Everlywell Sample Issue Definitions and Resolution Process

Within your Lens dashboard, if the result column shows a kit "Needs Review," this could indicate either (1) the test came back with one or more markers out of range or the result was deemed indeterminate. (2) This will also populate if a test was unable to be processed in the lab and requires a retest. Sample issue definitions and the resolution process are outlined below:

Issue Types 

Automatic Rejections

Issues that result in a sample being automatically rejected. These customers will be contacted and offered a replacement kit.

  • QNS - Samples that cannot be run due to insufficient quantities (ex: not enough blood).
  • Hemolyzed Sample - Samples that cannot be run due to hemolysis. This will only apply to samples on the ADx card.
  • Improper Return of Sample Packing - Samples that have been returned in packaging that corrupts the integrity of the sample, or leaking samples.
  • Rejected - Insufficient or Mismatched Identifiers - Samples that arrive to the lab without any identifiers (including kit ID) or samples that have completely different identifiers between the sample and registration. 
  • Rejected - Improper Collection - Any sample that was collected improperly by the customer. Examples include Microalbumin samples that were sent in the cup instead of the vacutainer, stool is collected on the wrong side of the card (FIT), a blood spot card is moldy, etc.
  • Expired Sample - This will almost always be logged as a secondary issue to “Missing or Incorrect Collection Date”, as we will attempt to confirm expiration before marking as expired.
  • Expired Component - This is used when the device or collection component has arrived at the lab and is expired.
  • Unused Kit - Kits that arrive at the lab without having been used. This will typically apply to enterprise kits that have been drop shipped to a member’s home without opting in. These members will not be contacted or sent a replacement kit.
  • Lab Error - Any error at the lab that wasn’t caused by a customer action. Examples include a dropped plate, a system error, or a QC error. Depending on the error, the lab will send through a note with more detail on the specific issue.

Confirm Before Proceeding

Issues requiring confirmation from the customer before we decide how to proceed with the sample.

  • Hold - Improper Collection - Any sample that was collected improperly by the customer. Examples include Women’s Health samples that were all collected on the same day, or if the samples collected on the same day aren’t collected 2 hours apart.
  • Missing or Incorrect DOC - This is used for any issues with the collection date. For example, if the customer doesn’t write it on their sample, if the date is far enough in the past that the sample should be expired or if the date is in the future.
  • Missing/Incomplete LMP paperwork - This is used if the customer didn’t fill in the physical requisition form with their last menstrual period for any Women’s Health test and we need to confirm the dates in order to proceed. 

Information Mismatches

Issues related to information on the sample being different from the information in the patient’s requisition.

  • Missing or Incorrect DOB - This is used if the customer’s DOB is not written on the sample card or if it doesn’t match what’s on the registration.
  • Missing or Incorrect Name - This is used if the name written on the registration card is missing or doesn’t match the name on the patient registration.
  • Missing or Incorrect Multiple Identifiers - This is used if there are issues with multiple identifiers (name & DOB). For example, if the customer didn’t write a date of birth AND the name written on the card doesn’t match the registration. 

Registration Errors

Issues related to registration, these issues will resolve themselves without any intervention.

  • Registered - Missing Physician Order - This is used if the sample is registered but there isn’t an associated physician order. This will usually resolve itself without any intervention from the Everlywell team by immediately re-issuing the requisition with our physician services. The majority of these samples will either be enterprise auto-registration orders that did not receive a USPS inbound scan, or a failed requisition for a customer registering a test they aren’t eligible to take (for example, people under 45 who register a FIT test). If there are multiple issues on a sample, log the other issue in the portal so that it doesn’t auto-resolve upon order generation.
  • Not Registered - Samples that arrive to the lab without being registered. The issue will automatically resolve itself as soon as the customer registers. If there are multiple issues on a sample, log the other issue in the portal so that it doesn’t auto-resolve upon registration.
  • Expired Order - Requisitions from our physician services expire after 6 months. This will be used if the requisition is older than 6 months.

Other

Other potential issues that don’t fall into the above categories.

  • Other - If the issue doesn’t fit into any of the above categories, log it as “Other” and provide any applicable details in the Notes section.
  • Missing Kit ID: This should be logged by the Everlywell team for any sample that arrives without a kit ID sticker on the collection materials. The lab will not need to log this issue, they should continue to send an email to Lab Support to resolve.
  • Re-registered Kit: This issue will be used for a kit that was originally registered to the wrong person and has to be reset. This issue will not need to be logged by the lab, it will always be logged by the Everlywell team.