MEDICAL ADVISORS IN OMNIMED

Omnimed implements medical advisors that help to identify patients that could suffer from rare diseases. Patients are identified through algorithms based on the combinations of disease elements present within the patients’ record.

Advisors are then designed through these algorithms and are enabled in order to help you in establishing proper diagnoses, and provide you with real-world resources to help patients suffering from rare diseases.

The rarity and relatively low awareness of these diseases are the two driving factors that lead to difficulty and delays in diagnosis. By activating medical advisors within its EMR, it is Omnimed’s goal to provide a solution to the clinical dilemmas presented by rare diseases. In doing so, Omnimed’s vision is to be an information enabler to help the clinician in providing the best possible care to patients suffering from such rare diseases.

 

 

WHAT IS PNH?

Paroxysmal nocturnal hemoglobinuria(PNH) is a rare, life-threatening acquired disease that can lead to the hemolysis of red blood cells due to uncontrolled complement activation.

Because of low awareness of PNH, it has taken up to 10 years before a patient with PNH is diagnosed 1-3. 35% of patients will die within 5-years of diagnosis despite best supportive care 4.

 

 

 

How can you help this patient?

Are you aware that this patient has clinical markers that are considered high-risk for paroxysmal nocturnal hemoglobinuria (PNH) according to the International Clinical Cytometry Society (ICCS) 2010 Guidelines?

Please answer yes or no to the question above.

You can further help your patient by ordering High Sensitivity Flow Cytometry testing in peripheral blood to rule out PNH.

We strongly encourage you to discuss this case with a specialist from your region, or you could click here to complete a specialized laboratory requisition form specific to this program. This requisition will allow you to order a high sensitivity flow cytometry test for your patient. All instructions are outlined within this form to ensure a simple and timely test for your patient. The program will cover all costs of this testing when this form is used.

 

ONCE THE RESULTS ARE RECEIVED

Based on the results, you may wish to further discuss this case with an expert specialized in PNH. To schedule a time to speak with an expert from the Canadian PNH Network, either now or in the future please go to PNHConnect.

 

PROGRAM OPT-OUT OPTION

If you would like to not participate in this Facilitated Quality Improvement Initiative (FQI) Program, please fill this form so that we can remove your patients from the program. As soon as they will be removed, the PNH advisor will not be displayed in the patients' record anymore even if clinical markers still show that the patient could be affected by HPN.


REfErences

  1. Canadian PNH Network. www.pnhnetwork.ca

  2. Heitlinger, E. Learnings from over 25 years of PNH experience: The era of targeted complement inhibition. Blood Rev. 27, S1–S6 (2013).

  3. Richards, S. J., Rawstron, A. C. & Hillmen, P. Application of flow cytometry to the diagnosis of paroxysmal nocturnal hemoglobinuria. Cytometry 42, 223–233 (2000).

  4. Dacie, J. V. & Lewis, S. M. Paroxysmal nocturnal haemoglobinuria: clinical manifestations, haematology, and nature of the disease. Ser. Haematol. 5, 3–23 (1972).

  5. Hillmen, P., Lewis, S. M., Bessler, M., Luzzatto, L. & Dacie, J. V. Natural history of paroxysmal nocturnal hemoglobinuria. N. Engl. J. Med. 333, 1253–1258 (1995).

  6. Borowitz, M. J. et al. Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. Cytom. Part B - Clin. Cytom. 78, 211–230 (2010).

  7. Movalia, M. K. & Weitz, I. Incidence of PNH Clones by Diagnostic Code Utilizing High Sensitivity Flow Cytometry. Blood 118, 1013 (2011).

  8. Hill, A. et al. Under-recognized complications in patients with paroxysmal nocturnal haemoglobinuria: Raised pulmonary pressure and reduced right ventricular function. Br. J. Haematol. 158, 409–414 (2012).

  9. Hillmen, P. et al. Long-term effect of the complement inhibitor eculizumab on kidney function in patients with paroxysmal nocturnal hemoglobinuria. Am. J. Hematol. 85, 553–559 (2010).

  10. Nishimura, J.-I. et al. Clinical course and flow cytometric analysis of paroxysmal nocturnal hemoglobinuria in the United States and Japan. Medicine (Baltimore). 83, 193–207 (2004).

  11. Weitz, I. et al. Cross-sectional validation study of patient-reported outcomes in patients with paroxysmal nocturnal haemoglobinuria. Intern. Med. J. 43, 298–307 (2013).

  12. U.S. National Library of Medicine. Medline Plus. Lactate dehydrogenase test. (2014). at <https://www.nlm.nih.gov/medlineplus/ency/article/003471.htm>

  13. U.S. National Library of Medicine. Medline Plus. Reticulocyte count. (2014). at <https://www.nlm.nih.gov/medlineplus/ency/article/003637.htm>

  14. U.S. National Library of Medicine. Medline Plus. Bilirubin blood test. (2014). at <https://www.nlm.nih.gov/medlineplus/ency/article/003479.htm>

  15. U.S. National Library of Medicine. Medline Plus. Haptoglobin blood test. (2014). at <https://www.nlm.nih.gov/medlineplus/ency/article/003634.htm>

  16.  Jang, J. et al. Predictive Factors of Mortality in Population of Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH): Results from a Korean PNH Registry. J Korean Med Sci 31, 214–221 (2016).