INFORMATION TECHNOLOGY
be a debate about whether POCT results should be sent to other systems like the GP record EMIS, ICE, or a patient portal. However, Katy Heaney from Berkshire
and Surrey Pathology Services, made a case for sending results to the LIMS, then on to the EPR, arguing that this means POCT results can be subject to the same kinds of data management, rules and audits.
The future workforce: think technology
The annual Clinisys event, held at The Belfry, is always very well attended.
of Liverpool and registrar of RCPath, talked about the supra-regional eye cancer pathology service that supports the three specialist centres for rare eye conditions in England. The service conducts genetic testing on eye tumours, which has enabled clinicians to work out which patients are likely to see their eye cancer metastasise to the liver. Although there is no treatment, Coupland said there is high patient demand: “People want to know if they have a good melanoma or a bad melanoma, and whether they will live for another 25 years or two years.”
Her hope is to build on the unique Ocular Oncology Biobank, and create a digital multimodal biorepository with digitised slides, ocular and radiological images. This will enable data mining by researchers, with the aim of improving diagnosis and, ultimately, patient survival. This template could be utilised by other biobanks, and the multimodal data analysis applied to other cancer types.
Helping the NHS family: relieving pressure, addressing prevention The final two presentations, however, returned to the opening question of how healthcare and pathology services can tackle growing demand with limited resources.
Dr Martin Myers from Lancashire
Teaching Hospitals NHS Foundation Trust argued that with “hospitals under pressure” and “ambulances backed up” there is a pressing need to move services into the community while addressing the demand caused by an ageing, unequal and increasingly poor population. Or, as he put it, the requirement is to: “i) shift pressure away from the front of the house; ii) treat patients in their own bed, rather than a hospital bed where possible; and
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iii) reduce the disease burden.” His trust has developed initiatives where point- of-care testing can be used to avoid unnecessary admissions. For example, it runs a COVID, influenza and respiratory syncytial virus (RSV) testing service for patients presenting at A&E “so we can assess them with our rapid team and send them home with appropriate medication and advice.” The intention is to also provide this service in community acute respiratory infection hubs.
The trust has also developed a range of services to support out-of-hospital care, from heart failure monitoring, to keeping an eye on jaundiced babies, and from a ‘pee in the pot’ remote POCT service for renal patients, to a ‘lab in a bag’ for virtual wards.
Dr Myers is also passionate about
projects to pick-up people with heart failure in the community, to diagnose people with pre-diabetes, and to run health checks for people with learning disabilities.
The Laboratory Anywhere Model must look at the strategic use of POCT in different spaces and different times to address deprivation and ill health, to prevent illness, to prevent existing illness getting worse, and to assist rapid decision-making, he argued. However, he added, these projects “need to be done properly – we need to make sure good pathology procedures are followed, that there is good governance, and that results are recorded.” There is a debate over whether the
results should be recorded in the LIMS, prior to reaching the electronic patient record (EPR), or sent direct to the EPR. Dr Myers said Lancashire passes the POCT results through the trust interface engine. From there, they can be diverted to any patient database required, because, he argued, there should also
Meanwhile, Chris Sleight, chief officer from the Greater Manchester Diagnostics Network, gave an entertaining presentation about the six generations that have been born over the past 100 years and their attitudes to the use of technology.
Sociologists, he said, have identified
six groups: the silent generation (born before the Second World War, who communicate face to face and by letter); the baby boomers (war babies, who communicate face to face and by landline); Generation X (the ‘latchkey kids’ of the 1980s who use email and invented text); Millennials (came of age around the year 2000 and are digital natives); Generation Z (influenced by the global financial crash, barely remember life before the internet); and Generation Alpha (today’s children and young teenagers, constantly streaming and social networking).
His point: is that laboratories today
are staffed mostly by boomers and Generation X, but the Millennials, Generation Zs and Alphas coming into the workforce or getting ready to choose their careers have different experiences and expectations. They don’t just want to use technology, they expect to use it, or – in the case of Generation Alpha – might not be able to imagine a workplace without it. “To build a sustainable workforce, we not only need a workforce that meets the needs of our patients and population, but the aspirations of our workers,” he said. “That means digital solutions are important because the future workforce won’t just expect them, they will need them. That’s why we’re so pleased to be working with Clinisys as partners; we have the same aspirations about staying at the cutting edge of technology.”
References 1 Hill W, Lim EL, Weeden CE et al. Lung
adenocarcinoma promotion by air pollutants. Nature. 2023 Apr; 616 (7955): 159–67. doi: 10.1038/s41586-023-05874-3.
2 Cancer Variant Interpretation Group UK (
https://www.cangene-canvaruk.org/about- canvig-uk).
SEPTEMBER 2024
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