Artificial Intelligence

The application of mass spectrometry in precision medicine for therapeutic drug monitoring

The Department of Laboratory Medicine has implemented Ultra-high-speed liquid chromatography tandem mass spectrometry (UPLC-MS/MS), supplanting the enzyme immunoassay (EIA) traditionally used by most hospitals in Taiwan for blood therapeutic drug concentration (TDM) testing in transplant recipients. The UPLC-MS/MS method reduces specimen interference, thereby enhancing the accuracy of TDM tests. It also significantly cuts down on medical waste production—by approximately 11,136 pieces or 109.1 kg annually—aligning with goals of environmental, social, and governance (ESG) for environmental protection and carbon reduction.

In contrast to other institutions that manually review raw data from mass spectrometers, we have pioneered in the development of the Mass Spectrum Intelligent Check System. This system adopts six automated data analysis algorithms, reducing analysis time from two hours per batch to just one minute. Furthermore, it ensures that standardized reports and quality control data are directly integrated into the Laboratory Information System (LIS), eliminating the risk of keying in error. This innovative project earned the National Healthcare Quality Award (NHQA) for Smart Care in 2023.

To enhance the TDM in transplant patients, we’ve implemented smart service strategies. These include expedited processing for patients in the outpatient blood drawing area, supported by a well-staffed team. We’ve prioritized the development of automated mass spectrometry data analysis software and a comprehensive liver transplant clinic information BI system. Our goal is to provide rapid and accurate test reports, ensuring precise monitoring of patient drug levels.

UPLC MS/MS in Therapeutic Drug Monitoring

Intelligent Innovation: Mass Spectrometry in Precision Medicine (Certification of National Healthcare Quality Award (NHQA)- Smart Care at 2023)

Strategy of Intellectual Examination Services: from the Perspective of Liver Transplant Patients

Therefore, from the perspective of liver transplant patients, we have introduced the following smart service strategies, including how to allow liver transplant patients to quickly clear customs in the general outpatient blood drawing area where there are many service staff and can support each other, and how to continuously and automatically send physical examination Prioritize testing and introduction of mass spectrometry equipment, develop automatic analysis software for mass spectrometry data that no one else has, and build liver transplant clinic information BI

Let our test reports continue to move towards the goal of being fast and accurate, and also help our doctors/patients get quick diagnosis

Highest Specification Blood Drawing Services: Safety and Warmth

• Blood-sampling assistance systems → Notification of difficult blood drawing patients
• Tri-level electronic patient verification → Comparison of medical orders, health insurance IC cards and sample barcodes

Automatic Transport System for Liver Transplant Specimens

• Automatic Transport System → Liver transplant samples are given priority, with a guaranteed round-trip transport time of only 3 minutes between the 1st and 3rd floors
• Automatic packaging, air delivery, and unpacking → Liver transplant samples are given priority

Exclusive Pathway for Specimen of Liver Transplant on Automatic Transport System

• Dedicated specimen transport routes, automatically loading to instrument → Integrated Biochemistry/Immunity/Hematology (4 track) systems
• A high-velocity robot arm, automatic specimen classification and shelving → 1,200 samples/hour
• Logic of specimen transportation → Emergency cases receive top priority with automated redirection and mutual backup systems

Rapid and Accurate Identification of Drugs by Using Mass Spectrometry

• Blood drawing QuickPass + Specimen transport continuously + Mass spectrometry automatic identification
• Improved turnaround times of testing and correlation between drug dosages and plasma concentrations

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