do cotton balls after being used for a venipuncture have to be thrown in biohazard waste or regular garbage? Answer was: The decision about what is considered Regulated Medical Waste has to be a local one. First contact your RMW disposal company; they should be able to give you a clear definition of what constitutes RMW. In our state, the cotton balls used in phlebotomy can go into regular trash, and so can the specimen caps provided they were not visibly dripping with blood. Question: What is the proper method of shipping and labeling Thin Prep vials for further analysis after a diagnosis is made? Answer: For air and ground transportation, Thin Prep vials with specimens should be transported using the regulations for Risk Group 1 items. Pathogens are considered non-viable after 15 minutes in solution. The package should be labeled as Exempt Human Specimen. This is a question that is being asked. Is the Laboratory industry growing and becoming a more aggressive and individual entity and getting an identity of its own not just part of the hospital or doctor s office, or an independent lab? A new Laboratory is starting to expand into the retail market. Just recently this lab in Palo Alto is partnering with Walgreens and placing draw centers in their stores where micro samples of blood are being extracted by Phlebotomists and the specimens are being sent to their Laboratory in California. This concept was initiated by a Stanford University student and may totally change the Lab testing over time. The concept for this change is: A micro sample low charge and a convenient location. This lab s charges will be approximately 50% of the Medicare fee schedule allowance. So if a patient has a high deductible they may want to go to this alternative that gives them the best price and the convenience it brings. Medicare. If you are interested in this new concept, look up the website of Theranos Lab at and the prices will be an eye opener. Even their Board of Directors is unique for a Laboratory. This includes Henry Kissinger, the former Secretary of State, William Perry former Secretary of Defense, Sam Nunn, former US Senator and James Mad Dog Mattis, retired four star Marine General. They could run a country, not just direct a laboratory. With this board composition they are not going to be a limpid, passive entity, but most likely an aggressive, competitive lab/pharmacy model that will be a powerhouse for other laboratories to compete with. This new concept or model will be something for Laboratory administrators to ruminate over. 9 P a g e

10 By Susan M. Beard, MT Salem Hospital Recently the hospital I worked with has implemented the new blood product labeling system in Transfusion Medicine. This system is called ISBT- International Society of Blood Transfusion. It is interesting how efficient this is and improves patient safety. History of ISBT 128 In 1970 Codabar was conceived and implemented. Codabar is a linear barcode symbol developed in 1972 by Pitney Bowes Corp. It was designed to be accurately read even when printed on dot-matrix printers for multi-part forms such as FedEx air bills and blood bank forms, where variants are still in use as of In the 1980s there was a need for an international standard in blood product identification and labeling. Effort was funded by the American Red Cross and AABB. In 1990s ISBT fulfilled this need of standardization. In the 2000s, United States began to transition to ISBT 128. CBC of Kansas City went live on July 1, What is ISBT 128? ISBT 128 is a global standard for the identification, labeling, and information transfer of human blood, cell, tissue, and organ products across international borders and disparate health care Systems. The standard has been designed to ensure the highest levels of accuracy, safety, and efficiency for the benefit of donors, patients, and ISBT 128 licensed facilities worldwide. Featuring a unique, highly flexible, and comprehensive coding method for every collected product, ISBT 128 provides international consistency to support the transfer, transfusion, or transplantation of blood, cells, tissues and organs. Every blood product has a label that is divided into four quadrants. ICCBBA (formerly known as International Council for Commonality in Blood Banking Automation), administers and manages ISBT 128. Barcodes This is an example of the barcode. It is both black bars and white blank spaces. When scanned it reads the bars and spaces and converts them into zeros and ones. The zeros and ones are converted into meaningful data such as O positive, CMV Negative, an expiration date or the anticoagulant inside. 10 P a g e

11 Product Labeling ISBT 128 has a standard labeling format that ensures a consistent layout of product labels with the barcodes, and critical eye readable information such as blood groups, product description, and expiration date appearing in the four quadrant positions on the label. This will reduce the risk of confusion when multiple sources of products are being used. characteristic of these data structures is the location code which allows the reading system to identify the item from which a code was read and to distinguish electronically between from a cross match label or a patient identifier scanned from a wrist band. This will permit a high degree of control over the verification process. 1. Donation Identification Number 2. ABO/Rh Blood Groups 3. Product Code 4. Expiration Date and Time 5. Special Testing Safety at the bedside improves. One of the prime causes of incorrect transfusion is the risk of error due to misidentification at the bedside. ISBT 128 data structures have been developed to hold patient critical information including date of birth and hospital number. A very important It has been easier to allocate or set up blood products to our patients because we only scan the unit number and the information just auto fills. We don t have to scan every barcode on each unit. 11 P a g e

12 VITAMIN D Provided by William K. Dettwyler, MT Many of you in the lab have heard about the myriad of important functions associated with or contributed to Vitamin D and it is not even a vitamin, it is a steroid hormone. This short report will cover some of the actual results described by a trauma surgeon who tried an innovative approach in the treatment of patients in a large hospital and how his patients have benefitted. This report should be shown to every member of the hospital and medical staff that you work for, as it shows the results of a study led by Dr. Matthews and just recently published by the American Journal of Surgery defining the benefits of the use of vitamin D in critically ill patients. Dr. Matthews is also writing a manuscript on the use of vitamin D in reducing the incidence of congestive heart failure. He has indicated that they are able to reduce the readmission rate associated with this condition by a very large percentage. This should make your hospital administration take interest in this report. Working in the clinical laboratory you can frequently affect which testing is readily available and will be beneficial to aid in the patient s quick recovery. As Dr. Matthews has indicated, at his hospital the mortality rate is down 42% with critically ill patients for all traumas with their new vitamin D protocol. If you can aid in helping with the quicker recovery of patients with supplementation with something as simple as vitamin D, do not hesitate to get this information out. There is also information out that the persons with an adequate 40 to 70 ng/ml level of vitamin D are much less susceptible to the Flu. Hospitalized patient s vitamin D level will usually drop during the first hours after admission and this makes them even more prone to hospital acquired infections. If your level of vitamin D drops below 18 ng/ml a study has shown that your risk of death increases by 30%. With a large population already at a deficient level supplementation with vitamin D is very important. I could go on and on describing the benefits of vitamin D supplementation but the information is available and we must encourage the medical community to act on this valuable information and put it to use. The labs that are already performing the testing in-house should be able to place this information and a reference to the article by Jon Finkel on the Vitamin D Story just recently published in the October Issue of Life Extension. The article is titled Dr. L. Ray Matthews Unleashes the Power of Vitamin D. (Information derived from Life Extension Publication) CALENDAR Oregon Spring Seminar Newport, Oregon May 16-17, 2014 National Convention Chicago, Illinois July 6-11, 2014 The MicroScoop Statement Policy is published two times a year under the sponsorship of the Oregon State Society of American Medical technologists- Allied Health Professionals. The opinions expressed in this publication are those of the contributors and are not necessarily those of AMT or ORSSAMT. The Editors reserves the right to edit any submitted material. Contents are not to be reproduced or reprinted without permission of the Editors. MICROSCOOP THE OREGON STATE SOCIETY OF THE AMERICAN MEDICAL TECHNOLOGISTS-ALLIED HEALTH PROFESSIONALS- 12 P a g e

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