![](media/image1.emf){width="2.14375in" height="2.201388888888889in"}

![](media/image2.emf){width="1.6465277777777778in"
height="0.7986111111111112in"} **EM News**

**Volume 2 Issue 3 August 1996**

EM Program Report packet

The annual Electron Microscopy Report packet containing the forms and
instructions for submitting the annual EM report for fiscal year 1996
(Oct. 1, 1995 - Sep. 30, 1996) was recently mailed to each Program's
Medical Center Director. A separate courtesy copy of the full report
packet will also be mailed to each EM Program Director along with a copy
of this current EM Newsletter issue.

Due to changes in workload recording and reporting methods (from AMIS to
LMIP) which became effective in the current FY 1996 reporting year, the
section of the annual report concerning [Reports on
Specimens]{.underline} has been changed this year to basically request
only information on the automatic DHCP capture of EM specimen
accessioning. The reason for this one-time change is that it is
important that each laboratory have their EM specimen accession log in
DHCP. Therefore, this year we are measuring compliance with that
requirement. Evaluation and review on the accuracy of that workload
capturing process is one of the more significant reporting components on
this annual report. We will correspond with the EM Directors separately
to explain the reporting format being developed for the FY '97 reporting
cycle.

Data sources

The count for "EM Specimen" 88057.0000 may be obtained locally from the
"PHASE 3" monthly report which is generated when the workload data for
all Pathology & Laboratory Medicine sections is compiled by the
designated laboratory person. The Phase 3 report should include an entry
titled **EM SPECIMEN** and beneath that will be **EMU WKLD Code:
88057.0000** then on the line underneath that you may see categories
such as \[IN PAT\] , \[OUT PAT\], \[OTHER PAT\] and \[OTHER\] The first
two are sub-categories of Patient file specimen accessions. \[OTHER
PAT\] are specimens logged in the REFERRAL file, such as non-VA or
outside referral EM cases. The \[OTHER\] category will list EM specimens
logged into the RESEARCH file. The monthly total for all those
categories is also provided. There should be a monthly PHASE 3 report
available for each month of FY 1996. The sum of those 12 monthly totals
will be the number of EM SPECIMEN workload codes "captured" by your DHCP
system. These monthly Phase 3 reports should be available from the
Laboratory Administrative Officer or the Chief Medical Technologist.

**Austin generated data**

The Austin data center sends back to the individual stations a monthly
electronic summary identified as an **LMI/DPG** mailman message. This is
sent to the LMI mail group at the local VA facility. This summary
consists of "billable" workload categorized by major lab sections. The
EM section workload is listed separately under the Anatomic Pathology
section. The EM SPECIMEN counts will be reflected in that EM section
summary. The LMI mail group members are usually members of the
laboratory staff and if the EM section is interested in obtaining those
monthly summaries automatically, they could request to be made a member
of that local LMI mail group.

**Sources for data discrepancy**

Clarification for differences noted in the EM Specimen workload numbers
which were "captured" in DHCP and those that the EM program actually
processed and examined may possibly be found among the following example
scenarios: **(1)** The appropriate DHCP workload files for the whole lab
package were not activated at the proper dates. **(2)** The EM accession
area was not activated for workload capture or the EM related workload
file entries were not defined properly. **(3)** Outside referral cases
or research cases were not logged into DHCP via the REFERRAL or RESEARCH
files. **(4)** When using the specimen "Log - in" option, the person
logging in the accession by-passes the prompt for SPECIMEN(s) but enters
all the other log-in information. Since the EM Specimen workload code is
linked to a specimen entry during the log-in process, a blank or null
field means [no]{.underline} automatic workload is captured for this EM
accession number. This situation does not prevent the rest of the DHCP
EM data entry and reporting process being carried to completion and the
report being released. The lack of an entry in the specimen field for an
EM accession can be determined and verified by using the print log-book
option for the EM accession area. **(5)** The monthly compilation and
data transmittal process may have had problems. Among those could be
that the compilation and processing date ranges were not selected
appropriately for the particular reporting month. The data transmission
message for some reason did not get to Austin data center or was not
processed because of message or transmission corruption. Normally for
each sending of the monthly workload transmission a confirmation e-mail
message notice is sent back to the local LMI mailgroup by the Austin
data center computer.

**SATELLITE TV PROGRAM: [L]{.underline}ABORATORY
[M]{.underline}ANAGEMENT [I]{.underline}NDEX [P]{.underline}ROGRAM**

On August 7, 1996 between 1PM and 3PM - Eastern time, the Dept. of
Veterans Affairs Pathology and Laboratory Medicine Service presented a
satellite video teleconference program on LMIP (Laboratory Management
Index Program). The VA and CAP panel presenters discussed the rationale
and reasons for changing from AMIS to LMIP workload methodology and how
and why different data elements are used to provide indexes to lab
managers for measuring productivity, utilization and cost effectiveness
of their lab and comparing their lab to VA labs of similar size and
complexity and also to all other laboratories participating in the CAP's
LMIP program.

Most VA facilities make video tapes of their satellite conference
sessions. If you did not see the original transmission, it may be very
informative and helpful to EM Program staff to obtain their station
video copy (medical media or library service are likely places to check
first) and play it back during a staff conference or continuing
education meeting.

FY 95 Annual EM Program review letters

The annual EM Program evaluation letters were sent to the VISN Network
Directors as well as the Medical Center Directors in the first weeks of
May 1996. If your EM Program office was not forwarded a copy by your
Medical Center Director's staff or it appears to have been lost, please
call Alex Tuszynski at 700-671-5218 and we will fax or send another copy
directly to you. Included in those mailings was an overview cover letter
to the Network Directors about the EM program along with a more detailed
"white paper" explaining the purpose, history and role of EM as a
standard of care in diagnostic pathology.

EM Workload codes

As of Oct. 1, 1995 \-\-- **AMIS** is dead! and **LMIP** is the VA's
official Pathology & Laboratory Medicine Service workload reporting
method. All EM laboratories should be using the LMIP workload
functionality available in DHCP to automatically capture EM specimens
when those are logged into DHCP. The **[only]{.underline}** data
currently required to be captured automatically is the number of EM
specimens. Do not send us copies of your AMIS worksheets. As explained
previously, the DHCP software will be revised sometime in the future to
capture the appropriate workload information at the end of the
processing and reporting functions in the pathology sections via the use
of CPT coding. As mentioned in the instructions for the FY 1996 annual
EM report, the reporting requirements were temporarily simplified and
changed for this year to primarily evaluate and validate the automatic
capture of the EM Specimen workload code at all diagnostic EM
facilities. When the direction, development and progress of the proposed
CPT code linked workload capture methodology becomes better defined,
instructions on what types of data may be requested on the next annual
EM report will be communicated to the EM Program Directors as quickly as
possible.

**AFIP & Tele-pathology**

Telepathology at AFIP is discussed in the Feb 1996 issue of the AFIP
letter and information is available at the AFIP Web Site at
http://www.afip.mil

The 1996 Telecommunications Act signed this past February by the
President includes provision to evaluate and report the use of advanced
telecommunication services for medical purposes. The VA HOST Program
office is working with a few interested sites in developing
telepathology within the VA system. Pilot projects at Iron Mountain and
Milwaukee plus one or two other sites are in progress and additional
sites are expressing interest. The HOST program coordinator, Joe Parker
at 304-264-4489 may be contacted for additional information. Contact via
FORUM E-Mail is also encouraged.

**E-Mail, Web sites**

**[MicroWorld News]{.underline}** is an e-mail newsletter for
microscopists and microanalysts. The Aug 10, 1996 issue lists a large
number of web sites, resources, meetings and conferences in the area of
EM, imaging, etc. To subscribe to the e-mail newsletter send an e-mail
message to MWN@mwrn.com

To subscribe to the e-mail Microscopy newsgroup or discussion group send
an e-mail message containing the message "Subscribe Microscopy
YourUserID@YourDomain" to Listserver@MSA.Microscopy.com

An example message from John Doe in FORUM might be:

Subscribe Microscopy doe.john@forum.va.gov

A few sample entries from the e-mail discussions and the Microworld
newsletter are provided in the meetings calendar section and in the
following web site listings.

**[From MicroWorld Resources, your guide to microscopy on the Internet
at]{.underline}**

http://www.mwrn.com/

http://www.mwrn.com/guide.htm

(the above location contains articles on electron microscopy, laser and
confocal microscopy, light microscopy, job postings, etc,)

**[University of Washington]{.underline}**

http://www.pathology.washington.edu./

**[University of Pittsburgh]{.underline}**

http://path.upmc.edu/

**[Uniformed Services University]{.underline}**

http://wwwpath.usuf2.usuhs/mil/

**[Virgil's Web]{.underline}**

http://virgil.mc.vanderbilt.edu/

**[GI and Liver Pathology]{.underline}**

http://www.pds.med.umich.edu/users/ greenson/

**[Osaka Medical College]{.underline}**

http://www.osaka-med.ac.jp/

**[Microscopy Society of America]{.underline}**

http://www.msa.microscopy.com/

***[MSA - FTP site address]{.underline}***

ftp.msa.microscopy.com

**[Emory University School of Medicine]{.underline} just developed a Web
page for the residency program**

http://www.emory.edu/PATHOLOGY/ RESIDENT/

For additional information on internet resources for pathologists and
laboratory professionals see "***A full menu for labs that navigate the
NET***" by Carl Graziano in **[CAP TODAY]{.underline}** (Vol. 9, No. 8,
August 1995). On page 40 of that issue, a table lists many additional
internet site addresses including details about signing up for pathology
related "mailing lists" on the internet.

**Future**![](media/image2.emf){width="0.2791666666666667in"
height="0.16944444444444445in"} **EM Newsletters:**

If you have any comments, suggestions, article submissions for use in a
future Newsletter, please send to: Alex Tuszynski (EM-QA/QM) Coordinator
via FAX 919-286-6818 or call 700-671-6925x5218 or E-Mail
tuszynski.a@forum.va.gov

  ---------------------------------- ------------------------------------
  Microscopy Calendar                1996 EM activities

  ---------------------------------- ------------------------------------

**EUREM \'96, XI EUROPEAN CONGRESS ON MICROSCOPY, UNIVERSITY COLLEGE
DUBLIN, DUBLIN, IRELAND, 26-30 AUGUST, 1996**. CONTACT: EUREM \'96
Office, Department of Botany, University College Dublin, Dublin 4,
Ireland. Telephone +353-1-7062254; FAX +353-1-7061153; E-mail:
JFLAH@macollamh.ucd.ie

**TUTORIAL IN ULTRASTRUCTURAL PATHOLOGY AND DIAGNOSTIC ELECTRON
MICROSCOPY OF TUMOURS, OTTAWA, ONTARIO, 23-27 SEPTEMBER, 1996.**
CONTACT: F. N. Ghadially, Telephone 613-238-1331, FAX 613-231-2179

**FOR INFORMATION** on specialty and regional meeting and links to
additional meeting information, **visit** the MicroWorld Resource\'s
Meetings and Conference at **http://www.mwrn.com/feature/meeting.htm**

**National Society for Histotechnology, Oct 19 - 23, Albuquerque, NM.
Contact NSH at 301/262-6221.**

**Cytikinemayics\'96, Quantitative Microscopy of Living Cells, Sept. 9 -
12, Czech Republic**

**5th Brazilian Conference on Microscopy of Materials, Rio de Janeiro,
Brazil 13-16 October 1996**

**Microscopy Society of Southern Africa, 26th Annual Conference,
December 4 - 6, 1996 Durban, South Africa. For further information
contact Dr. Fiona Graham MSSA96@ph.und.ac.za**

**[Short Courses and Training]{.underline}**

**A list of short courses and consultants that offer on-site training
for microscopists is available in the Products and Services Directory at
http://www.mwrn.com/products.htm**

**EMBO Practical Course in Cryo-electron Microscopy and Image
Reconstruction, Sept. 11 - 16 Heidelburg, Germany. Steven Fuller at
Fuller@embl-heidelberg.de**

**Purdue Cryoelectron Microscopy Workshop, November 3 - 6, 1996. Purdue
University, West Lafayette, IN USA. Email
workshop@bilbo.bio.purdue.edu**

**On-site cryo-ultramicrotomy consulting/training for immunocytochemical
studies and materials science research. CUMT training from A to Z,
fixation to the TEM. Contact Michele Wilhite, (619) 794-1719, e-mail
CryoMichel@AOL.com**