Ebola What Happened to the Science? Ebola: The Facts

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American Society for Clinical Laboratory Science November/December 2014 Volume XXVIII, Number 10 Ebola What Happened to the Science? On November 6, Dr. Toby Merlin, Director of the Division of Preparedness and Emerging Infections at the CDC presented an overview on the Ebola emergency, the healthcare community response, testing at CDC and the Laboratory Response Network (LRN), and the CDC guidance for clinical laboratories. Dr. Merlin described the CDC s work and response to the Ebola epidemic in West Africa, giving the latest data on the total number of cases per country and the mortality in each nation. In reviewing the cases in the United States, Dr. Merlin discussed the viremia pattern and the appropriateness of laboratory tests available to detect infection as well as the general laboratory findings early in the disease and with its progression. Real time PCR should be used to diagnose Ebola and will detect the virus within days of the onset of symptoms. FDA has granted emergency use status to three government developed methods and the BioFire Biothreat E test which is available to hospitals. He also stated that CDC has developed interim guidance for laboratory and other healthcare personnel collecting or handling specimens from suspected or confirmed Ebola patients and made it clear that Specimens should NOT be shipped to Laboratory Response Network labs or the CDC without consultation with local/state health departments and CDC. In addition, Dr. Merlin pointed out some problems that arose during the routine testing: Lack of data on safety of routine clinical laboratory procedures for Ebola specimens Ebola is considered a BSL-4 agent and most clinical laboratories are BSL-2 labs Lack of data about decontaminating laboratory instrumentation No organization evaluates, monitors, or approves clinical laboratory instruments for blood-borne pathogen safety Information given out by some manufacturers stated that testing Ebola specimens would invalidate warranties or render instrument unusable He summarized the need for ways to ensure that clinical laboratories are prepared for biological threats and emerging infectious diseases by assuring the safety of our instrumentation and compliance with standard and OSHA precautions. ASCLS will be working with other organizations and cooperating with the CDC to ensure that we are all ready for the next challenge. We will keep you posted! Ebola: The Facts President s Message Legislative Symposium Omicron Sigma Membership Awards Today s Agenda 2 3 4 4 Continued on Page 10 ASCLS members James Griffith, PhD and Rodney Rohde, PhD both highly respected in the fields of infectious disease and public health, have written a comprehensive article on the Ebolavirus and the implications for clinical laboratories. This is a must read for all of us in the medical laboratory professions because it explains the science and enables every one of us to calmly and scientifically explain this disease to everyone else the healthcare team, the public and our families. The announcement about the article is on the front page of the ASCLS web site and the article can be read at http://www.ascls.org/images/ publications/journals/ebola_virus_manuscript.pdf Official Sponsors Need CE?//Tenure Track Position Statement of Ownership CMM 5 6 7 11

2 ASCLS Today November/December 2014 FPO President s Message Susanne Norris Zanto, MPH, MLS(ASCP) CM SM ASCLS President 2014-2015 Consumer Advocacy: We Have a Role and a Responsibility I promised, during my speech at the Annual Meeting, to explain in more detail the ASCLS Strategy Canvas, and how the Board feels we can set ourselves apart from other laboratory professional organizations. Today s article is going to focus on enhancing our consumer advocacy role through outreach to patients and members of the healthcare team. Many years ago, when I was completing my CLS internship, we visited my uncle s ranch near Glacier National Park as they were rounding up the wild horses on their land to brand, castrate, and vaccinate. My relatives didn t quite understand what I was being educated and trained to become, but they knew it was part of the medical field. So, I was put in charge of the 12 gauge needle, the glass syringe, and a bottle of vaccine. When the ranch hands had roped the young horse and gotten him under control, I jumped into the corral, ran to the horse, stuck the needle in, and gave them the shot. I have since realized that was the beginning of my becoming the family expert in all things medical! Has your family or friends asked you to help them understand their interaction with the healthcare system? Do you get called upon to help interpret a laboratory test result, or why the doctor didn t want to prescribe an antibiotic, or if the CBC result is normal? If you answered yes, you are being a consumer advocate. Years ago, a group of ASCLS members who specialized in hematology realized there was an unmet need - patients needed help in understanding their laboratory test results. Many times patients left their doctor appointment with unanswered questions, or they didn t think of the questions until they had gotten home. This forward thinking group of dedicated volunteers decided to develop a website where patients (consumers of healthcare) could write in with their questions, and someone from the group would provide answers in plain language they could understand. Thanks to Susan Leclair and the other like-minded hematologists, the Consumer Information Web Team was born. These clinical laboratory scientists found the service was so popular they were getting more questions than they could handle. So, they devised a process for answering the questions. There would be a team, with a team lead for each day of the week, made up of clinical laboratory scientists with expertise in the disciplines of hematology, chemistry, immunology, and microbiology. These team members were trained and mentored prior to answering consumer questions. I have been lucky enough to join this team as a microbiologist, and it is one of the most rewarding professional duties I have. We get an opportunity to explain to folks that their results are perfectly normal, or if they should seek healthcare. ASCLS has since partnered with LabTestsOnline (LTO), and the Consumer Information Web Team also answers questions submitted through the LTO website. This service has become so successful that each day the questions are capped at 75, so the volunteers don t get too inundated. The Centers for Medicare and Medicaid has now mandated that patients have a right to view their laboratory test results. As more people receive a copy of their laboratory test results, more are having trouble interpreting them. A recent study by the University of Michigan School of Public Health and Medicine found that people with low comprehension of numerical concepts and low literacy skills were less than half as likely to understand whether a result was inside or outside reference ranges. These same people were also less able to use the data to decide whether to call their doctor. The format of laboratory reports were developed with the physician in mind; we did not generate our report for consumers. Continued on Page 10

November/December 2014 ASCLS Today 3 MAKE A DIFFERENCE WITH ASCLS, CLMA, ASCP, AGT & AMT! Legislative Symposium 2015 March 16-17, 2015 Washington, D.C. ASCLS IS PROUD TO WORK WITH CLMA, ASCP, AMT and now AGT on the 2015 Legislative Symposium. Joining an ASCLS tradition since 1989, CLMA, ASCP, AMT and AGT members will meet with their Representatives and Senators on Capitol Hill as a unified front on behalf of our profession. We need you!! laboratory professionals and leaders to come to Washington to provide a presence and informed voice and make our concerns known inside Congress! Issue Briefings CMS Lab Fee Schedule Project Newborn Screening Personnel Shortage and HRSA Molecular Tests Reimbursement Education, Experience, Leadership A key component of the Legislative Symposium is a guided education in the how-to s of lobbying. Our sessions will familiarize you with the organizational structure of Congressional offices, committees and staff. You will be coached on presentation techniques specifically tailored for the political environment. Newcomers will know what to expect and what to do when they arrive on Capitol Hill for appointments on day two. Everyone will return home from Washington with first-hand knowledge of the political system in action and confidence knowing you can make a difference. REGISTRATION FEE Postmarked by February 15: $205 Postmarked after February 15: $260 Online registration available at http://www.ascls.org/events SCHEDULE Monday, March 16: Registration/Continental Breakfast 7:30am, Sessions 8:00am-5:00pm, Wine Reception 6:00pm Tuesday, March 17: Breakfast 7:00am, Capitol Hill Appointments 9:00am-12:00pm, Departure 12:30pm ACCOMMODATIONS All attendees will be housed at the Hilton Alexandria Old Town, located in historic Alexandria, VA; convenient to shopping, Reagan National Airport and the King Street Metro stop (Blue and Yellow Lines). A block of rooms has been set aside for Legislative Symposium attendees and will be held until February 27 th. Accommodations are $149 for single or double rooms, plus any additional applicable taxes. To make reservations, please call the Hilton directly at 800-445-8667 and mention Hilton Old Town and the event, the American Society for Clinical Laboratory Science. Register online at www.ascls.org/events Or mail this form to: ASCLS, 1861 International Drive, Suite 200, McLean, VA 22102 If paying by credit card, you may FAX the form to 571.354.7571 OR email to elissap@ascls.org LEGISLATIVE SYMPOSIUM 2015 REGISTRATION Name ASCLS/CLMA/ASCP/AMT/AGT Member # Member # City State ZIP Email Daytime Phone # FAX# Enclosed is my payment of $ (Make check payable to ASCLS) Paying by credit card? Please complete the following: Visa MasterCard Am Ex Cardholder Name Card # Expiration Date Signature NO REFUNDS WILL BE ISSUED AFTER FEB. 19TH; THEREFORE PLEASE PLAN TO SEND A REPLACEMENT IF YOU MUST CANCEL. THANK YOU

4 ASCLS Today November/December 2014 ASCLS Omicron Sigma It will soon be time to recognize those ASCLS members who provide the Voice, Value, and Vision of our society. To do so, nominate them for the Omicron Sigma Award, the ASCLS Honor Roll for outstanding service! This award recognizes members at National, Regional, and Constituent Society levels. Nominees must be current members as of December 31, 2014. Instructions, deadlines and additional information can be found at http://ascls.org/about-us/celebrate/126-scholarships-and-awards2/omicron-sigma/102-omicron-sigma. Let your leadership know today of someone who is worthy to be nominated for an Omicron Sigma award! Deadlines are approaching fast! To minimize duplication of nominations, the Omicron Sigma nomination spreadsheet form will start with the ASCLS President, Susie Zanto, who will submit her nominees (up to 100) and share her list with the Region Directors. Region Directors will add their names (up to 15) on a different page of the same spreadsheet, and forward to their Constituent Society Presidents. Each Constituent Society will add its list of nominations to another page of the spreadsheet, and submit to the Awards Committee. At all levels, please check to see that names are not duplicated. Deadlines are as follows: ASCLS president for the national level awards: February 1, 2015 Region Directors for regional nominations: February 15, 2015 Constituent Society presidents for constituent society/state level awards: March 1, 2015 Constituent Societies may submit 8 or more nominations, depending on their membership total. Further information is available on the ASCLS.org website. Please submit the completed forms to awards@ascls.org. ASCLS Constituent Society Membership Awards These awards recognize the constituent societies that have excelled in recruiting and retaining members. Judging is by membership increase by percent in the last calendar year. Every constituent society of the American Society for Clinical Laboratory Science is eligible and automatically reviewed for their accomplishment during the past year. The membership data used will be from January of the current year and be compared with the data from January of the previous year. Recognition is given for: Greatest over-all percent in membership (all classes) Greatest increase in non-student members (recruitment of new student ) Greatest percent retention of membership in the past year. If you have any questions or concerns, please visit the ASCLS Awards and Scholarships webpage, http:// ascls.org/about-us/celebrate/119-scholarships-and-awards2/constituent-society-membership-awards or email the Awards Committee at awards@ascls.org.

November/December 2014 ASCLS Today 5

6 ASCLS Today November/December 2014 www.dcprovidersonline.com/ascls The Department of Clinical Laboratory Science, College of Health Sciences, Marquette University invites applicants for a tenure-track Assistant Professor position beginning as early as January 2015. Requirements include a PhD in a relevant field and ASCP certification. The candidate will be expected to teach undergraduate and potential graduate CLS courses and establish a successful externally funded research program. All areas of CLS expertise will be considered. Interested candidates should apply through the Marquette University employment portal https://employment. marquette.edu/postings/2679. Questions may be directed to: Dr. April Harkins Marquette University Department of CLS PO Box 1881 Milwaukee, WI, 53201 (414) 288-3402 april.harkins@marquette.edu

November/December 2014 ASCLS Today 7 Continued on Page 8

8 ASCLS Today November/December 2014 Continued on Page 9

November/December 2014 ASCLS Today 9

10 ASCLS Today November/December 2014 President s Message From Page 2 This can lead to confusion on the part of the patient, but also points to an opportunity for our profession to improve our report formats for ease in interpreting results. Interpreting results either through the Consumer Information Web Team, or through our interactions at our workplace is a service that sets us aside from others. Deb Rodahl, Region V Director, tells me that when her laboratory in Minnesota completes a glucose tolerance test, one of the clinical laboratory scientists sits down with the patient, goes over the results of the testing, and explains what the testing means. The patient has an opportunity to ask questions, and really understand the test results. This is a perfect example of our role! Not only is it within our scope of practice to interpret the results of laboratory tests for our patients and for physicians, we must also guide physicians in test utilization, to ensure the right tests are ordered at the right time. The ASCLS Strategy Canvas doesn t stop here. We are very well educated and experienced in the healthcare arena, and could also find a role in patient advocacy. One of my ASCLS-MT friends, Lana, was called to travel to her elderly mother-in-law s bedside in an assisted care facility. The staff had decided that her mother-inlaw was going to be referred to hospice because she was suffering from the accumulation of fluid in her lungs, and it was only a matter of time. When Lana arrived at the facility, her mother-in-law was very lucid and full of spunk, and did not appear to be someone who should just be made comfortable in their last days. My friend realized the fluid was accumulating overnight, when sleeping prone, and advocated for having her motherin-law sleep with the head of her bed elevated. This made a world of difference! Had Lana not been there insisting that other alternatives be considered, her mother-in-law would have had a very different outcome. I m sure you can tell your own story about how people you know didn t ask for alternatives, didn t demand clearer answers, or just accepted as gospel what the physician or health care team said. Lana was able to advocate for her mother-in-law, but what about people who don t have that advocate, who don t challenge the system? Is that a role we could fill? My baby boomer generation is used to asking questions, doing research, and demanding answers to all kinds of problems. Can we as Clinical Laboratory Science practitioners apply this assertiveness to patient advocacy? This role of patient (consumer) advocacy also bleeds over into the healthcare team. Laboratory medicine has grown exponentially over the past few years, with new technologies and testing associated with all the new omics. How are the physician and advanced practitioner expected to keep abreast on all of this, in addition to providing patient care? Our profession plays a vital role in ensuring the patients receive safe, effective, efficient, equitable, and patient-centered healthcare. Our vision in ASCLS, and what sets us apart from other laboratory organizations, is our recognition of the need to provide laboratory expertise to the healthcare team through the advanced practice Doctorate in Clinical Laboratory Science (DCLS). The DCLS will be a key member of the interprofessional healthcare team. There is currently one program where students are enrolled and being prepared for this role by gaining advanced knowledge and clinical training. Other schools are in various planning stages of offering DCLS programs. This is an exciting time to be considering an advanced degree in our profession. In my role as President, I have tasked some of our ASCLS Committees to come up with tools and trainings that will help medical laboratory science practitioners develop the confidence and expertise to fill the role of patient and consumer advocate. This outreach is also a way for us to make our profession more visible to the public, as well as to our fellow members of the healthcare team. You could fill that role. Are you ready to step up to the challenge? Ebola From Page 1 You can access Dr. Merlin s entire presentation at http://ftp.cdc.gov/ pub/cliac_meeting_presentations/ pdf/addenda/cliac1114/12_mer- LIN_Ebola_Response_CLIAC_Nov- 2014.pdf

November/December 2014 ASCLS Today 11 www.ascls.org/cmm

Periodical Postage Paid at McLean, VA and additional mailing offices Moving? Send the attached label and your new address six weeks in advance to ensure uninterrupted membership services. Keep in Touch with the ASCLS NATIONAL OFFICE ASCLS Today ASCLS: One Voice, One Vision. 1861 International Dr., Ste. 200 McLean, VA 22102 Phone: 571-748-3770 Fax: 571-354-7570 Email: ascls@ascls.org website: www.ascls.org Elissa Passiment Executive Vice President elissap@ascls.org ASCLS Today (ISSN 1073-466X) is published monthly except combined in Jun/Jul and Nov/Dec by the American Society for Clinical Laboratory Science 1861 International Dr., Ste. 200 McLean, VA 22102 Periodical postage paid at McLean, VA and additional mailing offices. Karrie Hovis Education Office karrieh@ascls.org Patrick Cooney Legislative Affairs Andrea Hickey P.A.C.E. Membership Services Coordinator andreah@ascls.org POSTMASTER: Send address changes to ASCLS Today, 1861 International Dr., Ste. 200 McLean, VA 22102 ASCLS Today is distributed as a regular service to ASCLS members only; $8 of society membership dues are allocated to an annual subscription. Cheryl Caskey, Editor