Drug Monitoring: New Tools and Technologies

AACC Annual Meeting & Clinical Lab Expo 2014 - July 28-Aug 1 - Chicago

In This Issue...

Pain Patrol: Therapeutic (or Not) Drug Detection, Monitoring

Learning About the Latest Technologies
learning technologies

The Institute of Medicine has estimated that one-third of Americans–about 100 million people–live in chronic pain and that chronic pain represents a significant public health problem that costs at least $560-635 billion per year. Laboratorians are on the front lines of monitoring appropriate use of prescription pain medications and spotting their diversion and abuse. Lab professionals also face an unenviable task of detecting an ever growing arsenal of illicit drugs. This year's Annual Meeting & Clinical Lab Expo features a broad range of programming to arm laboratorians with tools to stay on top of the always changing landscape of therapeutic pain management and drugs of abuse detection.

In an Afternoon Short Course on July 28 from 2:30 p.m. to 5:00 p.m. (72224), Drs. Paul Jannetto of Mayo Clinic in Rochester, Minnesota, Majid Moridani of the Medical College of Wisconsin in Milwaukee, and Andrea Terrell of the American Institute of Toxicology will look at pain management analysis, reporting, and consulting. This trio of experts will review best practices in pain management and will present a series of case studies to illustrate challenges in reporting and interpreting therapeutic drug monitoring (TDM) results. They also will discuss laboratorians' important role as clinical consultant to physicians in understanding TDM analytics and results.

Beyond pain management, Drs. Amitava Dasgupta of the University of Texas at Houston Medical School and Loralie Langman of Mayo Clinic in Rochester, Minnesota will explore the issue of erroneous results in both TDM and toxicology. In this Morning Short Course on July 28 from 10:30 a.m. to 12:00 p.m. (72109), Dasgupta and Langman will guide laboratorians through the troubleshooting process when doctors call the lab and say, "This result doesn't match what I'm seeing in my patient."

Unfortunately, drug abuse runs throughout society, and in Brown Bag Sessions offered twice on July 28, at 7:30 a.m. to 8:30 a.m. and at 12:30 p.m. to 1:30 p.m. (42118 and 52218), Dr. Steven Cotten of Ohio State University Wexner Medical Center in Columbus will address the special circumstance of drug testing in neonates as part of the workup for neonatal abstinence syndrome.

A trio of toxicology experts, Drs. Marilyn Huestis of the National Institute on Drug Abuse, Kara Lynch of San Francisco General Hospital, and Robert Kronstrand of the National Board of Forensic Medicine, will reveal the moving target of designer drugs in a Morning Symposium on July 31 from 9:30 a.m. to 12:00 p.m. (35104). From so-called Bath Salts to K2 and Spice, clinicians and laboratorians face challenges in coupling patients' clinical presentation with lab test results. The speakers will discuss designer drug trends, testing methods, and intoxication effects, so that attendees will be better prepared to respond to drug testing demands in their own communities.

Just as illicit drugs keep changing, so too do the technologies to detect them. In a forward-looking Afternoon Symposium on July 29 from 2:30 p.m. to 5:00 p.m. (33210), Drs. Ping Wang of Houston Methodist Hospital in Houston, Texas, and Zheng Ouyang of Purdue University in West Lafayette, Indiana, will describe two novel technologies for drug of abuse testing. Both a point-of-care volumetric bar-chart chip and a miniaturized mass spectrometry device seem fairly experimental right now, but they offer a glimpse of how illicit drug testing will evolve. Drs. Wang and Ouyang will describe for attendees these technologies and others.

Big Data Dossier

Meet the Expert: Sharing Big Ideas on a Small Scale
meet the expert

Big Data is a buzzword in healthcare and in many other aspects of life, but what does it really mean in the context of clinical laboratory practice? Monday's plenary speaker, Dr. Viktor Mayer-Schönberger, a professor of Internet governance and regulation at the Oxford Internet Institute in England will give attendees a grand view of how massive amounts of data output from genomic, proteomic, and metabolomic analyses are transforming medicine and even creating a new science around interpreting these large data sets. He'll connect the dots between the concept of massive data analysis and its emerging integration into lab practice. Attendees fascinated by his presentation who want to learn even more and perhaps ask a probing question or two of him outside of a large audience will have the chance to do so after the plenary. In a Meet the Experts session Understanding Big Data and its Impact on Your Laboratory (62101), Dr. Mayer-Schönberger will talk further about Big Data and its impact on lab-related research and society as a whole, with up to 50 participants.

Two other Annual Meeting sessions will bring Big Data from the healthcare industry wide perspective into more practical terms for laboratorians. The first of these is an Afternoon Symposium on July 29 from 2:30 p.m. to 5:00 p.m. Sonny Varadan, a leader in strategic information technology development and a consultant with Nichols Management Group, a laboratory consulting firm with a focus on lowering costs, increasing revenue, and optimizing laboratory operations, will discuss how Big Data can unleash the power of lab data for payers, patients and providers (34102). Despite its importance to patient care and to making the overall healthcare system more efficient, laboratory data has not achieved its full utility because existing lab systems don't make it easy to extract, monitor, and share data. Varadan will present the case for how lab-focused big data systems are enabling laboratories to dramatically grow their business, reduce operating costs, and deliver quality results in a shorter timeframe.

During an Afternoon Symposium on July 29 from 2:30 p.m. to 5:00 p.m. (33218), a trio of highly experienced laboratorians will share real-world applications of analytics in lab medicine. In this session—developed in cooperation with INFORMS-the Association for Analytics Professionals, Laboratory Information Systems and Medical Informa, and AACC's Management Sciences and Patient Safety and Personalized Medicine Divisions—speakers Dr. Jay Jones of Geisinger Health System in Danville, Pennsylvania, Bradley Brimhall of University of Mississippi Health Care in Jackson, and Nicole DeHoratius, PhD, of the University of Chicago will share case studies of their respective institutions' uses of data analytics and integration to improve patient outcomes and boost lab's value to the organization.

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