Physicians — see email below (originally sent to nursing) on changes to Bili. I've also received this communication.
Neonate Hyperbilirubinemia mPage
ED has submitted a change request to add the (already built) Neonate Hyperbilirubinemia mPage onto FirstNet and ED views. It's a great graph because it will place a dot with the lab Bili result — a nice feature if the physical copy/chart goes missing.
Anyway, there is a Cerner freeze happening so this likely won't be implemented until Spring 2027.
How Bilirubin Is Being Ordered & Resulted in Cerner Now
Order the Bilirubin Panel:
This returns Total, Direct (conjugated), and Indirect (unconjugated) Bilirubin under Routine Chemistry:
It's my understanding that this testing changed when Midtown got the new analyzers (we didn't receive much communication about it).
There is a new graph posted in Acute or ACA — will also be printed for your office.
Quick Reference — BiliTool
An online decision-support tool for neonatal hyperbilirubinemia — plots the TSB against age-specific thresholds and recommends next steps (repeat testing, phototherapy, escalation).
Hyperbilirubinemia Chart (Posted in Acute / ACA)
Any Total Serum Bilirubin result above the coloured lines needs immediate ED physician assessment. Curves are stratified by gestational age (35, 36, 37, ≥38 weeks).
Neurotoxicity risk factors:
- Hypoalbuminemia (serum albumin < 30 g/L)
- Isoimmune hemolytic disease or other hemolytic conditions
- Sepsis
- Significant clinical instability in the preceding 24 hours
Source: Guidelines for detection and management of hyperbilirubinemia in term and late preterm newborns, Canadian Paediatric Society, 2025.