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OUTREACH by UNM Pathology ---and--- TriCore Reference Labs

OUTREACH by UNM Pathology ---and--- TriCore Reference Labs. Presented By: Brian Hjelle, MD, FCAP Medical Director, Genetics and Cytometry Laboratory TriCore Reference Laboratories Int. Chairman, UNM Pathology. OUTREACH. Residents/Fellows TriCore Hemepath OMI. OUTREACH.

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OUTREACH by UNM Pathology ---and--- TriCore Reference Labs

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  1. OUTREACH by UNM Pathology---and---TriCore Reference Labs Presented By: Brian Hjelle, MD, FCAP Medical Director, Genetics and Cytometry Laboratory TriCore Reference Laboratories Int. Chairman, UNM Pathology

  2. OUTREACH Residents/Fellows TriCore Hemepath OMI

  3. OUTREACH Pathology Clinical Fellowships Hematopathology Forensic Pathology Cytopath Molecular Genetic Pathology Surgpath Transfusion Medicine Research Fellows Usually about 6 Grad Students Usually 10-12

  4. OUTREACH –resident alumni

  5. UNM Department of Pathology 58 faculty members, including 27 MDs 21 PhDs 5 MD-PhDs 5 Others An MLS (med lab sciences) program

  6. Braggin’ Rights NCI: Comprehensive Cancer Center Roadmap Initiative/Flow Cytometry SEER site 33rd highest NIH-funding for Path Depts T32 Training grant Office of Medical Investigator Top-tier residency w/broad training HTR, microscopy, FISH TriCore

  7. History of TriCore • Created in 1998 • University of New Mexico Hospital Health Sciences Center • Presbyterian Healthcare Services • The Reference Laboratory (TRL) • St. Vincent’s Medical Center (Santa Fe)

  8. University of New Mexico Hospital Health Sciences Center • Affiliated with only medical school in New Mexico • Pathologists university employed and faculty at UNM SOM • Diagnostic services • Research • Teaching – medical students and residents; medical technicians • Cancer Center • Level I Trauma Center • Transplant Center

  9. TriCore Structure • Independent not-for-profit entity • Sponsors (Presbyterian, University Hospital) comprise Board of Directors • Lab staff to be employed by TriCore • Non-urgent testing consolidated at Core lab • Histology and cytology consolidated at Core lab • Two pathologist groups to be contracted for medical directorship, technical oversight and anatomic path • TriCore-hired CEO and CMO

  10. New Building • Consolidated Core lab opened January 2004 • 1,000 TriCore employees at Core lab, in sponsor hospital labs, branch labs, patient draw sites • Service in New Mexico, El Paso, and southern Colorado • National consult service in hemepath, flow cytometry, cytogenetics

  11. HISTORY

  12. Hemepath and Related Services

  13. HISTORY

  14. Flow Cytometry Case Volume 2003-2006

  15. Consult Case Volume 2000-2007 (projected)

  16. Total Cytogenetics Tests 2000-2007 (projected)

  17. The Players • M Kathy Foucar, MD • Director of HemePath and Vice Chair for Clinical Affairs • John Hozier, PhD • Pioneering cytogenetics/FISH clinical investigator • Kaari Reichard, MD • Helped initiate FISH service • Mohammad Vasef, MD • Seasoned Molecular Onc, started MolPath fellowship • Carla Wilson, MD, PhD • Established leukemia “template” system for efficiency • Qian Zhang, MD, PhD • Kristin Hunt, MD

  18. Office of the Medical Investigator (OMI)

  19. New Mexico Office of the Medical Investigator • Centralized, statewide, university-based • 8 forensic pathologists • 10 central and 130 field investigators • Administers University Hospital autopsy service • Trains fellows & pathology residents

  20. New MexicoOffice of the Medical Investigator • Authorized by legislated state statute • Investigates violent, sudden, suspicious, unexplained & unnatural deaths • Determines: condition of body cause/manner of death • Investigates ~5100 of 14000 deaths/year • Performs ~2100 autopsies/year (>95% of NM autopsies)

  21. New MexicoOffice of the Medical Investigator • Comprehensive autopsy report & computerized database • Retrospective analyses/prospective coding for epidemiology & research • Organization: statewide population-based surveillance • UNM tie: consultation/collaboration, enhanced diagnostic accuracy, research

  22. Participation in National Surveillance Systems • National Violent Death Reporting System • Conjunction with crime lab, vital records, state health dept., & police agencies • Surveillance & granular epidemiology for all homicides, suicides & unintentional firearm fatalities • CDC funded • Drug Abuse Warning Network • Tracks all substance abuse (licit and illicit) deaths • SAMHSA funded

  23. Anthrax Med-X Surveillance Model for Bioterrorism & ID Mortality • Developed model for Medical Examiner ID surveillance with CDC funding • Uses antemortem symptoms to capture potential cases • Pathology-based syndromic reporting standards • Organism & toxin specific diagnoses • SLD NM Dept of Health • CDC - ID Pathology Activity - enhanced diagnostic capacity • Now implemented: NH, OR, MN, GA Nolte KB, et al: Hum Pathol, 38:718-725, 2007

  24. Some Summary Comments • We have pioneered in regional laboratory models • We have a model ME office • We have strong leadership in forensic path, hemepath, cancer biology • We have steady growth in hemepath, surgpath, molecular, cytogenetics, FISH, many other areas • Good old fashioned leadership and outreach..

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