Intelligent haematinic testing
My Topol fellowship problem / project:
My project is to improve delivery of the biochemistry haematinics service by introducing an intelligent reflexive approach, an “Intelligent” full blood count (iFBC), drawing inspiration from intelligent liver function testing (iLFT, University of Dundee). The premise of iFBC is that the identification of specific patterns of abnormalities within the standard FBC can be used to reflexively order targeted haematinic tests (vitamin B12, folate, ferritin, and iron studies).
iFBC will be a substantial improvement over the options currently available to our clinicians, which are either (1) order haematinics alongside the initial FBC, the majority of patients subsequently not being found to have any abnormalities and so these measurements not contributing to diagnosis, or (2) ordering FBC only but then having to contact the laboratory to request haematinics to be added if anaemia is found.
From a laboratory perspective, this project delivers the benefit of reduced activity, realising considerable cost savings in terms of consumables and reagents as well as laboratory analytical capacity. For patients it delivers “the right test at the right time”, improving patient experience by reducing unnecessary phlebotomy and diagnostic journey time. The benefits are amplified downstream for patients, clinicians and clinical service managers, for example reduction in delayed and cancelled operations related to inadequate pre-operative assessment of anaemia, and improved triage in diagnostic bowel pathways in primary care.
I am a principal clinical scientist in the department of Clinical Biochemistry and Metabolic Medicine at Liverpool University Hospitals NHS Foundation Trust (LUHFT). My undergraduate route was a master’s degree in molecular and cellular biochemistry at the University of Oxford, and I attained a further master’s in clinical biochemistry at University College London within my clinical scientist training. I am now a Fellow of the Royal College of Pathologists (FRCPath), with specialist expertise in biochemistry.
When I’m not in role as ‘Duty Biochemist’, performing clinical authorisation of laboratory blood test results and providing guidance to and responding to queries from medical colleagues, my main responsibilities all pivot around local digital improvement. I have taken an increasingly strong lead in clinical informatics within my laboratory work area over the last few years, playing crucial roles in informatics activities such as electronic patent record (EPR) upgrade, clinical harmonisation, local interoperability projects with external organisations, cost accounting and price rebasing, and a laboratory information management system (LIMS) merger. I have been recognised as the Clinical Lead for Informatics at Liverpool Clinical laboratories and recently joined the Faculty of Clinical Informatics.
As a champion of digital change, I have recently applied my experiences to assist in the national pathology code mapping reviews project to support the development of the Unified Test List (UTL), the new standard for specifying pathology test results. I look forward to applying the skills, knowledge and connections I will gain through this programme in enabling me to support the digital transformation of my regional pathology network.
In my free time I enjoy being an assistant Beaver Scouts leader, volunteering at my local Junior Park Run and tending my allotment and garden.