Curriculum Vitae

Personal
Data
Dr. Miswar Fattah, SSi, MSi
th June 1978
Makassar, 6th
Education
1997
2002
2006
2012

: SMAK Depkes Makassar

: Chemistry - UNHAS
: Master of Science in Clinical Chemistry, Biomedicine- UNHAS
: Doctor of Medicine Clinical chemistry, UNHAS

Current
position
1.
2.
3.

Research & Esoteric laboratory Head, Prodia Clinical Laboratory

Vice Chairman of PATELKI (2013-2015)
Scientific division of immunoassay & Molecular Diagnostic (20112013, Reference interval & Decision limit (2013 Now)
Indonesian Association for Clinical Chemistry (IACC-HKKI)
4. Corresponding Members Scientific Committee Asia Pacific
Federation for Clinical Chemistry (APFCB) 2010 - Now
5. Council member of ASEANAssociation For Clinical Laboratory
Sciences 2010 2012

Technology Update For

Standardization and Harmonization
of Medical
Laboratory
October 8th, 2015

DR. Miswar Fattah, MSi

Research & Esoteric Laboratory Head

Prodia Clinical Laboratory
miswar.fattah@prodia.co.id
miswarfattah@gmail.com

Open Mind

Fikiran seperti parasut

Laut Mati vs Laut Merah

Buat Tanda tangan diatas kertas

Sekarang Lakukan Lagi dengan tangan lainnya

Natural
Easy
Flowing
Comfortable
Took less
energy

Unnatural
Difficult
Jerky
Awkward
Took more
energy

Generasi Y in Clinical Laboratory

Medical Technology

Medical Technologiest :
Technology Expert

Very dynamic profession

Higly standardization

JCTLM Joint Committe for Traceability in Laboratory Medicine

CLSI Clinical Laboratory Standard Institute

Higly regulated
RUO, LDT, ASR, IVD

Metho
d

Test
Nam
e

Unit of

Measurement
Measurement

Competency

Medical
Medical
Medical
Technologis
Technologis
tt

Technologist

Harmoniz
e

Core
results
& POCT
Technology Knowledge

Reference
Interval

Action
Limit
Investigativ
Investigativ
e
e Protocols
Protocols

Persaingan ASPEK Pendidikan

Malaysia (D3 dan S1 combining degree

Australia)

Thailand (S1, S2 dan S3 sertifikasi

Internasional)

Singapura (D3 sertifikasi

Internasional)

Philipina (S1 Sertifikasi internasinal)

Indonesia (D3 D4)

Data Survey
Gaji profesi TLM
2014
Berdasarkan
Lama Kerja

International Salary

20,3 Juta - 46,9 juta

=Rp 5.350.000 + Rp2.170.000

50,4 Juta 82 juta / bulan

Technologies

Sustaining Steady, linear

improvement of existing technology
Disruptive Introduction of completely
new approaches that have the potential to
create a new industry or transform an
existing one
Revolutionary radical innovations
digital photography, microbots, high-temperature
superconductors

Evolutionary formed by the convergence of

previously separate research areas

MRI imaging, faxing, electronic banking

Christensen CM. The Innovators Dilemma: When New Technologies Cause Great Firms to Fail. Harvard Business School Press;
1997. 290 p.

Technology Users

Every product/technology has users that

range from basic to averege to
sophisticated

Over time, Customer can Utilize

more feature & Performance

Incombent
technologies often
add features, cost
& functionality
faster than their
user can utilize
Recognition an
opportunity, a startup
creates a new offering
that appeals to most
users because it is
simpler, easier to use &
costs less

What Everyone ought to know

about Distruptive Innovation

Disruptive Innovation in
Laboratory Medicine

The introduction & performance of new

tests on a large scale, some in a
decentralized setting, in an accurate & a
precise manner, thus leading to better
diagnosis, more accurate prediction of
disease prognosis, and improved patient
management

Rifai N, Topol E, Chan E, Lo YMD, Wittwer CT. Disruptive Innovation in Laboratory Medicine.
Clinical Chemistry. 2015 Sep 1;61(9):112932.

The core technology or concept of four

innovators

Eric Topol

Eugene Chan

Smartphones as
the hub of
medicine
going forward,
capable of
performing routine
laboratories (with
suitable hardware
additions), real-time

the rHEALTH sensor,

which is a small,
portable device
designed to take a
single drop of blood
and give a readout for
many different
laboratory tests.

Y.M. Dennis Lo

Carl T. Wittwer

Noninvasive
prenatal testing
(NIPT)

increasing the utility of

PCR in molecular
analysis by
decreasing the time
to result from over an
hour to 15 s, and
introducing melting
analysis to eliminate
ownstream
open-tube analysis.

Rifai N, Topol E, Chan E, Lo YMD, Wittwer CT. Disruptive Innovation in Laboratory Medicine.
Clinical Chemistry. 2015 Sep 1;61(9):112932.

Example distuptive innovation in

Hematology Analisis

Louis Charles
Malassez (1874)

Georges Hayem
(1875)

The counting chamber designed

and manufactured by William
Gowers (1881)

The counting chamber designed

and made by Sergei Alferow

This chamber was manufactured by the

optical company Carl Zeiss and Company
of Jena

the best cell-counting chamber

by 1921 and had surpassed the
Thomas-Zeiss hemacytometer
by becoming the most generally
used instrument

The hemacytometer rulings and counting

grids have changed many times
Modern day hemacytometer with double chambers
similar to Brkers chamber and Neubauers counting
grids

oc
yto
m

ry
o
t
ra
o
b
h la
ory
c
t
r
a
a
bor
ese
a
ry
r
l
o
t
e
e
ra
nc
nc
o
a
e
b
r
v
fe
Ad
e la
ry
r
Re
o
a
t
c
ra
y
o
r
b
a
nd
e la
o
r
c
a
c
Se
y
r
ma
i
r
P

He
m

Performance/features

et
er

Incumbent inovation single test

Hemacytometer

Time

Introduction of Impedance

Coulter patented
several different
implementations of
the Coulter Principle

He
m
oc
yto
m
et
er
He
an ma
aly to
ze log
y
r

Performance/features

Incumbent inovation single test

Hemacytometer vs Distruptive innovation
Hematology Analyzer

ory
t
a
or
b
a
ry
hl
o
c
t
r
ra
ea
o
s
b
e
ry
r
la
o
t
e
e
c
a
n
nc
or
a
e
b
r
v
a
fe
Ad
el
r
Re
ory
a
t
c
a
or
ry
b
a
a
d
n
el
o
r
c
a
Se
ry c
a
m
Pri

Time

Hematology analyzer a multiplex

testing technology distruptive
innovation for Manual & Single
testing at 1940s

Now Hematology Analyser are

sustained technology

oc
yto
m

ory
t
a
or
b
a
ry
hl
o
c
t
r
ra
ea
o
s
b
e
ry
r
la
o
t
e
e
c
a
n
nc
or
a
e
b
r
v
a
fe
Ad
el
r
Re
ory
a
t
c
a
or
ry
b
a
a
d
n
el
o
r
c
a
Se
ry c
a
m
Pri

He
m

Performance/features

et
e
He r
an ma
aly to
ze log
y
r

Which Technology become

distruptive innovation in
Hematology

Time

Liquid culture & Automation gram

staining

Automation in
microbiology

BD Kiestra

00:34

Maldi TOF Colony pickup

00:34

Big Data
WEB BROWSERS

SEARCH

ENGINES

Microsofts
Internet Explorer

Googles

Mozillas FireFox

Microsofts

(Non-profit foundation,
used to be Netscape)

Googles Chrome

Apples Safari

Time-Warners AOL
Explorer

Yahoos

IAC Searchs

CDC vs Google Flu Trends?

Source: http://www.google.org/flutrends/

Virtual good Real good

When you
Play Game
Browsing with Google
Facebook status
Tweet via twetter
Share pict ..Path
Instagram, BBM, SMS
Pinterest..
They collect data of You
Lazada, credit card, health care, Pharmacy......et.al......
Selamat datang... Di Zaman UPDATE terus... Selama 365 hari, 24 Jam dan 1.140
Menit sehari. Kita tak Bisa Lari... Ngumpet... Dari intaian informasi....

2013

2011

ICP MS
7700

HPLC
UV/Fluoro

Nutritional
Panel
simultane 16
element
Toxic Panel
simultane 4
element
Aging Panel
Urine, hair,
blood, serum
trace

Vitamin
Vitamin A
A
Vitamin
Vitamin E
E
Vitamin
Vitamin C
C
Homocysteine
Homocysteine
Caffeine
Caffeine
Muconic
Muconic acid
acid
Vitamin
Vitamin B1,
B1,
B2,
B6
B2, B6

2014

2015

LCMSMS

GCMS

Streoid
Streoid Hormon
Hormon

Fatty acid
profile
DHA/EPA
Confirmatory
Cocaine &
Opiate
Confirmatory
Benzodiazepi
nes

Testosteron,
Testosteron, 17
17 OH
OH
Progesteron,
Progesteron,
Aldosteron,
Aldosteron,
Androstenedione,
Androstenedione,
etc
etc

25OH
25OH Vitamin
Vitamin
D2
&
D3
D2 & D3
Inborn
Inborn Error
Error
(Acylcarnitine(Acylcarnitineamino
amino acid)
acid)

Immuno
Immuno
suppressant
suppressant
(tacrolimus,
(tacrolimus,
cyclosporin,
cyclosporin,
sirolimus)
sirolimus)

Update in Hematology

Differential method(s)
used
1
2
3

8
Centrifugation

5
6
7

Revolusi Sistem pendidikan Analis Kesehatan

Pengetahuan dan teknologi di Indonesia 5-10 tahun

terlambat
Perlu Revolusi sistem training dan pendidikan yang
mengakomodir laju perubahan

Ide sampai
selesai
Karya ilmiah
(2 4 tahun)

2 3 Tahun

3 5 Tahun

Gunung Es Test laboratorium

Hematologi rutin, urine rutin, glukosa
darah, sgot, sgpt, ureum, kreatinin,
asam urat, HbsAg, golongan darah,
HCG HCV RNA, HIV RNA dll
Western blot HIV, arsen, merkuri,
typing, sdLDL, Arsenic, Mercury,
Cytokine, chemokine, Isoprostan, MDA,
ADMA, (all special test in reference
laboratory), LPL

Proteomic analysis, CYP450 microarray.

Ekspresi gen sel tumor, microRNA dll

Gunung Es Teknologi lab

photometer, ELISA, impedance,
immunokromatografi,Microtome,
tissue processor,

PCR

Flow cytometry, mikroskop fluorosensi,

AAS, HPLC,GCMS, Realtime PCR, IHC,
xMAP
ICP-MS, microArray, Digital PCR,
massArray

LC-MS-MS
GC-MS-MS, NGS

Pengetahuan
Prinsip dasar elisa, mekanisme dasar
penyakit umum, basic Quality control
Validasi metode pemeriksaan, regulasi
reagen, Advance pengendalian mutu.
Pembuatan reagen, mencari
interference pemeriksaan, algoritme
analisis problem solving

Penemuan biomarker, merancang

metode baru, modifikasi metode.

Pendidikan Berkelanjutan yang

jelas
Med Lab
Scientist

S3, Sub
Specialist
Consultant

Medical
Lab Scientis

S2, Specialist
Medical Laboratory Scientist, MLS(ASCP)
Cytotechnologist, CT(ASCP)
Histotechnologist, HTL(ASCP)
Technologist in Blood Banking, BB(ASCP)
Technologist in Chemistry, C(ASCP) $210
Technologist in Cytogenetics, CG(ASCP)
Technologist in Hematology, H(ASCP)
Technologist in Microbiology, M(ASCP)
Technologist in Molecular Biology, MB(ASCP)

Medical
Medical
Technologist
Technologist

S1, D4

Medical
Medical
Technicians
Technicians
Assistance
Assistance
Medical
Medical
Technicians
Technicians

D3
SMAK

TELAPI

ASCP

Phlebotomy Technician, PBT(ASCP)

Donor Phlebotomy Technician, DPT(ASCP)
Histotechnician, HT(ASCP)
Medical Laboratory Technician, MLT(ASCP)
etc

Summary

Membuka fikiran, wawasan dan

pengalaman adalah cara terbaik
menerima ilmu, new technology

Harmonisasi kemampuan
menggunakan teknologi dapat dicapai
dengan upaya massive di Kampusdunia kerja

Perkenalan teknologi dan IT dilakukan

lebih proaktif

Thanks