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At Lab Quality Confab in New Orleans this Week, Speakers Addressed Major Issues Faced by Medical Laboratories, including the Need for Labs to Deliver More Diagnostic Value to Physicians
‘Best of class’ clinical laboratories and anatomic pathology groups shared case studies in effective cost-cutting and steps they are taking to add value to lab testing services
NEW ORLEANS, LOUISIANA—Here in the Crescent City this week, almost 300 clinical laboratory managers and pathologists gathered to learn and master the latest innovations in managing cost in medical laboratories, while introducing high-value medical laboratory testing services that help physicians deliver better outcomes for their patients.
This is not an easy tightrope to walk for clinical lab leaders. Across the United States, most medical labs and pathology groups are dealing with shrinking budgets and falling prices for lab testing. This means less money to perform the same or growing volume of patient specimens arriving daily at their labs.
Clinical Laboratories Evolving to Serve Needs of ACOs, Medical Homes
At the same time that the lab’s budgets are declining, hospitals, ACOs, and medical homes are shifting clinical emphasis toward early detection of disease and proactive management of patients with chronic disease. Their common goal is to reduce or prevent acute events, which might require hospitalization of the patients. As this happens, physicians need more sophisticated support from clinical laboratories because they are being evaluated on their ability to deliver appropriate care that keeps patients healthier and reduces the overall cost of care.
These themes were central to the eighth annual Lab Quality Confab that took place in New Orleans this week. At the opening general session on Tuesday, pathologists from Henry Ford Health System in Detroit, Michigan, shared a case study of how they have positioned their integrated clinical laboratory and anatomic pathology service to better meet the diagnostic needs of clinicians practicing in the health system’s hospitals, clinics, and specialty care settings by delivering more value with lab testing services.
This presentation was made by Richard Zarbo, M.D., D.M.D., Senior Vice President and Chair of Pathology and Laboratory Medicine and Gaurav Sharma, M.D., Director, Regional Medical Laboratory and Associate Medical Director, Core Laboratory, Quality Systems and Regulatory Affairs. The two pathologists emphasized that what the laboratory at Henry Ford Health is doing today comes after 10 years of intense effort to introduce Lean and a system of prevention, accompanied by helping the lab staff and pathologists embrace the culture of continuous improvement.
Big Payoff for Health System from More Effective Lab Test Utilization
The payoff from this quality management journey is substantial. After showing the audience the context and structure of the integrated clinical laboratory and anatomic pathology service, Zarbo and Sharma explained how the creation of medical laboratory test formulary was delivering huge economic benefits. Part of this project involved organizing two lab formulary committees involving physicians and other stakeholders.
These committees review different clinical lab assays and develop guidelines for appropriate utilization. It is noteworthy that pathologists and lab professionals are not voting members of these committees. According to Zarbo and Sharma, the reason is that the lab leadership wanted physicians on the committee to understand that they were making the decisions about when and how to use these tests.
What caught the attention of the Lab Quality Confab audience was the magnitude of savings that better use of companion diagnostics tests had produced for the health system. Presented below is a list of three molecular tests and targeted therapeutics where engagement with physicians through the laboratory test formulary committees resulted in a substantial reduction in pharmaceutical costs at Henry Ford Health due to more precise utilization of clinical laboratory tests:
(& Targeted Therapeutic)
|Type of Cancer||Cost of Treatment||Pharma Cost Saving-2013||Pharma Cost Saving-2014|
|Her2 FISH (Herceptin)||breast||$70k||$12,800,000||$13,248,00|
Zarbo and Sharma recommended that clinical laboratory managers learn to speak the language of the hospital and health system C-Suite. “Every day, hospital administrators put time and attention into monitoring and understanding key clinical and operational measures,” advised Zarbo. “Three examples are risk-adjusted length of stay (LOS), emergency room LOS, and pharmacy cost per DRG.”
Clinical Lab Managers Learn to Speak the Language of the C-Suite
“This is one way that you can get more visibility for your laboratory,” added Sharma. “By speaking the same language as the administrators, and by showing them metrics that document how the laboratory is contributing to positive improvement in these factors, you will elevate recognition of your lab’s contribution to improved patient care at less cost.”
Over the three days of Lab Quality Confab, there were more than 40 sessions and 60 expert speakers. Participants heard presentations dealing with achieving best practices in core lab automation and hematology from lab organizations serving multiple hospitals. Advanced training with certificates of completion were offered in such quality management techniques as value steam mapping, DMAIC, and mistake-proofing the lab.
For clinical lab managers and pathologists who would like to learn more about the different presentations and speakers, the agenda can be found at this link. (Or copy and paste this URL into your browser: http://www.labqualityconfab.com/agenda.) Digital audio recordings can be viewed and ordered with this link. (Or copy and paste this URL into your browser: http://www.labqualityconfab.com/2014-audio-recordings.)
Researchers at Livermore National Laboratory Develop Microbial Detection Array Capable of Detecting Thousands of Known and Unknown Pathogens in a Single Rapid Test
Developed to detect pathogens missed in wounds of soldiers, this technology was licensed to a company for development into a test for use by clinical laboratories
Diagnostic technology developed for rapid detection of pathogens in the wounds of soldiers has been licensed to a private company that intends to use it to create new medical laboratory tests. This new technology is capable of identifying thousands of bacteria and viruses in a single test.
Scientists at the Lawrence Livermore National Laboratory developed what is called the Lawrence Livermore Microbial Detection Array (LLMDA). Within 24 hours, this single test can detect multiple viruses and bacteria. The LLMDA technology has been licensed to St. Louis, Missouri-based MOgene LC, a supplier of DNA microarrays, according to a report published by UC Health. continue reading
Sonic Healthcare Limited Selected to Provide $3-Billion in Medical Lab Services to Edmonton and Parts of Central and Northern Alberta
Other clinical laboratory organizations responding to the RFP were Laboratory Corporation of America, Quest Diagnostics Incorporated, and Mayo Clinic
Last Friday, Alberta Health Services (AHS) in Edmonton, Alberta, announced that Sonic Healthcare Limited (SHL.AX), of Sydney, Australia, has been selected as the medical laboratory testing provider to serve Edmonton and parts of central and northern Alberta. This agreement is worth $3 billion Canadian over 15 years and is believed to be the world’s biggest clinical laboratory testing contract currently out for bid.
Competition for this clinical laboratory testing contract was intense. Last April, four organizations were identified as having submitted responses to Alberta Health Service’s (AHS) request for proposals (RFP). They were: continue reading
Companies Developing Non-invasive and Wearable Glucose Monitoring Devices That Can Report Test Data in Real Time to Physicians and Clinical Laboratories
Goal is to shift glucose testing away from medical laboratories and make it easier for diabetics to do their own testing, while capturing glucose test results in patient records
Because of the tremendous volume of glucose tests performed daily throughout the world, many companies are developing non-invasive methods for glucose testing. Their goal is a patient-friendly technology that does not require a needle stick or venipuncture and may even eliminate the need to send specimens to a medical laboratory.
What is intriguing about these initiatives is that, in their final form, they may create a flow of useful diagnostic data reported to clinical laboratories in real time. This would create the opportunity for pathologists and lab scientists to consult with the patients’ physicians, while archiving this test result data in the laboratory information system (LIS).
These glucose monitoring methods would also ensure that a complete longitudinal record of patient tests results is available to all the physicians practicing in an accountable care organization (ACO), medical home, or hospital. continue reading
Multi-national Gathering of Clinical Laboratory Professionals Assesses Benefits and Problems with Point-of Care Testing in Toronto this Week
Pathologists and medical laboratory professionals heard speakers from Sweden, Australia, New Zealand, and Canada discuss the latest developments in POCT
TORONTO, ONTARIO—Spirited discussion always results when pathologists and clinical laboratory professionals discuss point-of-care testing (POCT). That was certainly true during a special POCT workshop that took place here this week.
Attendees came from as far away as Sweden, Australia, and New Zealand to attend “Point-of-Care Testing: Today and Tomorrow.” The conference was produced by the Toronto-based Institute for Quality Management in Healthcare (IQMH).
Point-of-Care Testing Has an Essential Role in Patient Care
As most medical laboratory scientists know, POCT can be both a blessing and a curse. When used properly, POCT plays an essential role in patient care and can guide physicians in ways that improve outcomes. However, problems associated with the ongoing management and performance of an organization’s POCT program regularly frustrates laboratory scientists tasked with oversight of POCT. continue reading
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