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Maintaining a state-wide pathology network: the Western Australia experience

Dry chemistry systems have come to the aid of a pathology service network that operates across an Australian state larger than Western Europe. Andrew St John looks at some of the problems encountered and how they have been addressed. Forming the backbone of the PathWest laboratory network that stretches across the 2.5 million square kilometres of Western Australia are 23 VITROS analysers. They provide pathology services to many different and often remote communities, and one of their special attributes in one of the driest countries in the world is that they do not require water.

Perth is the state capital of Western Australia (WA) and is said to be the second most isolated city in the world. With a population of 1.6 million, it is located in the south-west corner of a state, which is larger than Western Europe and four times larger than Texas. The remaining 0.7 million people of WA live in many different locations scattered across the state including the remote outback. The extent of the PathWest network is indicated by a presence in towns like Kununurra, which is 3215 km by road to the north-east, Esperance, 720 km south, and Kalgoorlie, 600 km east of Perth – all have hospitals and PathWest laboratories.

PathWest is the sole public provider of pathology services in WA, and the service includes 70 regional hospitals, 40 remote nursing posts, a number of GPs and aboriginal communities. All the laboratories make up what is probably the most geographically extended laboratory network in the world. Collectively, they perform more than a million biochemistry panels per year. The menu of tests covers general chemistry performed by VITROS Chemistry systems, haematology, limited microbiology and blood transfusion. All other samples are transported to Perth for analysis in the central laboratories, with the results delivered back to the outlying laboratory electronically overnight or by the next morning.

The decision to use VITROS 250/350 systems in all the laboratories was made in 1995. Other than the obvious desire and need to standardise instruments across the network, the other overwhelming reason to use the dry chemistry system that are a feature of VITROS systems was the fact that no water of any kind is required by the analyser. Thirty years ago, when the dry chemistry system was first launched, many people perceived it as a possible cost-saving and also a convenience in the sense of limiting the plumbing and support services required for the instrument.

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