Increased Test Volumes in Recent Years Trigger an Important Review of Coverage and Funding for Pathology Testing Services
DATELINE: MELBOURNE, AUSTRALIA—Pathology testing is under the gun in Australia. Fast-rising utilization of pathology testing over the past decade has caught the attention of health system policy makers. They are concerned about the funding and clinical service implications in downstream years should these growth rates in the volume of tests performed continue to increase at comparable rates into the future.
At the same time, a five-year master contract between the Australian national government and a representative group of national pathology and clinical laboratory associations that has brought some predictability in year-to-year spending on pathology testing expired on June 30, 2009. This contract is known as the Pathology Quality and Outlays Memorandum of Understanding (MOU). The MOU process was launched in 1989 and continued for 20 years. Since expiring in June, this MOU has not been renewed and the pathology profession in Australia is waiting to learn what new approach may be proposed by government health officials.
This was one big issue here in Melbourne this week, as an international crowd of pathology and clinical laboratory leaders gathered for “The Business of Pathology,” (TBOP). the biannual conference on pathology management co-produced by the Australasian Association of Clinical Biochemists (AACB) and The Dark Report.
Your Dark Daily editor, Robert Michel is here in Melbourne to deliver a presentation and participate in all the events at TBOP. Themes at the key sessions will be familiar to laboratory professionals in other countries. They included:
- Commoditization of pathology was addressed by several speakers. Jane Hall of the University of Technology in Sydney, a healthcare economist, observed that one effective way for pathology laboratories to demonstrate value to improve pricing for lab testing is to emphasize the information they produce. Another important strategy is to be more responsive to the needs of patients. Case studies of pathology labs in Canada and New Zealand reinforced this point.
- A detailed look at the opportunities for laboratories to improve quality and cut costs by using Lean, Six Sigma, and other quality management methods was evidence that innovative clinical labs are raising the bar on their performance. Ken Worth of Palms Pathology in Sydney shared lessons learned in sustaining Lean Six Sigma projects in his laboratory over a two-year period.
- Fascinating presentations on the changing expectations of consumers in regards to clinical laboratory services and genetic testing was addressed. Graeme Suthers, M.D., Deputy Head of the South Australian Clinical Genetics Service in Adelaide, emphasized that, with the complexity of genetic testing, it is essential that clinical laboratories distill the raw information generated by these assays into wisdom that helps guide the decisions of both clinicians and patients.
Workforce issues are a high profile issue in Australia’s pathology profession. Based on demographics of projected lab testing demand (as an aging population generates more utilization) and the shortfall in the number of new pathologists, laboratory scientists, and technical staff trained each year, there is recognition that the nation’s pathology testing system is likely to fall short of filling needed positions within just a few more years. Dark Daily will provide more intelligence on this issue in an upcoming e-briefing.
From Melbourne, your Dark Daily editor,