Montana Laboratory Sentinel

Updates from the MT Laboratory Services Bureau
Phone: 800-821-7284 Fax: 406-444-1802
Lab Website

Lab Manual 

(Please reference this for testing or submission questions.)

July, 2024

MT PHL Employee Highlight: Jenna Mashek is a Laboratory Data Specialist. She started at the laboratory in 2017 as a Clinical Laboratory Assistant, then moved into the LIS team in the Laboratory System Improvement office. Jenna enjoys fishing, hunting, camping, and slow pitch softball. She and her husband, Jerry, love to be outside running around with their two boys and their dogs.

News and Updates 

Specimen Transport

• URGENT: Specimen Transport Temperatures

  • Following national regulatory requirements, the Montana Public Health Laboratory is implementing a more stringent process for verifying specimen integrity. To help ensure that specimen integrity is not compromised during transport, we will be recording temperatures inside coolers upon receipt. If a specimen(s) is not shipped appropriately and/or a temperature is found to be out of range upon receipt, the specimen(s) will be rejected.

  • Please ensure your cold packs are thoroughly frozen before packaging. Many cold packs are arriving thawed, which should not happen in overnight transport if they are properly frozen.

  • Take time to ensure your specimens are being packaged and transported under appropriate conditions to avoid rejection. This may include adding extra ice packs in the warmer months.

  • Please help us with this process. We do not want to reject specimens any more than you want them rejected, but we must follow the regulatory requirements.

  • You can place an order online if you need extra transport supplies (coolers, cold packs, specimen transport bags) to help comply with this request.

  • Acceptable transport temperatures for specimens can be found in the Public Health Laboratory Services manual. Montana Public Health Laboratory Services Manual (mt.gov).

IT Corner

• Collection Information

  • We have made a minor change to our ordering screen. You will no longer see collection information under the collection information column. It will now read "see lab manual". 

  • There is a direct link to our lab manual on the left hand side of the screen under quick links. 

• Lab Portal Tips- Placing order on existing Patients

  • Did you know you could enter an MR or DOB in the patient field on order patient samples to find a patient when entering an order? This is especially useful for repeat newborn screens where the patient’s name can change from one sample to the next. Please click here for more information.

• Single Sign On (SSO) coming to all state systems

  • The state has adopted OKTA as its SSO platform. All state systems are being required to transition to OKTA for user authentication. This means users will need to sign-up for an OKTA account, and will use that account to sign in to any state system they access, including the lab portal. The user access request process will also be transitioned to an online process that integrates with OKTA. We don’t have a current time frame for when we will start this transition, but expect more information from us in the coming months!

Newborn

• Newborn Screening Go-Live in new LIS

  • July 8^th is our go-live day for newborn screening in the new LIS.  Any samples received from Saturday 7/6 on will be processed in the new system. Pending samples will be completed in the old system. However; reports for ALL samples will be using the new report format. Click here to see a comparison of the old format to the new one. The original report from the old LIS will still be available as a linked document for those samples that were processed in the old system.

  • With this transition, there is more data validation happening at order entry, so you may see messages asking you to verify information if something triggers a warning.  One example would be if an order is entered for a baby who was less than 24 hours old at the time of collection and is not in the NICU.

• Changes to Newborn Panel 2 Reporting

  • We are working on changes to the way Newborn Panel 2 is reported in cooperation with our reference laboratory, Wisconsin State Laboratory of Hygiene (WSLH). These changes will coincide with the transition to the new LIS, so reports for samples received Saturday July 6^th forward will be reported the new way. Newborn Panel 2 will now serve as a summary screening panel for tests performed at WSLH, and will only show the final interpretation for the tests – Screen Normal or Screen Abnormal. If there are any abnormal results, additional detailed test results for the abnormal screen will be provided on the report under a different test heading. If any secondary testing is done that ultimately results in a normal screen, ONLY the screen normal result will be shown on the summary panel. We feel this will clear up any confusion and make the final screen interpretation more clear.

Microbiology

• Enteric Season is Here

  • Please remember to send your positive enteric specimens and/or isolates to MTPHL. By Montana Administrative Rule, required submissions include Shiga-toxin producing E. coli (especially E coli O157), Vibrio, Salmonella, Shigella, Listeria from any body site, and Cronobacter sakazakii from invasive sites. We are also interested in submissions of Campylobacter and Cronobacter sakazakii from any body site for surveillance.

    • Isolates are preferred but molecular positive stools and CIDT positive stools are also acceptable for testing.
    • When ordering, please select the specific organism and “confirmation” on the web portal. For example, “E coli confirmation”.

  • MTPHL performs additional surveillance testing on the isolates, such as Serotyping/Serogrouping and Whole Genome Sequencing. The information is shared with our Communicable Disease Epidemiologists for state surveillance and with CDC for their nationwide surveillance system.

  • Thank you for helping support our state and national surveillance efforts!

Preparedness

• Select Agent Exposure and Destruction Reporting

  • When an occupational exposure of laboratory workers to a Select Agent occurs, APHIS/CDC Form 3: Report of a Release/Loss/Theft must be immediately submitted to the Federal Select Agent Program (FSAP). This is a federal mandate. The form and guidance for completing it can be found at https://www.selectagents.gov/forms/form3.htm

    • If there has been an exposure, it is important to notify your local public health authority and healthcare provider for any post-exposure prophylaxis or other follow-up guidance. You can find information regarding Biorisk management on our website: https://dphhs.mt.gov/publichealth/LaboratoryServices/Biosafety. Please contact Crystal Fortune if you have any questions.

  • When an organism has been identified as a Select Agent, APHIS/CDC Form 4: Report of the Identification of a Select Agent or Toxin must be submitted to the Federal Select Agent Program. Form 4A specifically is used by clinical labs to notify the FSAP of the identification and destruction of a Select Agent. All culture material containing the isolate must be destroyed. The form and guidance for completing it can be found at https://www.selectagents.gov/forms/form4.htm

  • Some Select Agent microorganisms occur naturally here in Montana and others are brought in by tourists, active-duty military personnel, and business contractors. Remember to be vigilant at the bench for your protection!

  • Please contact the State Public Health Laboratory with any questions concerning possible Select Agents, their rule-out testing, and regulatory filings: Call 406-444-3068 (Kim Newman, Laboratory Preparedness Specialist).

Reminders:

• Lab Portal Information

  • All of our lab portal procedures and access paperwork can be found on our website. Here is the link to the direct page with all of our forms and procedures: https://dphhs.mt.gov/publichealth/LaboratoryServices/onlineorderingandresults.

  • There is also a link in our lab portal that will take you directly to this page. This link can be found under quick links. "MT PHL Lab Portal Procedures and Forms". 

• Courier 

  • The Courier will NOT pick up on July, 4th but will resume their schedule on July 5th.

  • Please click here for our full courier schedule.

• Previous Laboratory Sentinels 

  • All previous Laboratory Sentinels can be found on our website on the column on the left hand side by selecting "Public Health Laboratory Newsletter". Here is a link to all our previous Laboratory Sentinels.