IHS NEWS
Major Enhancements to IHS' Online Pathology Service
June 2010
Leading-edge web-access software was developed by IHS. some time ago enabling clients to securely view reports online and track the progress of samples in the laboratory. This allows for faster than ever response times and convenient, round the clock, worldwide access to reports and images.
Now following the completion of a major enhancement programme, IHS is delighted to announce that the online reporting service 'SafirLIS Connect' is now available on 3 alternative internet browsers. In addition to Internet Explorer, SafirLIS is now accessible on Apple Safari, Mozilla Firefox and Google Chrome. This will allow our consultants more flexibility when using this service and also make reports available to view in the ever growing Apple Mac market.
All it takes is a phone call to get started. Once you are up and running you can access information, reports and images from any internet-enabled PC.
All your reports are protected by personal password and privileged access, making it a highly secure system. There is facility to print, digitally store or archive the resulting viewable PDF files
For more information and to set up access simply contact david.ferris@unilabs.com, or ihsenquiries@unilabs.com
Stuart Money
Sales and Marketing Director, IHS
Dr Dia Kamel
April 2010
IHS introduces a new sessional pathologist Dr Dia Kamel who's sub-specialties include Skin, Lymphoreticular, Breast, Renal and Urological pathology.
Dr James Carton joins IHS to strengthen Uropathology and Dermatopathology team
March 2010
Mihir A. Gudi MBBS, FRCPath, MD, DMS, FEBP
March 2010
IHS further strengthens breast sub-specialty team with the arrival of Dr. Mihir Gudi.
New courier company for IHS
March 2010
It is absolutely essential for our institutional clients, consultant colleagues and their patients that we provide a professional service in the area of specimen collection and transportation.
IHS is pleased to announce that they have engaged “PDQ”, a Medical Registered company who provide a seamless audit trail. No sub-contractors are involved.
PDQ will complement the excellent service currently provided by ECourier.
IHS under successful surveillance
February 2010
On 16th February 2010, Independent Histopathology Services underwent its surveillance visit by Clinical Pathology Accreditation (UK) Ltd (CPA). This was carried out by a Regional Assessor and was, as normal, within two years of IHS receiving Full Accreditation. The emphasis of a surveillance visit was on the “A” (organisation and quality management system) and “H” (evaluation and quality assurance) standards however other areas of the standards could have been be sampled as well.
IHS resulted in 11 recommendations, of which none were mandatory, and the Regional Assessor commented that it was the lowest number that he had ever issued to a laboratory. Therefore IHS continues to hold full accreditation with CPA and will undergo its next full visit in 2012.
IHS achieves important UK Cytology QA recognition
January 2010
On 19th January 2010, the cytology laboratory of Unilabs Ltd was visited by The East of England Quality Assurance team.
View the following documents:
Breast Cancer Assay Now Available from IHS
October 2009
The Oncotype DX® Breast Cancer Assay
What is the Oncotype DX® Breast Cancer Assay?
Oncotype DX® is a test that examines a breast cancer patient's tumour tissue at a molecular level, and gives information about the patient's individual disease. By providing an individualised assessment of the magnitude of chemotherapy benefit and the likelihood of distant recurrence at 10 years, Oncotype DX® can inform adjuvant treatment decisions.
Who is Eligible for the Oncotype DX® Breast Cancer Assay?
The Oncotype DX® assay is intended to be used by women with early-stage (Stage I or II), node-negative, oestrogen receptor-positive (ER+) invasive breast cancer who will be treated with hormone therapy and for post-menopausal women with node-positive (up to 3 nodes positive), oestrogen receptor-positive (ER+) invasive breast cancer.
What is required for the Oncotype DX® assay to be performed and how long does it take?
The Oncotype DX® assay is a 21-gene assay which is performed on formalin-fixed, paraffin-embedded tumour tissue by the developers of the assay, Genomic Health Inc. The result is available within 14 days of commencement of the test.
To order the test or for more information, please call 020 7299 4490 or email ihsenquiries@unilabs.com
For complete information on Oncotype DX® visit www.Oncotypedx.com
Roberto Dina MD FRCPath
October 2009
Roberto qualified as Histopathologist at the University of Bologna in 1983 where he was Lead Cytopathologist and Honorary Professor until 1999. In 2000 he was appointed Consultant and Honorary Senior Lecturer at Hammersmith Hospital where he is lead pathologist for Gynaecological Oncology and Cytopathology. His main research interests are in Gynaecological cancer and e-learning(www.eurocytology.eu). He is also lead pathologist for thyroid cancer.
CYTOPATHOLOGY FOR THE 21st CENTURY
October 2009
Cytopathology is in the process of rapid change as advances in technology have provided new tools to the clinician and pathologist. Fine needle aspiration (FNA) has been used as a diagnostic technique since the 1970s, however, in recent years, its role has markedly expanded as advanced imaging technology and new instrumentation for obtaining samples has made virtually any body site accessible through minimally invasive methodologies.
Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has become the method of choice for almost all pancreatic mass lesions owing to its improved resolution of small lesions and for its ability to diagnose and stage patients during the same procedure. EUS-FNA is clinically very useful for establishing the diagnosis of abdominal lymphadenopathy of unknown cause and can provide sufficient tissue for immunohistochemistry and subtyping of lymphomas.
EUS-FNA is the method of choice for the diagnosis of gastrointestinal stromal tumours (GIST) and other intra-abdominal masses.
Endobronchial ultrasound guided fine needle aspiration (EBUS-FNA) is replacing mediastinoscopy in the evaluation of patients with a radiographically abnormal mediastinum.
A crucial component for the success of EUS-FNA and EBUS-FNA is to have an experienced consultant cytopathologist examine the cellular aspirate onsite in the endoscopy suite. This practice ensures accurate and consistent results for delivering a preliminary onsite diagnosis as well as ensuring that the specimen aspirated is adequate for cytological diagnosis and that the appropriate ancillary tests are requested without delay.
Dr Glen Dixon, Lead Cytopathologist at Unilabs/IHS, is currently providing onsite cytopathology support at the London Bridge Hospital (EBUS-FNA) and the Wellington Hospital (EUS-FNA).
We continue to offer a state-of-the-art, cytopathologist-led, rapid FNA cytology service for patients with palpable lumps e.g. thyroid, head and neck, lymph nodes, salivary glands, subcutaneous lumps etc. Our cytopathology team are able to offer this service to you and your patients in a comfortable outpatient setting in our facility at 148 Harley Street. We are also able to provide onsite FNA cytology support to radiologists working in ultrasound clinics and clinicians working in specialist head and neck and thyroid clinics within the London area.
For further information about any of these services or to request onsite cytopathology support please contact the cytology department on: 020 7299 4494 or email ihsenquiries@unilabs.com.
DR AL-SARRAJ
March 2009
IHS is pleased to announce that the renowned Specialist Neuropathologist Dr Safa Al-Sarraj is joining the team.
Dr Al-Sarraj is Head of Department of Clinical Neuropathology at King's College Hospital NHS Foundation Trust, Director of the Brain Bank and co-director of Brain for Dementia Research.
Dr Al-Sarraj has established a comprehensive neuropathology service for various needs such as diagnosis of brain biopsies, brain tumour, pituitary lesions in addition to full examination of autopsy brains including those for medico-legal purposes
Dr Al-Sarraj is one of the national experts on forensic neuropathology with special interest in head injury. He offers full brain examination and constructive correlation and opinion. The brain is examined grossly and comprehensively analysed by histological and immunohistochemical stains.
DR CLIVE WELLS MA MB FRCPath
February 2009
Cytologists & Histopathologist
IHS is delighted to announce that Dr Clive Wells is joining IHS. Clive will greatly strengthen our capability in this important subspecialty.
Specialists in analysing tissue and cells under the microscope
Dr Clive Wells has been reporting cytology and histology for The London Breast Clinic since 1991.
He qualified from Cambridge University in 1978 having attended clinical school at St. George's Hospital in London, and trained in histopathology at Oxford. He was appointed Consultant in Histopathology and Cytopathology and Honorary Senior Lecturer at St Bartholomew's Hospital in London in 1989. He publishes widely on breast pathology and was elected as Chairman of the European Working Group for Breast Cancer Pathology in 2000.
His research interests include the molecular biology of apocrine epithelium, telepathology and quality assurance of breast pathology.
UNILABS REBRAND
June 2008
Dear Clients
I would like to take this opportunity to advise you of the forthcoming rebranding of Independent Histopathology Services Ltd by its owners Capio Diagnostics AB (Sweden). This follows the successful acquisition by Capio Diagnostics of Unilabs in 2007 and expands the network of operations to 11 countries employing over 2,800 staff. The decision has been made to rebrand the entire European business to the name of ‘Unilabs’. In the United Kingdom the legal registered company name will change from Independent Histopathology Services Ltd to Unilabs Ltd on 16th September 2008.
‘Independent Histopathology Services’ will retain its identity in the market by becoming a trading name of Unilabs Ltd under which the cellular pathology services will continue to be provided. There will be no change of management in UK and our focus will be to continue providing the highest possible levels of service to all our customers under current arrangements. It will be very much a case of ‘business as usual’.
The benefits for the UK business of being part of the ‘Unilabs’ European organisation will be the continued support and financial commitment necessary to invest heavily in both staff and the development of new innovative services. We look forward to continuing our working relationship and assure you of the ongoing support and commitment from ‘Independent Histopathology Services’ for the future.
Yours sincerely
Andrew Coutts
Managing Director
MORE INNOVATION IN 2008 FROM IHS
March 2008
24 hour access….now at your fingertips
We have often discussed the success and huge popularly of doctors’ web-access to their results – around the clock – via a secure link to
www.unilabs-ihs.co.uk. So now, in order to stay well ahead of the game, we are responding to consultant feedback – particularly the younger generation – by providing them access to their pathology results from their mobile phone devices. Client validation has been very positive and we are now undergoing commercial viability study and expect to launch this unique selling point in quarter three of 2008.
While-U-Wait Prostate
IHS proposes to perform rapid processing and reporting of prostate biopsies from both symptomatic and “well-man” screening patients. Our consultants will offer a “while you wait” service, enabling them to reassure or discuss further management with patients on the same day as their initial consultation and biopsy. Already, a large number of eminent London-based urologists have subscribed to use this service.
Stuart Money
Sales and Marketing Director, IHS UK
IHS Laboratory successfully completes CPA Inspection
March 2008
The IHS laboratories in UK recently went through its Clinical Pathology Accreditation (CPA) inspection. This involved being assessed against the following standards:
- Organistion and Quality Management System
- Personnel
- Premises and Environment
- Equipment, Information Systems and Materials
- Pre-examination process
- Examination process
- Post examination process
- Evaluation and Quality Assurance
The standards were assessed by a regional assessor specialising in quality management and IHS had a particularly rigorous examination as the assessor was an ex-United Kingdom accreditation system employee (UKAS) and scrutinised administration in intense detail. Our Quality Control Manager was also interviewed at great length.
He was then joined by three peer assessors comprising of two consultants and an experienced Biomedical Scientist. The process involved examination and vertical audits on the laboratory staff and procedures against the above standards. At the end of the inspection IHS had relatively few non critical, non conformities. These were mostly relating to documentation and remedial action will be now taken. The next visit will be a surveillance in 2010 and further full inspection in 2012.
Neil Barrett
Laboratory Operations Manager, IHS UK
NEW YEAR, NEW IDEAS
January 2008
A programme of continuous innovation is vital to ensure that IHS not only consolidates its strong client base but is successful in 2008 in capturing profitable new business. The provision of path images and enabling doctors to access results via the website has served IHS well during 2007. Competition, however, is intensifying from both the public and private sectors so it’s important keep delivering new points of difference.
In order to cultivate growth in the high-margin “Drs For Drs” sector, IHS is launching its PREMIER service with an holistic approach to delivering the best service in every sense- from personal pathologist reporting, guaranteed turnaround times of results, flexible courier and transport arrangements, to providing designated personal contacts in the lab and office.
The service will be extended to a limited number of existing heavy-users but more importantly to recognised “heavyweight” non-users. Premier Members will be given a Premier privilege card and number which will allow fast-track access to relevant members of the IHS team. Tailor-made request forms will be used to alert the lab to prioritise processing and reporting. A major team brief will take place to ensure that all IHS personnel are involved in this important development.
Stuart Money
IHS Move Project
October 2007
When IHS Ltd was established in 2001, one of the first challenges was to find suitable premises. Working closely with the Livemore Partnership – surveyors and project managers in previous moves – we chose 18 Wimpole Street as the site of our first histology laboratory, consultants’ offices and secretaries’ office – housing around twelve staff in total.
The most challenging part of these moves is finding the right property. There are strict controls over laboratories, particularly in an area where many neighbouring buildings have residential use. As there is very little natural light in 18 Wimpole Street, we established a cytology laboratory over the basement and second floor of 150 Harley Street. This complex project involved converting a basement flat into a cytology reception and preparation rooms, screeners’ rooms, rest room and a marketing office. It still houses fourteen of our staff.
In 2002, with the rapid expansion of the business, the histology laboratory transferred to a new building at 100a New Cavendish Street, a large basement with all-round natural light.
Due to further expansion, in 2006 a decision was taken to relocate the consultants, marketing, office staff and cytology screeners to new premises nearby, and relocate the cytology preparation into the vacated space. A suitable property was found in early 2007 on the second floor of a small office block. Since then, a large open-plan area has been converted into self-contained offices, a meeting room, an open-plan secretary’s office, a new server room, and a screening room for the cytologist. David Ferris, our Systems Administrator, has smoothly handled all our IT and communications issues as they arise. We even have a small veranda – ideal for staff to relax and socialise on sunny evenings.
Neil Barrett
Laboratory Operations Manager
IHS Shares Success in Breast Diagnostic Clinic
August 2007
I set up our One Stop Breast Clinic with IHS in 2002. It had seemed to me that both patients and GPs really wanted a breast diagnostic clinic that could provide all the tests and all the results at the same visit. This ideal was not easy to set up, but has been easy to market and proved extremely popular. The clinic is the only one in the private sector in London that always delivers the results of the fine needle cytology at the initial clinic visit.
IHS have contributed to the One Stop Breast Clinic by providing the cytopathology expertise. This involves a consultant cytopathologist and a technician being present within the clinic to process and immediately report the samples. With the increasing use of core needle biopsy, we pioneered touch imprint cytology of the cores. This provides an immediate preliminary result that is more than 90% accurate. Glen Dixon, Consultant cytopathologist and Head of Cytology at I.H.S has worked with me since the beginning to provide a high quality cytopathology service at every clinic. I am grateful to Glen and IHS for that commitment and expertise, particularly in the early stages when the volume of patients was low. IHS have demonstrated their commitment by providing every clinic with a high quality consultant cytopathologist.
The clinics popularity with GPs and patients alike is the best measure of its success. We now run three clinics a week at the London Bridge Hospital and within their diagnostic centre in the heart of the City of London. I would like more patients to have access to this type of high quality, rapid diagnosis and with this in mind we are looking to create a similar facility close to London’s famous Harley Street.
Ideal Patient Care
August 2007
There is no doubt in a busy Paediatric Gastroenterology Practice, and this I think reflects other sub-speciality type practices, that instance and accessible access to electronically available reports provides a foundation for efficiency and a vehicle to acceleration towards ideal patient care in terms of excellence, speedy decision making, accuracy and promotion of dialogue between the physician and the investigating laboratory. In this age of increasing electronic accessibility I can envisage a time when these facilities will be accessible by not just the ordering physician but the referring physician also.
The fact that we can now generate business via worldwide consumer access to our website is now paralleled by such an excellent service from IHS. If one presumes that patients require an excellence of opinion but in today’s fast moving lifestyle require and expect, and deserve, speed of delivery to match this excellence then this is a situation which must pertain and should be developed further.
I am delighted to be able to use this service and it is of great benefit when one works remotely in terms of oneself and one’s team and the hospital in question as we can access results and discuss them away from the hospital. In this regard it is something of great merit that should be further evolved in time to such access to x-ray images, endoscopic images and other facilities that are accessible by electronic image capture and web access.
Dr Mike Thomson
Consultant in Paediatrics
The Portland Hospital for Women and Children
The Cromwell Hospital
The new IHS Triple-Combination Gold Standard Test
February 2007
Both patients and clinicians have responded positively to this service, launched in the Autumn of 2006. This procedure, which enables the patient to be tested for High-Risk HPV, Chlamydia as well as the standard cervical smear from a single vial, has resulted in a vast increase in demand for HPV and Chlamydia testing. IHS Cytology has therefore increased lab frequency for these tests in order to maintain the crucial, rapid turnaround times of patient results.
For more information on the ‘I H S Triple-Combination Gold Standard Test’ please click the links below
Consultants – Triple-Combination Gold Standards Test
Patients – Triple-Combination Gold Standards Test
New Services Update – Positive feedback on Digital Imaging & Online Pathology
February 2007
The two new services of digital imaging, along with offering consultants and pathology managers the facility to access results via a secure link to this web site, have proved extremely popular with clinicians in all sub-specialties. More consultants are now electing to use IHS as their cellular pathology provider - and from more of their locations of practice.
For more information on digital imaging and our web based reporting please click the links below
Digital Imaging
Online Pathology
Gene-Based Urine Test (Gen-Probe PCA3) for Diagnosis of Prostate Cancer in EU Now Available Through IHS
November 2006
The European Commission has recently approved a gene-based test (Gen-Probe PCA3, made by Gen-Probe, Inc and DiagnoCure, Inc) to aid in the diagnosis of prostate cancer.
The test quantifies the presence of PCA3 mRNA (also known as DD3) in prostate cells released into the urine after a digital rectal examination.
Because prostate-specific antigen (PSA) is produced by both malignant and nonmalignant tissue, PSA tests tend to produce many false-positive results that cannot be confirmed by biopsy in up to 80% of patients.
In contrast, PCA3 mRNA is markedly upregulated (60- to 100-fold) in cancerous prostate cells, and it is not expressed (or expressed only at very low levels) in normal or hyperplastic prostate tissue, which improves the accuracy of screening results.
In one study of 225 patients with elevated serum PSA levels and negative results on previous biopsy, the PCA3 assay demonstrated significantly increased specificity for cancer compared with the PSA test (74% vs 17%). In another study (n = 491), higher PCA3 scores correlated with a higher probability of positive biopsy but (unlike PSA) did not correlate with prostate gland size, thereby decreasing the potential for false-positive results.
The PCA3 test will was formally launched at a meeting at the meeting of the British Association of Urologic Surgeons in the United Kingdom.
Flow Cytometry
September 2006
One ancillary technique that exemplifies the combined modality approach is the addition of flow cytometry to the cytomorphological evaluation of lymph node fine needle aspirations. Flow cytometry is also a useful ancillary investigation in the assessment of other cytological samples where there is a strong clinical suspicion of lymphoma, e.g. serous cavity effusions, CSF samples etc. In order to obtain a fresh sample, the laboratory must be informed that flow cytometry is required before or at the time the sample is taken.
“Hot” FNA Service - Patient referral to IHS for fine needle aspirations
September 2006
Fine needle aspiration (FNA) is a biopsy technique which employs a fine needle (21 gauge or finer) to obtain cells and small tissue fragments from lesions for diagnosis. Procurement and interpretation of FNA specimens requires specialized training in the pathology subspecialty of cytopathology.
The Department of Cytopathology at IHS operates an ad hoc FNA Clinic for the evaluation of superficial, palpable lesions. Lesions commonly aspirated in our clinic include enlarged lymph nodes (cervical, supraclavicular, axillary, inguinal), palpable thyroid nodules, palpable breast masses, and salivary gland masses. Virtually any subcutaneous, palpable, discrete nodule is suitable for FNA analysis.
FNA is the procedure of choice for the initial evaluation of thyroid nodules. It is useful in the evaluation of persistently enlarged lymph nodes. FNA rapidly provides information about the nature of worrisome breast masses.
We are now able to offer a gold standard level of service in this developing area. Our unrivalled “hot” FNA service provides our clients and patients with a same day consultation with a consultant cytopathologist who is accompanied by a cytotechnologist to ensure an adequate sample is obtained and that sufficient material is taken for ancillary testing. Because a portion of the FNA specimen is analysed at the time of the aspiration, a preliminary impression can usually be provided to both the patient and the referring physician. A final diagnosis is usually available within 24 hours. If necessary an ultrasound examination can be performed at the same consultation to provide additional clinically useful information.
For additional information regarding FNA, to request a “hot” FNA or to refer a patient to the IHS Department of Cytopathology FNA Clinic, please call or email the following address: : ihsenquiries@unilabs.com / Cytology Office
020 7299 4494
Introduction of Dragon Voice Recognition Software at Capio IHS:
September 2006
Pictured: IHS’ Professor Marco Novelli using Dragon NaturallySpeaking voice recognition software to dictate the macroscopic description of specimens in Cut-up.
Between February and April this year Capio IHS’ Histology department based at New Cavendish Street in London completed installation of Nuance’s Dragon NaturallySpeaking v8.0 voice recognition software for use in dictation of the cut-up and reporting of diagnostic specimens.
This software replaces the traditional use of micro-cassettes for dictation, and instead can convert spoken words to text at speeds of up to 160 words per minute. The subsequent need therefore, for processing these micro-cassettes by an audio-typist/secretary prior to the pathologist authorising the report, is now no longer required. The effectiveness of this software has been proven through the reduction in turnaround times in the laboratory, and in the levels of staffing needed for the office/admin department.
In a recent case study completed at Kings College Hospital NHS Trust they reported a 50% reduction in turnaround times of diagnostic pathology samples in the 12 months after installation of the Dragon NaturallySpeaking software. The software is also currently being introduced in histopathology and radiology laboratories at NHS Trusts throughout the UK and other areas such as the South East London Cancer Network as a means of reducing turnaround time of samples in the laboratory. David Ferris, Information Systems Manager, Capio - IHS UK
Digital Pathology Images
September 2006
We can now offer the incorporation of digitally acquired images of both microscopic and gross pathology into printed reports, and for display on our secure website (see Web-based access). This unique service adds a new dimension to the delivery and presentation of pathology reports.
Web-based access
September 2006
IHS is now able to offer a web-based service, enabling the clinician to access results via a secure link on the IHS website 24 hours a day. All users are given a unique username and password in order to gain access to results. Reports will be available in PDF format (Adobe Acrobat) and can be easily viewed and printed at any time from any PC with internet access and Adobe Acrobat Reader software installed.
Electronic transfer of information (ETI)
September 2006
IHS is now able to provide secure electronic transfer of authorised pathology reports to clients. This is currently available in two different formats:
- Via a dedicated BT data network connection between IHS and the client’s laboratory information system (LIS) to allow for secure transfer of data.
- Via the internet from IHS to the client’s LIS, using 128-bit encryption software for secure transfer of data.