Q&A column

The soundest approach is for the laboratory to validate the effects of hemolysis by performing interference studies with the tests and analyzers in question. Without such data, the safest practice is to reject coagulation samples with more than trace hemolysis, unless the patient is experiencing in vivo hemolysis. Patients with in vivo hemolysis, such as those who have hemolytic anemia or are on ECMO circuits, may require coagulation testing, and their samples will be hemolyzed regardless of the phlebotomy technique and sample transport method used. Those samples should be analyzed and resulted in consultation with the clinical service. All specimens determined to have hemolysis merit a comment or disclaimer regarding the presence of hemolysis, particularly if the result is beyond the reference interval.

1. 1. Moreira PL, Lansden CC, Clark TL, Gawryl MS. Effect of Hemopure on prothrombin time and activated partial thromboplastin time on seven coagulation analyzers. Clin Chem. 1997;43(9):1792.
   2. Nougier C, Jousselme E, Sobas F, Pousseur V, Négrier C. Effects of hemolysis, bilirubin, and lipemia interference on coagulation tests detected by two analytical systems. Int J Lab Hematol. 2020;42(1):88–94.
   3. Woolley A, Golmard JL, Kitchen S. Effects of haemolysis, icterus and lipaemia on coagulation tests as performed on Stago STA-Compact-Max analyser. Int J Lab Hematol. 2016;38(4):375–388.

Clarence Chan, MD, PhD
Fellow, Clinical Chemistry
Department of Pathology
University of Chicago
Chicago, Ill.
Junior Member, CAP Hemostasis and Thrombosis Committee

Jacob Ritter, MD
Post-graduate Year-four Pathology Resident
Department of Pathology and Laboratory Medicine
UT Health San Antonio
Long School of Medicine
San Antonio, Tex.
Junior Member, CAP Hemostasis and Thrombosis Committee

Q. I am a medical laboratory scientist who would like to move into a laboratory information technology/information systems career to support the growing need of professionals in that aspect of health care. What education is advised and what licensing is required, and do you have any suggestions on how to make such a move?

A.In my organization, the majority of our laboratory informatics team members come to us with prior bench experience as clinical laboratory scientists (CLS). Their ability to understand local testing workflows and the data generated from testing is often key to guiding and supporting each of our testing departments with their laboratory information system and EHR requests.

A good way to get involved is to become the point person from your testing department who works with your local IT teams on any LIS-related changes, such as adding new test orders, interfacing new instruments, modifying test orders or results, and reviewing security needs for patient-protected health information. Learning to translate your testing department’s needs to the LIS/EHR and IT requirements should give you real-world experience that will help you determine whether this might be a good career move. Beyond that, I don’t think there are necessarily any required special certifications, but different job postings may have different needs, which should be spelled out in the job requirements or by inquiry to the recruiter.

Ji Yeon Kim, MD, MPH
Physician Director, Laboratory Informatics
Kaiser Permanente Southern California
Los Angeles, Calif.
President, Association for Pathology Informatics

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