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Educational Services

Welcome to Educational Services! Department of Labs produced webinars are offered on the first Tuesday of every month covering disease specific and utilization management topics. Our webinars are PACE and ACCENT accredited. Contact Megan Hinch at MTS for more information: meganh@medtraining.org.

2018 Webinars

January

Tues 9

January 9th, 2018, 11am-12pm PT

Description of Program Content:

Autism and intellectual disability (ID) are common, highly heritable neurodevelopmental disorders that frequently bring children to the attention of geneticists, neurologists, and other subspecialists . Autism and ID are characterized by extreme genetic heterogeneity and there is a growing variety of genetic testing options available to patients. After a brief review of these conditions, we will compare various testing options and discuss the implications of genetic testing for medical management.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  • Participants will be able to discuss the current and future approaches to clinical genetic and genomic testing for children and families affected by autism and related disorders.
  • Participants will be able to identify diagnostic utility and challenges related to clinical genetic and genomic testing for autism and related disorders

Presenters:

Benjamin D. Solomon, MD, Managing Director, GeneDx

Tracy Brandt, PhD, FACMG, Assistant Director of Neurogenetics

 

MON
29

January 9th, 2018, 11am-12pm PT

Description of Program Content:

LabTalk: Happy Lab Happy Life, a Seattle Children's Hospital Series.
What is LabTalk?
In this series, experts from around the country discuss the hottest and most difficult topics in pathology and laboratory medicine with an emphasis on lab management and trends in testing, such as the explosion in genetic testing. You will laugh, you will cry, you will learn, and then you will cry again.  If it is a topic that makes you think about retiring early, we will talk about it and get you excited to get back to work.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  • List two technology trends regarding autoantibody testing.
  • Describe two challenges in the ordering of autoantibody testing by primary care providers in the context of systemic rheumatic (and related) diseases.
  • Discuss current challenges in test utilization regarding celiac disease.

Moderator:
Mike Astion, MD, PhD
Medical Director, Department of Laboratories Seattle Children’s Hospital, Clinical Professor University of Washington Laboratory Medicine

Presenters:

Mark Wener, MD
Department of Laboratory Medicine, University of Washington

Melissa R. Snyder, PhD
Consultant Division of Clinical Biochemistry and Immunology
Associate Professor of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine

FEBRUARY

TUES
6

Description of Program Content:
Implementation of Diagnostic Management Teams (DMTs), multidisciplinary teams of clinical experts whose role is to deploy evidence-based diagnostic testing algorithms and patient-specific interpretive reports, may reduce laboratory and, ultimately, diagnostic error.  This talk will discuss the epidemic of laboratory error and how DMTs reduce this error.  Using the example of a DMT focused on hypertension, the session will summarize methods for successfully implementing a diagnostic management team.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  • Define a Diagnostic Management Team (DMT)
  • Discuss how to choose an focus area for a DMT
  • Describe an example of a DMT in endocrine mediated hypertension

Assess the clinical utility of the hypertension (PA) DMT

Presenter:
Alison Woodworth, PhD, DABCC, FACB

University of Kentucky

Dr. Alison Woodworth is currently Associate Professor of Pathology and Laboratory Medicine at the University of Kentucky Medical Center.  Where she is also Medical Director of the Core Clinical Laboratory and Point of Care testing. She is a Diplomate of the American Board of Clinical Chemistry and currently serves as a director on the ABCC exam committee and Vice President of the credentialing committee. She is actively involved in teaching – having taught pathology residents, medical students, medical technologists, and endocrinology and maternal fetal medicine fellows.  She has also directed a COMACC certified clinical chemistry fellowship training program and will start a new program at the University of Kentucky.  Dr. Woodworth has been actively involved in numerous organizations including AACC where her service on numerous local and national committees including on the AACC Academy Board of Directors, Vice Chair of the House of Delegates, Vice Chair of the Pediatric/Maternal Fetal Medicine Division, and the Science and Practice Core Committee earned her the SYCL Service award.  She also serves on executive council of ACLPS.  Dr. Woodworth is actively involved in clinical/translational research and her noteworthy contributions in the areas of sepsis, endocrinology, and Maternal/Fetal Medicine have resulted in multiple publications and awards.

 

TUES
13

Description of Program Content:
Introduction to the effect of extracorporeal Life support (ECLS), also know as extracorporeal membrane oxygenation (ECMO) on the hemostatic system. Hemostatic changes in the patient, development of thrombi in the extracorporeal circuit and anticoagulation used to prevent thrombi.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  • List the different types of extracorporeal cardiopulmonary support
  • Describe the bleeding and thrombotic problems associated with cardiopulmonary support.
  • Name two tests used to monitor hemostasis and anticoagulation during cardiopulmonary support

Presenter:
Wayne Chandler, MD
Division Chief Laboratory Medicine, Department of Laboratories, Seattle Children’s Hospital

Wayne L. Chandler, MD is currently Division Chief for Laboratory Medicine, Department of Laboratories at Seattle Children’s Hospital and Clinical Professor of Laboratory Medicine at the University of Washington. He received his undergraduate degree from the University of Utah, his medical degree from St. Louis University School of Medicine, and completed a residency in Clinical Pathology at the University of Washington. He worked in the Department of Laboratory Medicine at the University of Washington for 20 years and for 4 years in the Department of Pathology and Genomic Medicine at Houston Methodist Hospital. His clinical practice and research focuses on diagnostic testing for hemostatic and thrombotic disorders.

JUNE

TUES
12

Description of Program Content:
There are not enough genetic counselors (GCs) to fill open positions, graduate school spots are limited, and the demand is outweighing supply. By creating a GCA program, our team was able to re-assign tasks and offload mundane duties to our GCA team (who considers the experience a treasure). Ultimately we have improved the scope of what GCs can bring to the company and prepare aspiring genetic counselors for graduate school.   Presenter will include PreventionGenetics’ experiences, lessons learned & details about their GCA program.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  1. Address importance of continuing to expand the role and value of genetic counselors despite shortage in workforce.
  2. Demonstrate one group’s creative approach to solving workforce issues.

Presenter:
Christina Zaleski, MS, CGC
Director of Genetic Counseling/ Client Services, PreventionGenetics

Christina Zaleski earned a Master of Science degree in human genetics/genetic counseling from Sarah Lawrence College in New York in 1999.  After graduation, she continued the research work that she started as a student for Rockefeller University on mental illness in South Africa. She then returned to her home town of Marshfield, Wisconsin and worked at the Marshfield Clinic as lead genetic counselor from 1999-2012. Christina is currently Director of Genetic Counseling & Client Services at PreventionGenetics.  Christina has experience in many areas including prenatal, pediatric, cancer, specialty clinics, stillbirth evaluations, research, administration, public health education, laboratory and industry.  She developed clinical genetics outreach & telehealth genetic counseling services in several locations throughout North Central Wisconsin.  She has served on St. Joseph Hospital’s Bioethics team as well as co-investigator on several research project.  Christina has published scientific articles in the areas of clinical genetics, stillbirth evaluations, cystic fibrosis newborn screening, laboratory utilization management, and genetic workflow.  Highlights of her career include receiving 2007 Leadership Award for Excellence in Community Service from the March of Dimes, Wisconsin Chapter, and being nominated by peers as a JEMF Master Genetic Counselor in 2010.

JULY

TUES
10

Description of Program Content:
Clinical laboratories often receive orders for tests that are outside the mainstream of clinical testing.  Some of these are new/emerging tests for which there simply isn’t a lot of clinical experience.  Some are research biomarkers that are primarily of interest to bench scientists.  Some are panels or algorithms designed largely in response to marketing considerations.  What these all have in common is a lack of clinical evidence demonstrating clinical utility, i.e. therapeutic benefit for patients as a consequence of the tests.  How should clinical labs evaluate requests for such tests?  Historically many laboratories have approached these requests from a financial and/or logistical perspective, approving the tests as long as they don’t overly burden the local laboratory (and provided that they are performed in a CLIA-licensed setting).  This presentation will present an additional framework for consideration, namely bioethics.  What is the ethical impact of such testing on the individual patient as well as on society as a whole?  And how can potentially useful – but still unproven – laboratory tests be introduced into clinical settings in an ethically consistent manner?

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  • Describe the main ethical principles presented in the Belmont Report and the Declaration of Geneva
  • Describe the primary ethical tradeoffs involved in use of lab tests that lack evidence of clinical utility
  • Describe ethically sound ways to introduce new tests into clinical settings.

Presenter:
Brian Jackson, MD, MS
Associate Professor of Pathology (Clinical), University of Utah
Medical Director of Support Services, Business Development and IT, ARUP Laboratories

Dr. Jackson received his MD as well as his informatics master’s degree from the University of Utah.  He completed a residency in clinical pathology from Dartmouth-Hitchcock Medical Center.  Following residency he worked for a hospital IT department as well as a healthcare software startup company.  He is currently the medical director at ARUP Laboratories responsible for pre-analytic services, business development, and IT. Dr. Jackson's research interests include economic analysis of diagnostic testing and physician utilization of laboratory tests. He is certified in clinical pathology by the American Board of Pathology.

TUES
24

Description of Program Content:

In this webinar, panelists will recap the most thought-provoking presentations and discussions from the 2018 PLUGS Summit. Join us for continued discussions, ask the burning question that you forgot to ask in Seattle, and continue to learn more about clinical laboratory stewardship.

Measurable Learning Objectives 
At the end of this activity the participant will be able to:

  • Identify 2 ways to utilize data to advance your laboratory stewardship program
  • Describe 3  elements required to ensure the success of a laboratory stewardship initiative
  • List 2 challenges related to insurance authorization for genetic testing

SEPTEMBER

TUES
11

Combined Test Review and Consultative Service: An Institutional Approach to Positively Influence Providers’ Behaviors
September 11th, 2018, 11am-12pm PT

Description of Program Content:

The potential impact of genetic test misorders on patient care is broad and sometimes severe. Therefore, developing strategies to curtail this problem is critical to providing optimal patient care. A few studies have shown that an active utilization management (UM) program focused on a test review intervention can control the cost of genetic test misorders. However, little is known about the nature and types of misorders as well as the impact of a test review intervention on each type of misorder. Similarly, the potential effect of preventive interventions, such as consultation, remains largely unknown. This presentation will discuss Stanford’s genetic test stewardship effort to categorize misorders into five types to better measure the impact of the UM interventions implemented. In addition, we will demonstrate that the combined approach of test review and consultative service effectively reduced misorders over time and can positively influence healthcare providers’ behaviors.

Measurable Learning Objectives 
At the end of this activity the participant will be able to:

  • Describe the different types of genetic test misorders
  • Identify strategies to control the misorder
  • Recognize the significant impact of preventive interventions on certain types of misorders

Presenters:

Carlos Jose Suarez, MD
Clinical Assistant Professor, Department of Pathology, Stanford University School of Medicine

Dr. Suarez is a board-certified pathologist specializing in anatomic, clinical and molecular genetic pathology. He received his M.D. degree with the highest honors (summa cum laude) from the University of the Valley (Universidad del Valle), Cali, Colombia. After medical school, he was a research fellow at a WHO-collaborating center investigating pattern of nosocomial antibiotic resistance, and later joined the University of California at San Diego (UCSD) as postdoctoral research fellow in cancer and lung immunology laboratories. He completed an anatomic and clinical pathology residency at the University of Washington, Seattle, and a Molecular Genetic Pathology fellowship at Stanford University. Dr. Suarez is currently a Clinical Assistant Professor of Pathology at Stanford University, and he is also Co-Director of the Genetic Testing Optimization Service (GTOS) and Associate Director of the Molecular Pathology Laboratory at the Stanford University Medical Center.

Linbo Yu, MS, CGC, LCGC
Genetic Counselor, Clinical Lab- Genetic Testing Optimization Service (GTOS), Stanford Health Care

Linbo received her Bachelor of Science in Microbiology, Immunology and Molecular Genetics from UCLA and graduated as a UC Regents’ Scholar. She graduated from the Genetic Counseling Program at UC Irvine in 2009 and was certified by the ABGC in 2010. Prior to joining Stanford, Linbo had worked as a lab genetic counselor at Ambry Genetics for three years, where she performed a variety of roles including results interpretation, test coordination and test development. She also worked at UCSF and in the Variant Curation team at Counsyl after moving to the Bay Area. In 2014, She became the first lab genetic counselor at Stanford Hospital and a founding member of Stanford’s Genetic Testing Optimization Service (GTOS). As a passionate clinical liaison between Stanford Clinical Lab and the ordering providers at Stanford, some of her roles include assisting clinicians with selection of genetic tests, reviewing genetic test orders for clinical appropriateness and educating ordering providers about genetic diseases and test information.

 

TUES
18

Description of Program Content:

The presentation will outline the experience at Rady Children’s Institute for Genomic Medicine (RCIGM) in conducting multiple internal and external clinical research studies to investigate the clinical and economic utility of rapid genomic sequencing for infants in the neonatal intensive care unit (NICU). A review of the current literature will be presented as well as selected case studies to highlight the clinical utility of the rWGS testing approach. The advantages and challenges of rWGS will be discussed.

Measurable Learning Objectives 
At the end of this activity the participant will be able to:

  1. Identify the benefits of rapid genomic testing
  2. Understand the current state of genomic testing and gaps exist in the literature
  3. Assess the future directions and what data is needed for wide spread adoption of rapid genomic testing in the NICU

 

Presenters:

Shimul Chowdhury, PhD, FACMGG, CGMB
Clinical Laboratory Director
Rady Children’s  Institute for Genomic Medicine

Shimul Chowdhury serves as a clinical laboratory director at the Rady Children’s Institute for Genomic Medicine (RCIGM). His work involves various activities related to the implementation of rapid whole genome sequencing (rWGS) for children in the intensive care unit. Prior to joining the RCIGM team, Dr. Chowdhury served as a Senior Scientist in the Illumina Clinical Services Laboratory where his work included the clinical interpretation of whole genome sequencing data for rare and undiagnosed disease patients. Dr. Chowdhury is licensed as a clinical laboratory director for molecular genetics by the state of California. He conducted his American Board of Medical Genetics and Genomics (ABMGG) clinical molecular genetics fellowship at Sacred Heart Medical Center in Spokane, Washington. He obtained his PhD in Clinical and Translational Sciences at the University of Arkansas for Medical Sciences, and his Bachelors of Science at the University of Minnesota- Twin Cities. He is an active member of the Association for Molecular Pathology and the American Society of Human Genetics.


 

OCTOBER

THURS
25

Description of Program Content:

Clinical laboratories are extremely proficient at generating, processing, and storing patient data in a transactional way with high quality. They are generally less sophisticated in converting this data into knowledge and information that helps drive decision-making. However, laboratories may now have more opportunities to develop this capacity. Data analytic infrastructure resources are increasingly being recognized for their value, and thus, being implemented in clinical organizations to meet the demands of modern, digitized medicine. The potential for data analytics applications in laboratory medicine is great and will benefit from the expertise and leadership of laboratorians. This presentation will describe efforts to build capacity for data analytics within our department and how this aligns with the overall initiatives of the hospital. It will illustrate examples of how this has been applied in quality assurance and daily operations activities in the laboratory.

Measurable Learning Objectives 
At the end of this activity the participant will be able to:

  1. Describe phases of data analytic maturity.
  2. Discuss approaches to increasing capacity for data analytics.
  3. List two examples of applications for data analytics in laboratory medicine.

Presenters:
Shannon Haymond, PhD
Associate Professor of Pathology, Northwestern University Feinberg School of Medicine
Vice Chair for Computational Pathology and Director of Clinical Mass Spectrometry, Ann & Robert H. Lurie Children’s Hospital of Chicago

 

TUES
30

Description of Program Content:

Genomic testing (whole exome sequencing (WES) and whole genome sequencing (WGS)) has revolutionized the laboratory evaluation of patients with rare disorders. The range of conditions that can be diagnosed with these methods is increasing rapidly.  It has become important for clinicians to understand how these two approaches compare when choosing a genomic test.

WES and WGS will be compared in terms of coverage, turnaround time, diagnostic yield, ease of interpretation, range of variation detected, reanalysis yield, and cost.

Measurable Learning Objectives 
At the end of this activity the participant will be able to:

  1. Identify which test, WES or WGS, has better coverage of the coding portion of the genome
  2. Describe the types of disease-associated variants that can be identified through WGS
  3. Explain the cost considerations when choosing WES vs WGS

Presenters:

David Bick, M.D.
Chief Medical Officer and Faculty Investigator
HudsonAlpha Institute for Biotechnology

David Bick, MD, is the chief medical officer and a faculty investigator at the HudsonAlpha Institute for Biotechnology, the medical director of The Smith Family Clinic for Genomic Medicine, LLC., and a laboratory director in the HudsonAlpha Clinical Services Laboratory, LLC. He comes to HudsonAlpha from the Medical College of Wisconsin where he was a professor in the department of pediatrics and the department of obstetrics and gynecology. At the Medical College of Wisconsin, he was the director of the Clinical Sequencing Laboratory at Medical College of Wisconsin; director of the Advanced Genomics Laboratory at Children’s Hospital of Wisconsin; medical director of the Genetics Clinic at Children’s Hospital of Wisconsin; and chief of the division of genetics in the department of pediatrics at Medical College of Wisconsin.  

Bick received his medical degree from George Washington University School of Medicine in 1981 and completed his residency in pediatrics at Yale-New Haven Hospital in New Haven, Conn. At the Yale University School of Medicine, Bick completed a fellowship in human genetics and pediatrics in 1986, followed by a postdoctoral research fellowship in human genetics in 1987. Bick is board-certified in pediatrics, clinical genetics and clinical molecular genetics.

As a leader in the field of genomic medicine, Bick has published numerous peer-reviewed articles, chapters and reviews. Bick’s laboratories at the Medical College of Wisconsin and Children’s Hospital of Wisconsin were the first in the world to offer whole genome sequencing as a clinical test.

 

TUES
6

Description of Program Content:
An emerging body of evidence is providing support for the use of whole genome sequencing (WGS) early in the diagnostic trajectory of patients with suspected genetic diseases, with studies demonstrating both high diagnostic utility and clinical utility. As the clinical evidence continues to grow, it is important to evaluate the economic impact of clinical WGS. In this webinar, we will review the current evidence evaluating the economic utility of WGS in clinical care, discuss the strengths and weaknesses of current data, and share an economic model we have developed to project the economic impact within a defined healthcare system.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  1. Discuss the published evidence evaluating the economic utility of WGS in patients with undiagnosed suspected genetic diseases
  2. Discuss the strengths and weaknesses of existing published economic data, key challenges, and critical areas for future evidence development

Presenter: 
Brock Schroeder, PhD, Director, Health Economics & Outcomes Research, Illumina, Inc.

BIO
Brock Schroeder is Director of Health Economic & Outcomes Research (HEOR) at Illumina.  In this position, Brock oversees Global HEOR and Market Access Strategic Plans in support of existing and new clinical applications of next generation sequencing (NGS). Prior to joining Illumina, Brock led Medical Affairs at Biotheranostics, Inc, where his team was responsible for generating evidence supporting the clinical utility and economic utility of 2 proprietary molecular diagnostic tests in the oncology therapeutic area, as well as engaging with academic researchers and payers on the value of the tests to patients and healthcare systems. Brock’s industry experience includes multiple therapeutic areas, including oncology, endocrinology, nephrology, and neurology, and has included both pharmaceuticals and molecular diagnostics. Brock has authored or co-authored 25 peer-reviewed manuscripts and more than 50 scientific congress abstracts. He received his BA in Biology from Washington University in St. Louis, and his PhD in Neurosciencefrom University of Wisconsin-Madison.


TUES
20

Description of Program Content:
This webinar will outline why insurance companies deny claims for medical necessity, what information is need to appeal and the process for appealing these denied claims. The presentation will cover processes that tend to apply to most insurance companies. Please keep in mind that each payer may have a slight variation based on their internal processes or state insurance laws.

Measurable Learning Objectives
At the end of this activity the participant will be able to:

  1. Explain why insurance companies deny “medically necessary” claims
  2. Understand what information is needed to appeal these claims
  3. Understand the general process for appealing these claims

Presenter:
Natalie Thurston RN, MBA, CPHQ
Consultant

BIO:
Natalie Thurston RN, MBA, CPHQ is a health care reimbursement professional. With almost 20 years of experience, Natalie has the unique perspective of working on the insurance side and provider side of healthcare. Insurance experience includes managing a team of clinicians responsible for guiding members to the Humana National Transplant Network, and implementing Humana’s new clinical program (Personal Nurse). Currently, Natalie is utilizing her insurance experience in her current role with a California based provider to obtain positive coverage decisions and contracts for a molecular diagnostic test. Her ability to obtain coverage covers both commercial and government lines of business. Examples of successful positive coverage decisions includes Humana, Cigna, Highmark, BCBS Kansas City, Wellmark, California Medicaid, Florida Medicaid, and NY Medicaid. She has a comprehensive understanding of insurance operations from claim submission thru payment.

Natalie received a Bachelor’s in Nursing (BSN) from Indiana University – Indianapolis and a Master’s in Business Administration (MBA) from Indiana University Southeast. She also maintains a certification in Healthcare Quality (CPHQ).