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DARK Daily Laboratory and Pathology News

DARK Daily is an e-briefing service providing up-to-the minute news of relevance for anyone working in diagnostic medicine, from clinical laboratories and pathology groups to lab industry suppliers and diagnostic technology companies. DARK Daily is part of The Dark Intelligence Group, Inc. and is dedicated to bringing useful business and management intelligence to laboratory managers, pathologists and diagnostic executives. Our recognized expertise in the strategic direction of laboratory medicine and the management of laboratories is available through DARK Daily, The Dark Report, free White Papers, Lab Resource Directory, the Executive War College on Laboratory and Pathology Management, Lab Quality Confab, and strategic consulting services.

Latest E-Briefings

Narrow Networks Mean Shrinking Opportunity for Pathology and Clinical Medical Laboratories

Pathology groups and medical laboratories may benefit if federal and state legislators legislate broadening of provider networks

Insurers are increasingly using narrow networks as a business strategy to control costs. As a consequence, more consumers are complaining even as some excluded providers are suing health insurers. For pathologists and clinical laboratory managers, this accelerating trend of excluding providers means increasingly restricted access to patients.

Health Insurers Walk a Fine Line between Cost and Access

Many health plans currently sold on the new state insurance exchanges offer substantially smaller networks of providers than was typical in recent years, according to a story published in Modern Healthcare. The payers say narrower networks are necessary for two reasons.

First, narrow networks can keep premiums affordable. Second, health insurers say narrow networks help them address the requirements of the Patient Protection and Affordable Care Act (ACA). continue reading

‘Genetic Testing Handbook’ Provides Physicians, Pathologists, and Clinical Lab Managers with Comprehensive Reference for Clinical Genome and Exome Sequencing

This new tool offers clinicians the dos and don’ts of genetic testing, what physicians need to know to do it properly 

Clinical use of gene sequencing information has advanced to the point where a team of genetic experts has compiled and issued the Genetic Testing Handbook. The goal of the clinical genome and exome sequencing (CGES) handbook is to provide clinicians—including pathologists and clinical laboratory scientists—with a useful reference tool.

The authors of the Genetic Testing Handbook are Leslie G. Biesecker, M.D., of the National Human Genome Research Institute (NHGRI) in Bethesda, Maryland, and Robert C. Green, M.D., M.P.H., a geneticist who is an Associate Professor of Medicine at Harvard Medical School.

Primer Distills Human Genome Project Technologies for Practical Use

“The technologies that were used for the Human Genome Project are now distilled down to practical tools that clinicians can use to diagnose and, hopefully, treat diseases in patients that they couldn’t treat before,” stated Biesecker, who serves as Chief and Senior Investigator at the NHGRI’s Medical Genomics and Metabolic Genetics Branch, in a press release issued by the National Institutes of Health (NIH). continue reading

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.

One keynote speaker at the eighth annual Lab Quality Confab in New Orleans, Louisiana, this week was Richard Zarbo, M.D. (pictured above). He is Chair of Pathology and Laboratory Medicine at Henry Ford Health System in Detroit, Michigan.  Zarbo shared the successes of his laboratory in working with physicians to create lab test formulary committees. One benefit to these committees is that more precise use of molecular tests for diagnosing cancer have reduced the unnecessary use of cancer drugs by millions of dollars annually. (Photo by Duane Stork, copyright The Dark Report.)

One keynote speaker at the eighth annual Lab Quality Confab in New Orleans, Louisiana, this week was Richard Zarbo, M.D. (pictured above). He is Chair of Pathology and Laboratory Medicine at Henry Ford Health System in Detroit, Michigan. Zarbo shared the successes of his laboratory in working with physicians to create lab test formulary committees. One benefit to these committees is that more precise use of molecular tests for diagnosing cancer have reduced the unnecessary use of cancer drugs by millions of dollars annually. (Photo by Duane Stork, copyright The Dark Report.)

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.

Pathologist Gaurav Sharma, M.D. (pictured above) explained how clinical laboratory and anatomic pathology services have been integrated in recent years at Henry Ford Health System in Detroit, Michigan. He described the use of daily management within the laboratory and how it helps lab staff identify recurring sources of errors and reduce or eliminate them. Sharma is Director of the, Regional Medical Laboratory and Associate Medical Director, Core Laboratory, Quality Systems and Regulatory Affairs. (Photo by Duane Stork, copyright The Dark Report.)

Pathologist Gaurav Sharma, M.D. (pictured above) explained how clinical laboratory and anatomic pathology services have been integrated in recent years at Henry Ford Health System in Detroit, Michigan. He described the use of daily management within the laboratory and how it helps lab staff identify recurring sources of errors and reduce or eliminate them. Sharma is Director of the, Regional Medical Laboratory and Associate Medical Director, Core Laboratory, Quality Systems and Regulatory Affairs. (Photo by Duane Stork, copyright The Dark Report.)

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:

Molecular Profile
(& 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
BRAF (Ipilimumab) melanoma $12k $1,560,000 $2,880.000
EGFR (Gefitinib) lung $72k $14,184,000 $14,823,000

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.)

 

Related Information:

Lab Quality Confab 2014: Live Digital Audio Recording Set

Agenda for Lab Quality Confab 2014 

Most Clinical Laboratories and Pathology Groups are Under Pressure to Cut Costs and Deal with Shrinking Budgets for 2015

Effective Lab Cost-Cutting and Budget Strategies for 2015: webinar information and webinar CD

Hit by Lower Lab Test Prices, Nation’s Clinical Pathology Laboratories Embark on Cost-Cutting Programs

Clinical Pathology Laboratory Leaders Reported Big Savings from Cost-Cutting Programs during Last Week’s Lab Quality Confab

When Cost-Cutting in the Clinical Pathology Laboratory Collides with Effective QA/QC: How Savvy Labs Sustain the Accuracy and Quality of their Lab Test Results

Clinical Laboratory Industry’s Best Cost-Cutters to Share Success Stories Studies, at Lab Quality Confab in New Orleans October 1-2, 2013

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

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