We've had a couple of issues with AutoReview rules that we need to make you aware of.
The most significant is what appears to be an isolated incident of some abnormal Ferritins being Auto-Reviewed, which we never Auto-Review currently. This occurred where a lab was including Ferritin results under the header "B12/Folate". Our AutoReview rule was built to only factor in B12 and Folates and so wasn't excluding abnormal Ferritins from being Auto-Review. The practice where this came to light is reviewing the patients impacted and we've amended the rule, and similar rules, to mark any for review where an abnormal Ferritin is included with B12/Folate.
We have reviewed our rules and put additional safeguards in place to check for investigations that could be included under a battery header but that may not be normally anticipated in the rule. We're going to do more work on this in the coming weeks.
We've run reports on many practices to check the same issue hasn't occurred anywhere else and haven't found any evidence it has. However, we're mindful that labs do sometimes change their comments, ranges, and investigations included under a battery header. Please let us know if you notice your lab starting to include additional investigations under a battery header. We'd also really appreciate it if you forwarded any updates sent to you from your labs. Some of you have been doing that and its really helpful for us to be aware of changes labs are making.
The other issue is that some raised Vitamin D's have been filed for practices configured to only file satisfactory results for Vit D. We've fixed the rule to prevent this from happening again and have created reports you may want to use to review patients.
The complication here is that a raised Vitamin D is not well defined - there doesn't seem to be a consensus at what level a raised vitamin d is of concern. At one point we had the upper limit set at 250, we now have it set at 150.
We've built reports you can use to review any potentially impacted patients and created a report output "WI - Review Vitamin D" that you could use to aid review. These are the reports:
Practices who are using the full vitamin D system will also have some patients in the report for >=150 as this reflects the previous changes in levels. We've ran these reports across many practices and only found a couple of patients where a result >=250 has been AutoReviewed as Satisfactory.
As ever, if results aren't being auto-reviewed when they should, or the other way round, please email us with the details (support@welbyinnovate.co.uk) so we can update our rules accordingly.
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