Meredith 2015

Pathology (2015) 47(S1), p.
S3
Innovations – Plenaries
DAVID ROTHFIELD MEMORIAL ORATION: DEFINING apace in the wider medical community. Data mining tools, social
ANALYTICAL PERFORMANCE GOALS media and decision support are expected to improve health
resource utilisation, evidence-based practice, and clinical effec-
Callum G. Fraser tiveness. These tools will also become widely deployed as patients
Centre for Research into Cancer Prevention and Screening, and health consumers have more control over health service
University of Dundee, Ninewells Hospital and Medical School, delivery and expect an improved experience in their contact with
Dundee, Scotland the health system.
Since 1999, the ‘Consensus Agreement’ from the Stockholm

Conference has provided professionally accepted guidance as to
a hierarchical approach to setting analytical performance goals. POINT OF CARE TESTING AND GOVERNANCE: A SHIFT
However, many aspects of laboratory medicine have changed since IN PARADIGM
then. In consequence, the 1st EFLM Strategic Conference on
Samarina M. A. Musaad
‘Defining analytical performance goals 15 years after the Stock-
Department of Chemical Pathology, Labtests, Auckland, New
holm Conference on Quality Specifications in Laboratory Medi-
Zealand
cine’ was held on 24–25 November, 2014. The conference
developed a proposal for a modified and updated consensus state-
Point of care testing (POCT) has changed dramatically since its
ment. There was general agreement that three different models,
earliest applications in ancient civilisations. An increase in popu-
again set in a hierarchy, should be used to set analytical perform-
lation density, health inequity and an increase in the prevalence of
ance goals. The proposal is simple. Model 1 is based on the effect
chronic diseases associated with longevity, disasters both man-
of analytical performance on clinical consequences, which can be
made and natural, and the resurgence of critical infectious diseases,
assessed using different approaches including outcome studies,
together with advances in technology and a competing market
simulations of uses of test results, and surveys of clinicians’ and/or
place have made POCT an integral part of modern healthcare
experts’ opinions investigating clinical settings. Model 2 is the
delivery.
widely used strategy based on components of biological variation.
While POCT is an essential part of the solution to some healthcare
Model 3 is founded on state of the art, but that should be based on
delivery problems, if not appropriately governed and regulated it
the highest level technically achievable or, alternatively, could be
can create problems of its own. The multiple tiers to providing a
defined as the analytical quality achieved by a certain percentage of
POCT service need to be managed in alignment with best practice
laboratories. Whether this new approach becomes widely adopted
guidelines and principles of clinical governance to ensure safe and
remains to be assessed.
reliable processes providing clinically useful results.
Gaps in clinical governance of POCT can be filled by a progressive
and critical paradigm shift in healthcare delivery in the 21st century
A PATHOLOGIST HITCHHIKER’S GUIDE hence providing the opportunity to maximise benefits from the
TO INFORMATICS practice of POCT while mitigating associated risks. Raising
awareness within the profession is vital to this achievement.
Michael Legg, Lawrence Bott, Glenn Edwards, David Ellis and
Ken Sikaris
RCPA Informatics Committee
DEALING WITH DIFFICULT PEOPLE
The contemporary practice of pathology is heavily reliant upon Donna Meredith

information systems. These systems are becoming increasingly Managing Director, Keystone, and Principal, Interaction
sophisticated and College Fellows are frequently required to have Associates Australasia
input on their design, selection, implementation and evaluation.
Laboratories are adopting decision support technologies to support Difficult people are everywhere; everyone is difficult during
workflow management and clinical interpretation of pathology certain moments of their life. Eventually all of us need to work
tests. The computationally intensive field of bioinformatics is or compromise with a person that we think is difficult. In many
growing rapidly especially in genomics laboratories while stat- cases the first response is to ignore or avoid that individual, but that
istics, another informatics discipline, has always been an important seldom provides a sustainable, long term solution. Unaddressed,
part of Fellowship training. College Fellows have a professional necessary conflict simmers just below—and often erupts counter-
duty of care, and also carry ethical and medico-legal responsibility, productively above—the surface at work. There are specific strat-
for the efficacy, reliability, safety and security of such systems. egies that can assist in dealing with this challenge; and that can be
Significantly, the development of Health Informatics also proceeds used to create agreements among individuals that last.
Print ISSN 0031-3025/Online ISSN 1465-3931 # 2015 Royal College of Pathologists of Australasia
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
S4 PATHOLOGY 2015 ABSTRACT SUPPLEMENT Pathology (2015), 47(S1)
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.

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Pathology (2015) 47(S1), p.

Since 1999, the ‘Consensus Agreement’ from the Stockholm

The contemporary practice of pathology is heavily reliant upon Donna Meredith

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