Oral Presentation Australian Institute of Medical Scientists National Scientific Meeting 2013

Clinical Biochemistry - Integral to Patient Care (#5)

George S Streitberg 1
  1. Southern Cross Pathology Australia, MMC, Clayton, VIC, Australia, Clayton, VICTO, Australia

Clinical Biochemistry is an integral part of patient care. Approximately 60 – 70% of diagnoses rely upon pathology results. The three pillars contributing to patient care are technology, the laboratory information system, and the staff. Technology has contributed in the transition from manual assays to automated instruments, a more extensive range of assays which are more sensitive and specific, and the introduction of the laboratory information system to manage information flow from the laboratory to the healthcare team. These developments have been assisted and underpinned by entry level scientific staff having an increased academic knowledge base in clinical biochemistry.

Automation has occurred in three streams – first generation with the introduction of commercial kits, second generation with mechanised instruments which later had embedded computers, and third generation representing total laboratory automation which encompasses pre-analytical, analytical, and post-analytical phases. Each of these developments has removed steps in the pathway from sample collection to patient result thereby ensuring greater uniformity of process.

Biochemistry assays encompass analytical principles such as ion selective electrodes, colorimetry, nephelometry, immunoassay, HPLC, GCMS and LCMS. Each of these analytical principles has improved both sensitivity and specificity which ensures more useful information for diagnosis and management.

The laboratory information system has evolved to be the management tool which encompasses patient registration, analysis, and reporting.

Development of the academic credentials for staff entering clinical biochemistry has seen the entry level qualification move from certificate to degree status. The AIMS accredited degrees provide an educated pool for the pathology workforce. The required skills have changed and now encompass not only traditional analytical skills but those required for trouble-shooting instrumentation and computing.