Lab Tests Online UK

Lab Tests Online UK
…and the informed patient
….and the informed Dr?
Stephen Halloran
LTO Managing Editor
www.labtestsonline.org.uk
Lab Tests Online UK
Information
…and thesource
informed
patient
….and the informed Dr?
www.labtestsonline.org.uk
Lab Tests Online UK
Presentation to the Diagnostic Summit
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Why LTO?
Site Development
Challenges
Aspirations and Plans
Why Labtestsonline?
Pathology - a discipline at the interface
70% of diagnosis
depend on a lab tests
Why Labtestsonline?
Patient - Doctor Consultation
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Intimidating
Frightening
Questions to ask
Questions to answer
‘Better do a few lab tests…’
In England in one year…
„ >700,000,000 tests
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> 500 million biochemistry
>130 million haematology
>50 million microbiology
>13 million histo slides
>4 million cytology slides
> third (35-45 per cent)
from primary care
‘Better do a few lab tests…’
‘I could give you a copy of
your lab report but…
…I doubt you’d understand it.’
Language confusing
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FBC
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LFT
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TFT
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IgE
Why Labtestsonline?
Time is of the essence
‘No time to think!’
‘So I said…
…how long have I got Doctor?
and he said…
…ten minutes maximum!’
2005 Health Commission Report
‘A third of patients said results of
diagnostic tests were not explained in a
way that they could understand’
Conclusion
‘… people are still not being told enough
about… what the results of diagnostic
tests mean…’
Health on the TV & Radio
Pathology Tests!
Information on the internet
Internet Access 2007
„ 15 million households
„ 84% with broadband
Information on the internet
‘On the Internet,
nobody knows
you’re a dog’
Information sources
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BBC /Charities /Societies specific diseases
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Individuals /companies unregulated & biased
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Information from
outside UK
Lab test information on the net…
…understandable, professional, unbiased
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American Assoc of Clin Chem
Launched Aug 2001
Reflects US Healthcare…
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medical practice (population screening)
test protocols (just-in-case testing)
emphasis on personal health care
management
expenditure on health care
FDA regulations
Lab test information on the net…
…understandable, professional, unbiased
Labtest online 'Hits' 2001 - 2004
400,000
2004
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350,000
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300,000
250,000
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200,000
150,000
100,000
50,000
Months '01 - '04
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>500,000 visits / month
>30% of visits - health
professionals
1% of visits - UK
Lab Tests Online UK
2002 - Challenge
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Finance (Health Foundation)
IT platform (Atomz)
Editors & Authors
Volume (1800 pages)
Publicity
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Professional challenge
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Lab Tests Online UK
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Experience in publishing - journals, books, web
Awarded grant by
The Health Foundation in 2002
Funding secured for 3 years - £85,000
Content and structure - licensed from US
Used Atomz Publish - used by the US
Fusionbot search engine - cheap UK solution
Lab Tests Online UK - Organisation
Project Board
(6 UK scientists &
pathologists)
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Chair of Project Board
Managing Editor
Project Manager
IT Lead
Finance Lead
Lay liaison
Support from…
Association for Clinical Biochemistry
„ RCPath (Lay Advisory Committee)
&
„ Group of very willing and productive
pathologists and clinical scientists
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Lab Tests Online UK
Authors - all pathology specialties
Completely revised for the UK
18 months writing & editing
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1854 Pages
158 Tests
75 Conditions
158 Glossary terms
800,000 words!
HON Accreditation
Support…
Nat. Ass’n of Phlebotomists
NHS Direct (England)
NHS24 (Scotland)
NHS Direct (Wales)
NHS Information Authority
Lab Tests Online UK
Launch Richmond House
16th June 2004
• Minister of Health Rosie Winterton
• TV Presenter Lynn Faulds-Wood
• Sue Doughty MP
Inside the Lab
Understanding Your
Tests
• At a glance
• What’s tested
• Why
• Questions
• Links
Understanding Your
Tests
•Tests
•Diseases
•Screening
Topics in the News
Spreading the word…
Lab Tests Online Cards
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Distribution by local labs
GP surgeries & clinics
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1 million distributed
Record names of tests
Visit Labtestsonline.org.uk
Presentations
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Nursing in Practice Conferences
Phlebotomy Conference
GP Conference
Pathology meetings
LTO monitoring performance
Visitors until December 2007
160000
140000
100000
80000
60000
40000
20000
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Total
4 million by
January 2008
120000
Visitors
3,935,962
visitors
since launch
LTO monitoring performance
Referrals to site
Month of March 2007
• 20.6% - search engine
• 6.1% - other sites
• 73.3% - directly
Referral to site
QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
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Google.co.uk
Google.com
NHSdirect.nhs.uk
12,304
7,266
5,018
LTO monitoring performance
Month of March 2007
Search Terms
Pages Viewed
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Full Blood Count
TSH
Liver Function
Haemoglobin
Cholesterol
Monospot
T4
Tumour Markers
Reference Ranges
5,345
4,590
3,138
3,124
2,841
2,079
1,997
1,780
2,659
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Haemoglobin
Full blood count
Monospot
Cholesterol
Oestrogen
Creatinine
Ferritin
Urinalysis
Iron studies
1,104
844
594
493
351
339
237
196
195
LTO monitoring performance
Month of March 2007
Visit Statistics
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131,276 distinct visits to the site
Average visit 3 minutes and 48 seconds.
Average visit - 3.05 page views
1,582 individual pages viewed a total of 400,577 times
Average - 1 minute and 14 seconds a page.
User Comments & Queries
User Comments & Queries
This year - 189 written comments…
Compliments!
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Thank you for the information I gained from this site. It was enough to allow me an insight, allowing me to
understanding decisions made by my husbands G.P The information was I feel not scaremongering but allowing the
lay person the facts that they need when extremely concerned and not left in the dark.
I have been looking for sites like this for a long time. Thank you!
i think this site is brilliant,very informative,easy to follow,good work.
Excellent idea, provides much needed information for a range of patients.
As a BMS myself i found this site to be excellent - i came here looking for some info on ER testing and i have found
the info to be brilliant -thanks!
I am a practice nurse for the army and picked up the leaflet yesterday and have just visited your site- I have found it
immensely useful and will definitely recommend it to my patients.Thank you so much
This site is very easy to find information on and also very well set out. the information is not to technical and is very
easy to read i the person is not in a medical profession.
I work in a hospital lab, even I found this information really helpful !
I recently had some pathology tests done and thought how useful it would have been to get an interpretive key to
them. Two weeks later and out of the blue a friend sent me a link to this website. Perfect!
You have an outstanding good and well structured site.
Thank you for your site. I have found here much useful information.
Hi I have looked on your site which is very interesting and have always found what I am looking for
Information is fine as it is.
User Comments & Queries
2007 - >189 emailed comments…
Others!
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Personal advice (95)
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Interpretation of results
Concerns about symptoms
Concerns about advice given GP etc
Request for specific tests to be added to site (8)
Want to purchase tests
Questions from professionals (36)
Complaints (7)
Test reference ranges - what is a normal results
International Development
• US - August 2001
• UK June 2004
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Australia August 2007
Germany April 2007
Spain 2007
Italy 2007
Poland 2007
Hungary 2007
Lab Tests Online UK
2008 Challenges
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Finance - (RCPath & DH)
IT platform - flexible enough?
Authors & Editors
Content - tension (more or less)
Language - how simple?
Updates are a priority
Enquiries - quick and efficient
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Reference ranges
LTO Finances
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2004 Health Foundation Award 3 years
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One off licence to use AACC material
2007 Income DH 1 year, RCPath 5 years
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LTO Expenditure
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Software
Software licences
licences (Atomz)
(Atomz) -- £10,000
£10,000
Server
Server use
use and
and maintenance
maintenance
Project
Project Board
Board -- £1,000
£1,000
Editorial
Editorial &
& office
office expenses
expenses -- £4,500
£4,500
Publicity
Publicity -- dependent
dependent on
on income
income
Future - Aspirations & Plans
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Audit effectiveness (?2008)
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Site review and update (?2008)
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Requests from Paed. Hospitals
Graphics & layout enhancements (start ?2008)
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Paid editorial support - 3 months
‘Labtestsonline for kids’ (start ?2008)
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Trainee NHS Scientists / Medics
Commission artwork - art college project?
Layered information source (no dates)
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Resource for a spectrum of users
PCA3 - at a glance
LTO Professional
Professional
A resource for those providing and
utilising laboratory tests
ESTABLISHED ANALYTES
Evidence-based
Non-commercial
NEW ANALYTES
TRIALS
January 2009
…in the news
PCA3 - under evaluation
under
development
A new test is based on DNA technology
Related Tests: Total, Free & Complexed PSA, EPCA,
AZGP1
under evaluation
approved for
adoption
evaluation sites
required
At
At aa Glance
Glance
Clinical
Clinical
Analytical
Analytical
Literature
Literature
Contacts
Contacts
Background details
In the early 1990s, at about the same time that PSA testing was starting
to gain widespread adoption, William B. Isaacs, Marion Bussemakers a
molecular biologist from Holland working at The Brady Urological
Evaluation forum Institute of Johns Hopkins University performed studies on human
Clinical tips
prostate tissue using the technique of differential display, a then newly
Specialist labs
described method to identify gene expression in different tissues.
During this series of experiments, an mRNA was discovered that
appeared to be highly specific for prostate cancer.
Labtestsonline.org.uk
‘…a patient centred initiative of national importance’
…the definitive web information source to
patient for clinical laboratory tests…
…could it develop to serve pathology,
pathologists, scientists and the
Healthcare community?
‘www.labtestsonline.professional.org.uk???’
PCA3 - at a glance
LTO Professional
Professional
A resource for those providing and
utilising laboratory tests
ESTABLISHED ANALYTES
Evidence-based
Non-commercial
NEW ANALYTES
TRIALS
January 2009
…in the news
PCA3 - under evaluation
under
development
A new test is based on DNA technology
Related Tests: Total, Free & Complexed PSA, EPCA,
AZGP1
under evaluation
approved for
adoption
evaluation sites
required
At
At aa Glance
Glance
Clinical
Clinical
Analytical
Analytical
Literature
Literature
Contacts
Contacts
Background details
In the early 1990s, at about the same time that PSA testing was starting
to gain widespread adoption, William B. Isaacs, Marion Bussemakers a
molecular biologist from Holland working at The Brady Urological
Evaluation forum Institute of Johns Hopkins University performed studies on human
Clinical tips
prostate tissue using the technique of differential display, a then newly
Specialist labs
described method to identify gene expression in different tissues.
During this series of experiments, an mRNA was discovered that
appeared to be highly specific for prostate cancer.