Pathologists and clinical lab leaders heard about innovations in microbiology automation, genetic testing, use of mass spectrometry, and lab informatics advances
DATELINE: TORONTO, ONTARIO: From across Canada, clinical laboratory executives, pathologists, and health service administrators assembled last week to attend Executive Edge, this nation’s largest conference on innovations in the management and operation of medical laboratories.
Healthcare in Canada faces challenges that are common to healthcare systems in most developed countries. Demand for healthcare is growing at a fast pace due to an aging population and increased incidence of chronic disease. Government budgets cannot grow fast enough to meet the rising demand for healthcare services.
Shrinking Budgets for Medical Education Mean Fewer Trained Med Techs
The money squeeze also affects medical education. In Canada, because of tighter budgets, the number of trained healthcare professionals produced each year is less than what is desired and needed.
As a consequence, medical laboratories and histopathology laboratories in Canada report that it is ever more difficult to recruit and retain adequate numbers of medical technologists, histotechnologists, and lab professionals trained in molecular diagnostics and genetic testing.
Another factor of concern about the supply of lab professionals is the looming retirement of baby boomer med techs and pathologists. At Executive Edge, several speakers addressed this situation. They noted that last decade’s predictions of the great mass retirement by baby boomers has yet to happen.
No Mass Retirement by Baby Boomer Med Tech … at Least Not Yet
In part, this is because many med techs who do retire are continuing to work some number of part-time hours in the clinical lab where they served, often for decades. However, speakers at Executive Edge pointed out that, as these individuals move from their sixties into their seventies, they will cease working part-time in these laboratories and move into full retirement.
Laboratory Personnel Training and Certification Inspires Open Discussion
In fact, one of the most spirited sessions at Executive Edge was a panel presentation with audience participation that focused on the need for significant changes in how medical laboratory technologists, pathologists, and laboratory scientists are trained and certified. Serving as panelists were the leaders of key organizations involved in medical laboratory education and licensure. They were:
• Jelena Holovati, PhD, Assistant Professor, Department of Lab Medicine and Pathology, University of Alberta, Edmonton, Alberta
• Aline Gagnon, Director, Canadian Medical Association Accreditation, Ottawa, Ontario
• Christine Nielsen, Executive Director of the Canadian Society of Medical Laboratory Science, Hamilton, Ontario
• Kathy Wilkie, Chair of the Canadian Alliance of Medical Laboratory Professionals Regulators and Registrar & Executive Director College of Medical Laboratory Technologists of Ontario, Toronto, Ontario
These panelists delivered a common message to the medical laboratory administrators and managers sitting in the audience. In order to graduate more medical laboratory technologists and laboratory scientists, the training programs in Canada need a higher level of support and engagement from laboratories throughout the nation.
“Many academic programs are struggling to find enough laboratories in their community willing to take students and provide the hands-on clinical training that is required for students to graduate and earn certification,” noted panelist Christine Nielson. “If there was any single way that clinical labs could help academic programs graduate more students, it would be to provide this in-laboratory training for students.”
Diagnostic Technologies and Lean Workflows Spotlighted
Many of the sessions at this year’s Executive Edge featured clinical laboratories and anatomic pathology labs that are doing innovative things with the latest diagnostic technologies. Automation and workflow redesign in microbiology were the key elements in a presentation delivered by Norma Page, Vice President of Clinical Operations at DynaLIFEDx, based in Edmonton, Alberta.
Page shared the lessons learned and successes in a major project to implement Canada’s first comprehensive automated microbiology system. She explained how the lab team used Lean and workflow redesign to incorporate the BD Kiestra automated microbiology system in such a way as to significantly reduce average lab test turnaround times while improving quality, particularly by eliminating the variability that is inherent in manual processes.
Advancements in Digital Pathology and Mass Spectrometry Spark Innovation
Another lab doing innovative things is the Laboratory Medicine Program at University Health Network (UHN) in Toronto, Ontario. In his presentation, pathologists Andrew Evans, MD, PhD, Director of Telepathology at University UHN, described what is recognized as one of the earliest digital pathology networks to operate in the world.
Currently the digital pathology lab network consists of the UHN hospitals in downtown Toronto, plus four other hospitals located as much as 400 miles from Toronto. “Currently, about 40% of the pathologists regularly use whole slide images on a regular basis,” stated Evans. “Glass slides and microscopes still make up about 80% of the work handled by our pathologists daily.”
It was in 2004 when the UHN pathologists were using telepathology as a way to handle frozen sections at the different hospitals that are part of UHN. Within a few years of that, UHN’s Laboratory Medicine Program acquired a digital pathology system and began using whole slide imaging to support its frozen section service. “Since that time, we’ve worked to understand the benefits and limitations of digital pathology and digital scanners,” explained Evans. “We currently have digital pathology systems by Leica Aperio and Omnyx and the technology utilized in these systems is advancing at a steady pace.”
Another presentation that focused on innovation in a Canadian laboratory was delivered by Victor Leung, MD, who is the Physician Lead, Antimicrobial Stewardship, at Providence Health Care in Vancouver, British Columbia. Leung discussed how the use of mass spectrometry and MALDI-TOF (Matrix Assisted Laser Desorption/Ionization-Time of Flight) mass spectrometers for infectious disease testing was shortening the time to answer for clinicians while also providing more precise information to guide therapeutic decisions. He also provided a spreadsheet analysis that showed how labs can identify the return on investment (ROI) for mass spec systems in order to win the capital required to acquire and use these testing systems.
These examples show the rich learning experience that happened over the two days of Executive Edge. And these labs are not exceptions. Across Canada, there are inspiring examples of other medical laboratories and histopathology laboratories that innovating in ways that put them ahead of the curve.
Certainly, as the Executive Edge speakers last week admitted, not every innovation proves successful in real life. But as the outcomes data and performance metrics shared by these speakers demonstrated, when something succeeds, it generally provides a big boost to patient outcomes while bending the cost curve downward. That should be an inspiration to medical labs everywhere.
Your Dark Daily Editor,
Robert L. Michel