Screening results now available online

The National Newborn Bloodspot Screening Programme, based in Temple Street Children’s University Hospital can now produce a single, consistent electronic record for each infant, writes David Wall.

David Wall
David Wall

The National Newborn Bloodspot Screening Programme identifies babies who may have rare but serious inherited conditions, which are treatable if detected early in life. Most babies born in Ireland will not have any of these conditions. However, for the very small numbers who do, the benefits of early detection by screening and treatment are enormous. Early treatment can improve their health and prevent severe disability or even death. The screening test is offered to all parents when the baby is about four days old.

Newborn screening for Phenylketonuria (PKU) started in Ireland in February 1966. Ireland was one of the first countries in the world to have a national screening programme. Since then other conditions have been added, most recently Cystic Fibrosis in July 2011.

The National Newborn Bloodspot Screening Laboratory, based in Temple Street Children’s University Hospital receives a heel-prick blood sample on every baby born in the Republic of Ireland from which six inherited or congenital disorders are screened. Timing of collection, receipt of sample and analyses are critical to the outcome of those infants identified with one of these six conditions.

The NNBSL had been using a module of the hospital’s existing lab system however it was apparent that it no longer met existing or future requirements. Following a competitive tender process Specimen Gate from Perkin Elmer was chosen as the preferred solution. Head of ICT David Wall states “we had to use a computer system which was not meeting our requirements. We are delighted with the partnership with Perkin Elmer, which promotes smarter ways of working”.

Ireland was one of the first countries in the world to have a national screening programme.

Specimen Gate integrates activities within the NNBSL and office processes to provide a single, consistent electronic record for each infant. The process begins with ‘specimen receiving’ where blood and demographic cards linked via barcodes are separated to enter their respective processes. Upon completion, a single laboratory report is produced and sent to the designated provider for each specimen. For records that require special activities, such as unsuitable specimens and high risk cases, a case record is created and followed through to completion. Prof. Philip Mayne – Director NNBSL says “Not only is it enabling us to speed up our baby screening process and enabling us to get results back much quicker, it’s also helping to significantly reduce paperwork.”

Four Specimen Gate® modules provide control and monitoring tools for the entire screening process:

    • Laboratory – Managing the pre- and post-analytical processes
    • Screening Center™ – Patient demographics, reporting and overall screening management
    • PatientCare™ – Follow up of screen-positive patients and unsatisfactory specimens
    • eReports™ – Electronic reporting of results and remote data entry via the web

All four modules have been implemented at the NNBSL in Temple St.

One of the additional essential requirements was that the solution had the functionality to allow public health nurses, maternity hospitals and Local Health Offices access screening results via the internet. A pilot study commenced in May 2013 to four Maternity Hospitals (three in Dublin and one in Cork) to identify that the reporting system met the requirement that reports could be accessed via the internet securely.

Earlier delivery of reports has significantly improved the screening service to families with shorter time frame for completion of the bloodspot screening process.

A training and education programme was then rolled out by the NNBSL staff on a phased basis starting in November 2013 through the four regional leads for newborn screening, initially in Dublin Mid Leinster. Workshops were organised in Dublin (three), Galway, Cork and Kilkenny to which appropriate midwifery, public health nurses and clerical staff, identified as key individuals by the respective HSE Regional leads, were invited.

The training workshops provided an up-date on the new-born bloodspot screening programme and an introduction to e-Reporting. Existing users of the e-Reporting software were also invited to answer any practical questions which might arise and to demonstrate the benefits of the new reporting system. “Specimen Gate has changed the overall management of the screening process in the laboratory and therefore makes the results reporting much easier” comments NNBSL Chief Medical Scientist, Geraldine Roche.

Outcome

This quality improvement in the NNBSL has significantly reduced the turnaround time of the delivery of reports to end users and has allowed daily reporting of results by the laboratory scientists.

With the implementation of eReports, staff in maternity Hospitals and LHOs can view and download their own reports in pdf format. These reports are available to users as soon as they are created and authorised in the NNBSL.   Staff can access reports effectively in ‘real time’ and the time taken to print, batch, envelope and post up to 500 reports daily is eliminated.

Earlier delivery of reports has significantly improved the screening service to families with shorter time frame for completion of the bloodspot screening process for those from whom a second sample is requested and thus reducing parental anxiety. The facility also exists to print off single reports, which can be made available to parents for inclusion in their child’s record. The longer term objective of a paperless system should be achieved by end 2014.

David Wall, Head of ICT & Information Governance Lead, Temple Sreet Children’s University Hospital, Dublin.