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COVID-19 Test Sales Fall Nearly 90% at Abbott in Q2, a Clear Marker to Clinical Laboratories That the Pandemic Has Passed

Sales of SARS-CoV-2 tests at other IVD companies, including Roche Diagnostics and Danaher’s lab businesses also report declines in COVID-19 test revenue

Clinical laboratory leaders and pathologists seeking a marker that the COVID-19 pandemic has passed may have it in the plunge in SARS-CoV-2 test revenue during the second quarter at Abbott Laboratories, Abbott Park, Illinois.

COVID-19 test sales in Q2 2023 at Abbott fell a “whopping” 89% as people try to “move on” from the SARS-CoV-2 outbreak, the Chicago Tribune reported.

Developer of the BinaxNOW rapid COVID-19 antigen self-test, Abbott saw its COVID-19 sales revenue decline from $2.3 billion in Q2 2022 to $263 million in the quarter ending June 30, the Chicago Tribune noted. 

The decline was expected by Abbott. Nonetheless, the company will likely sell more than $1 billion in COVID-19 tests by the end of this year—business it did not have in 2019.

Abbott lowered its forecast for COVID-19 sales in 2023 to $1.3 billion, down from $1.5 billion, MedTech Dive reported.

“We decided to bring our COVID-19 number down a couple of hundred million dollars, because we’re seeing—as the public health emergency ended—a little bit of a decline in testing,” said Abbott’s Chairman and CEO Robert Ford during an earnings call transcribed by Motley Fool. “So, we’ll see how that’s going to play out in Q4 (2023), the first quarter we will see an endemic respiratory season.” Clinical laboratories that performed high numbers of SARS-CoV-2 test during the pandemic will likely experience similar declines in test volumes. [Photo copyright: Abbott Laboratories.)

Overall, Abbott Has ‘Good Recovery’

COVID-19-related diagnostics was just part of the financial report by Abbott, which also develops other clinical laboratory tests, clinical laboratory analyzers and automation, medical devices, pharmaceuticals, and nutritional products such as infant formula.

Abbott said in a news release that its sales—driven by base business performance—were $10 billion in Q2.

“We have had a really, really good recovery here as the health systems are opening up, and are seeing routine testing come back,” said Abbott’s Chairman and CEO Robert Ford during the earnings call.

Here are diagnostics financial results for Q2 2023 as compared to Q2 2022, according to the news release:

  • Diagnostic sales fell to $2.3 billion from $4.2 billion.
  • Core laboratory sales were flat at $1.2 billion.
  • Molecular sales plunged to $141 million from $212 million.
  • Rapid diagnostics plummeted to $741 million from $2.7 billion.

As need for COVID-19 testing contracts, Abbott is focusing on research and development of assays that may be “missing on the menus,” Ford said during the earnings call.

“We’ve been working on expanding the menu in molecular and point-of-care. One of the most exciting assays that the team has developed for point-of-care is a rapid test for traumatic brain injury,” he added.

COVID-19 Revenue Falls at Roche, Danaher

Abbott is not the only in vitro diagnostics (IVD) manufacturer to report a recent significant decline in demand for COVID-19 products.

Another sign the major wave of the pandemic has passed is the dramatic fall in COVID-19 product revenue at Roche to 0.4 billion Swiss Francs (CHF) (US$460 million) from 3.1 billion CHF (US$3.5 billion) in the first half of 2022, according to a Roche news release.

The Basel, Switzerland company—reporting on six months of financial results—said its Roche Group base business increased 8% and Diagnostics Division base business rose 6% in 2023, as compared to the first six months last year.

Diagnostics Division sales overall fell 23% to 7 billion CHF (US$8 billion) from 9.9 billion CHF (US$11.3 billion), Roche said.

Here are more first-half of 2023 financial results at Roche as compared to the same period in 2022:

  • Core lab: 3.9 billion CHF ($US 4.4 billion), up 10% from 3.8 billion CHF (US$4.3 billion).
  • Molecular lab: 1.1 billion CHF (US$1.2 billion), down 40% from 1.9 billion CHF (US$2.1 billion).
  • Diabetes care: 723 million CHF (US$831.7 million), down 5% from 832 million CHF (US$957 million).
  • Pathology lab: 687 million CHF (US$790 million), up 12% from 652 million CHF (US$750 million).
  • Point of care: 635 million CHF (US$730.6 million), plummeted 74% from 2.6 billion CHF (US$2.9 billion).

“In the first half of 2023, sales in the base business of both of our divisions (diagnostics and pharmaceuticals) grew strongly, largely offsetting the impact of declining demand for COVID-19 products,” said Roche CEO Thomas Schinecker, PhD, in the news release.

COVID-19 test revenue also impacted financial results at Danaher Corporation, the Washington, D.C.-based parent company of Beckman Coulter Diagnostics, Cepheid, and Leica Biosystems.

Revenue was down in Q2 7.5% to $7.1 billion as compared to $7.7 billion in the same quarter last year, the company said in a news release.

COVID-19 took a toll on sales of 9% in the quarter as compared to Q2 2022, according to a Danaher earnings release presentation.

As to plans for growth, Cepheid is adding assays for Group A Streptococcal and hospital-acquired infections to the menu of the GeneXpert System which performs COVID-19 testing, said Danaher CEO Rainer Blair in remarks to analysts during an earnings call prepared by the Weekly Transcript.

COVID-19 May Linger as IVD Companies Refresh Menus

As the COVID-19 pandemic wanes, healthcare providers will continue to test patients for the SARS-CoV-2 coronavirus.

But it also appears that IVD companies are aiming to keep their instruments—which ran full tilt performing COVID-19 testing during the pandemic—of high value to clinical laboratories by developing new tests for possible inclusion on labs’ testing menus.

—Donna Marie Pocius

Related Information:

Abbott’s COVID-19 Test Sales Dive by Nearly 90%

Abbott Q2 Net Profit Falls as Weaker COVID-19 Test Sales Drag on Revenue

Abbott Laboratories Q2 2023 Earnings Call Transcript

Abbott Reports Second Quarter 2023 Results, Increases Outlook for Underlying Base Business

Abbott Receives FDA Clearance for First Commercially Available Lab-based Blood Test to Help Evaluate Concussion

Roche Reports Strong Growth in Both Divisions’ Base Business; Group Sales Reflect Declining Demand for COVID-19 Products

Danaher Reports Second Quarter 2023 Results

Danaher Earnings Presentation

Danaher Q2 2023 Earnings Call Transcript

Hospital, Health System Mergers and Acquisitions Impact Clinical Laboratories

Post-merger, a first goal is often to achieve cost savings by consolidating hospital laboratory testing into fewer medical laboratory sites

Major integrated delivery network (IDN) healthcare systems continue to acquire other hospitals. These deals are getting larger in scope and confirm that the trend of hospital consolidation is robust and ongoing. They also present a challenge for clinical laboratories that service the IDN’s physicians from both inside and outside the networked systems.

One most recent example is the announced mega-merger of non-profit BJC HealthCare (BJC) in St. Louis and faith-based non-profit Saint Luke’s Health System (St. Luke’s) in Kansas City, both in Missouri. St. Louis Post-Dispatch described the deal as “one of the biggest local hospital mergers in recent memory.”

And for good reason. According to Healthcare Dive, the partnership that will create a 28-hospital, $10 billion dollar health system with more than 100 specialty and primary care offices serving patients in Illinois, Kansas, and Missouri. Fiscally, BJC showed $6.3 billion in revenue last year and Saint Luke’s $2.4 billion.

Mega mergers are a big deal (pun intended). They can give the new healthcare organization unrivaled competitive authority in the marketplace potentially passing along lower healthcare prices to patients. But they come at cost to embedded clinical staff, including medical laboratories.

The health system merger gives BJC/St. Luke’s “huge leverage in terms of negotiating power with the insurers,” Ryan Barker, an independent healthcare policy consultant, told the St. Louis Post-Dispatch. Clinical laboratories are also impacted in these mergers when hospital systems consolidate their testing capabilities and locations. (Photo copyright: Missouri Foundation for Health.)

Impact of the BJC/St. Luke’s Merger

BJC and St. Luke’s signed a non-binding agreement to merge on May 31 and plan to reach a final agreement before the year’s end barring regulatory interference. The duo’s combined 28-hospital system will operate out of two headquarters: One in St. Louis managing southern Illinois and eastern Missouri, and another in Kansas City to serve parts of Kansas as well as western Missouri, Healthcare Dive reported.

The merger of BJC and St. Luke’s means the formation of a “clear market leader in Missouri,” St. Louis Post-Dispatch reported, adding that BJC has 40% of the market’s patient discharges and St. Luke’s holds 20% of the market share in the “state’s second largest metropolitan area.”

This will likely manifest itself in leverage during negotiations with healthcare payers that service that area.

“It continues to be the case that the hospitals are trying to gain the upper hand on the insurers,” John Romley, PhD, Associate Professor in the University of Southern California (USC) Price School of Public Policy and USC Mann School of Pharmacy and Pharmaceutical Sciences, told the St. Louis Post-Dispatch. Romley is also an economist at the USC Schaeffer Center for Health Policy and Economics, and adjunct economist at the Rand Corporation. “That was true 10 years ago. That’s true today,” he added.

“That’s what I always worry about with consolidation is the impact on [healthcare] pricing,” Ryan Barker, an independent healthcare policy consultant in St. Louis and former Vice President of Health Policy at Missouri Foundation for Health, told the Post-Dispatch.

Other Large Health System Mergers and Acquisitions

There have been a growing number of large-scale mergers and acquisitions of IDNs in the last few months. Dark Daily’s sister publication The Dark Report has covered these deals in multiple intelligence briefings.

Most recently, in “Kaiser Acquires Geisinger Health in Value-Based Deal,” The Dark Report outlined Kaiser Foundation Hospitals’ (KFH) acquisition of Pennsylvania-based Geisinger Health. Based in Oakland, California, KFH is part of the Kaiser Permanente integrated delivery network.

Healthcare policy makers were surprised by the merger, as Kaiser and Geisinger were often cited as two of the best IDNs in the nation.

Now under single ownership there will be implications that take years to play out, especially for clinical laboratories that now must service a significantly larger physician base. Conversely, if the new combined healthcare system decides to combine multiple medical laboratories to save on costs it will have a huge impact on lab staff.

Another deal recently announced involves UPMC’s (University of Pittsburgh Medical Center) announcement to merge with multihospital Washington Health System (WHS) in Washington, Pennsylvania, a WHS news release noted. But the move has drawn pushback from elected officials and organized labor, the Pittsburgh Post-Gazette reported.

UPMC has recorded rapid growth over the year acquiring smaller hospitals, but hospital mergers are getting closer inspections from federal regulators, the Pittsburgh Post-Gazette noted.

SEIU Healthcare Pennsylvania—part of the Service Employees International Union—was first to request an investigation by the US Department of Justice for what it called a “long and egregious history of labor law violations.” It also claimed that UPMC merged with 27 hospitals from 1996 to 2019, adding 10 between 2016 and 2018, the Pittsburgh Post-Gazette reported.

And in “Sanford/Fairview Merger Has Implications for Clinical Labs,” The Dark Report explored the merger between IDNs Sanford Health of Sioux Falls, South Dakota, and Fairview Health Services in Minneapolis. The mega merger creates a 58 hospital/79,000 employee multi-hospital system.

Concentrated ownership of diagnostic services impacts clinical laboratories in many ways. The Dark Report noted that combined IDNs often review clinical laboratory services across the entire healthcare network. Opportunities for third-party commercial labs to step in and run the hospitals’ local laboratory services may also present themselves.

Impact IDN Mergers Have on Clinical Laboratories

Mergers occur for many reasons. Monetary stress has a wide-reaching impact, and some healthcare researchers suggest that financial pressures may cause hospitals formerly hopeful about their medical laboratory outreach businesses to consider selling their programs, as The Dark Report noted.

One significant impact that health system mergers and acquisitions can have on clinical laboratories is to reduce their number, particularly by consolidating testing from multiple sites into a core laboratory.

“There is a growing body of empirical research about the potential for competitive harm to labor markets from consolidation and concentration,” Federal Trade Commissioner Rebecca Kelly Slaughter, JD and FTC Chair Lina M. Khan, JD, wrote in a joint 2022 statement about the merger of the first and second biggest healthcare providers in Rhode Island. “The loss of competition from mergers may be especially pernicious in the healthcare sector where skilled medical professionals are uniquely limited in employer options within their local geographic area,” the Pittsburgh Post-Gazette reported.

In this case, the plans to merge were ended after the FTC sued to block the partnership.

More IDN Mergers on the Way

But increased FTC scrutiny does not seem to have slowed the trend toward larger merger and acquisition deals. Kaufman Hall’s 2023 National Hospital Flash Report states that both mergers and acquisitions are trending toward cross-regional partnerships and predicts a “new wave of transaction activity,” Healthcare Dive reported. The report looks at actual and budget data collected over the past three years that was sampled from more than 900 hospitals on a recurring monthly basis.

And so, moving into the future, clinical laboratories can expect to see more mergers and acquisitions of IDNs, with consolidation, regionalization, and standardization occurring in the combined IDN’s clinical laboratory once the merger is completed and leadership begins to look for ways to save costs. Labs are generally first to be consolidated because it is easier to move lab specimens than it is to move patients.

—Kristin Althea O’Connor 

Related Information:

BJC Healthcare, Saint Luke’s Health System Plan to Merge, Forming $10B System

BJC Saint Luke’s Hospital Merger Would be One of the Area’s Largest, It May Not be the Last

Merger of BJC and St. Luke’s Will Likely Raise Hospital Prices in Missouri, Analysts Say

BJC HealthCare and Saint Luke’s Health System Sign Letter of Intent to Form Integrated Missouri-based Health System

UPMC Plans to Acquire Washington Health System

UPMC, Washington Health System Sign Letter of Intent to Affiliate

Washington Health System to Merge with UPMC

UPMC Seeks to Add 2-Hospital Washington Health System

Stiff Headwinds Await UPMC in Its Bid to acquire Washington Health System

National Hospital Flash Report: April 2023

Kaufman Hall’s 2023 National Hospital Flash Report

Larger Hospital Mergers Expected in Post Pandemic Market, Kaufman Hall Says

13 Healthcare Mergers and Acquisitions Making Headlines in May

Clinical Laboratory Trends Kaiser Acquires Geisinger Health in Value-Based Deal

Major Data Breaches at Hospitals, Clinical Laboratories, and Health Plans Continue to Put Patient Data at Risk

Lapses in security measure testing can give healthcare employees a false sense of protection against data breaches, says cybersecurity expert

Cyberattacks on our nation’s hospitals, clinical laboratories, other healthcare organizations, and health plans, continue to plague the healthcare industry. As of July 7, 2023, 324 data breaches have occurred and are currently under investigation, according to the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) data breach portal.

This has affected more than 39 million people, HealthITSecurity reported.

When cybercriminals attack hospitals, clinical laboratories, and other medical organizations, healthcare consumers’ protected health information (PHI) may be stolen.

Dark Daily has covered such cyberattacks extensively.

In “Healthcare Cyberattacks at Two Hospitals Prompt Tough Decisions as Their Clinical Laboratories Are Forced to Switch to Paper Documentation,” we reported how in response to cyberattacks on two hospitals, medical laboratories in Florida and Maryland were forced to switch from digital to paper documentation and, in at least one case, the organization reportedly had difficulty accessing electronic laboratory test results.

And in, “Nearly One Million Patient Records of Hospitals, Health Clinics, Medical Laboratories, and other Providers Stolen in Ransomware Attack on Medical Records Company,” we covered how a single ransomware attack on a medical records company netted nearly a million PHI records from 28 healthcare providers in New York. This include names, home addresses, treatment dates, health plan numbers, and internal account numbers of 934,138 patients.

Below is a list of the data breaches this year that affected the most people.

“The way that computer network environments work today, users are acknowledged as the weakest link and offer the most potential for access to a hacker,” Ben Denkers (above), former Chief Innovation Officer at CynergisTek, told Dark Daily’s sister publication The Dark Report. He added that data breaches at clinical laboratories can start with “missteps” by lab employees who have a false sense of protection caused by lapses in testing a lab’s security measures. CynergisTek merged with Clearwater in 2022. (Photo copyright: CynergisTek.)

Top Data Breaches in First Six Months of 2023

Here are healthcare’s top 10 data breaches for the first half of 2023, listed by organizations with the most people affected, according to HHS:

  • Managed Care of North America, dental benefits organization, Atlanta, Georgia, 8.8 million individuals affected.
  • PharMerica Corporation, pharmacy services for skilled nursing, Louisville, Kentucky, 5.8 million individuals affected.
  • Regal Medical Group, Reseda, California, 3.3 million individuals affected.
  • Cerebral, mental health services, Claymont, Delaware, 3.1 million individuals affected.
  • NationsBenefits Holdings, supplemental benefits company, Plantation, Florida, three million individuals affected.
  • Harvard Pilgrim Health Care, health plan, Canton, Massachusetts, 2.5 million individuals affected.
  • Enzo Clinical Labs, clinical reference laboratory, Farmingdale, New York, 2.4 million individuals affected.
  • ZOLL Services, medical equipment, Pittsburgh, Pennsylvania, 997,097 individuals affected.
  • Community Health Systems, healthcare provider with 15,000 licensed beds at 89 acute care hospitals in 16 states, Brentwood, Tennessee, 962,884 individuals affected.
  • CentraState Healthcare System, healthcare provider with a 284-bed acute care medical center, an ambulatory campus, and an urgent care clinic, Freehold, New Jersey, 617,901 individuals affected.

Clinical Laboratory Brings in Cybersecurity Experts

Following a ransomware incident in April on its computer network, Enzo Clinical Labs in Farmingdale, New York, “immediately took steps to secure our systems and began an investigation with the assistance of a cybersecurity firm,” the lab’s Notice of Data Security Incident explains.

“The investigation determined an unauthorized party accessed files on our systems,” the notice continues. “The files contained patient names, dates of service, clinical test information, and, in some instances, Social Security numbers.”

Enzo “has incurred, and may continue to incur, certain expenses related to this attack, including expenses to respond to, remediate and investigate this matter,” according to the lab’s Securities and Exchange Commission (SEC) filing.

Multiple Large Health Systems Suffer Data Breaches

At Community Health Systems (CHS) it was a security incident at Fortra, a cybersecurity firm engaged by CHS, that resulted in “unauthorized disclosure of patient information,” according to CHS’s Notice of Third Party Security Incident.

The extent of data theft from the breach of Fortra’s GoAnywhere MFT secure managed file transfer software was not immediately clear, HIPAA Journal reported.

“The personal information may have included full name, address, medical billing and insurance information, certain medical information such as diagnoses and medication, and demographic information such as date of birth and Social Security number,” the CHS notice explained.

At CentraState Healthcare System, “an unauthorized person obtained a copy of an archived database that stored certain patient information,” the healthcare provider’s Notice of Security Incident states. 

“There was no financial account and/or payment card information involved in this incident,” CentraState noted.

Financial Impact of Data Breaches

One of the effects on healthcare providers is costly settlement of lawsuits following data breaches that allege failure to secure patients’ PHI. For example, according to Becker’s Health IT:

  •  UMass Memorial Medical Center in Worcester, Massachusetts, paid $1.2 million “to settle a March 2022 lawsuit regarding a data breach of its payroll management system Kronos.”  
  • Advent Health in Altamonte Springs, Florida, paid $500,000 “to settle a data breach lawsuit alleging that the health system failed to protect patients’ confidential information after a September 2021 data breach.”
  • CommonSpirit Health in Chicago spent $150 million recovering from a ransomware attack in October 2022 that also sparked lawsuits over stolen PHI.

Tips for Clinical Laboratories on Securing Patient Data

In “Labs Must Audit Their Cybersecurity Measures,” Ben Denkers, former Chief Innovation Officer at CynergisTek, an Austin-based cybersecurity company which has since merged with healthcare cybersecurity and compliance company Clearwater, told Dark Daily’s sister publication The Dark Report, “The way that computer network environments work today, users are acknowledged as the weakest link and offer the most potential for access to a hacker.”

Denkers advises that while training employees is important for cybersecurity because it aims at changing human behavior, laboratories and other healthcare organizations also need to audit the technological measures they have in place to protect data.

“What we find is that organizations have security technology or processes in place that are either not effective or not working as designed,” he said, adding that when data breaches do occur “it’s a complete blindside for a lot of organizations that think they have protections in place because they bought a product, or they developed a policy.

“Testing, validating, and auditing whether measures are working as designed is a change of mentality for a lot of organizations. I would recommend taking those steps,” he added.

Clinical laboratories hold vast amounts of patient data and cannot afford disruptions to testing and results reporting. Vigilance can help labs avoid catastrophic cyberattacks, secure their patients’ protected health information from being stolen, and prevent the subsequent lawsuits that ensue following a data breach.

—Donna Marie Pocius

Related Information:

US Department of Health and Human Services Office for Civil Rights Breach Portal

2023 Largest Health Data Breach So Far Brings Legal Flurry

Biggest Healthcare Data Breaches Reported This Year, So Far

Notice of Data Security Incident: Enzo Clinical Laboratories

Securities and Exchange Commission (SEC) Filing: Enzo

Third Party Security Incident Impacting Community Health Systems

Up to One Million Community Health Systems Patients Affected by GoAnywhere MFT Hack

CentraState Healthcare System Notice of Security Incident

How Much Three Health Systems are Paying to Resolve Cyberattacks

Sophisticated Cyberattacks Target Healthcare

Labs Must Audit Their Cybersecurity Measures

Healthcare Cyberattacks at Two Hospitals Prompt Tough Decisions as Their Clinical Laboratories Are Forced to Switch to Paper Documentation

Nearly One Million Patient Records of Hospitals, Health Clinics, Medical Laboratories, and other Providers Stolen in Ransomware Attack on Medical Records Company

Continued Cyberattacks on Hospitals, Clinical Laboratories, and Other Providers Cause Closures as Hackers Grow in Sophistication

Cybersecurity experts recommend clinical laboratories have in place a plan for performing tests and distributing results prior to a cyberattack

Hospitals of all sizes continue to be prime targets for sophisticated cyberattacks, where hackers remotely disable a healthcare network’s computer systems—including its laboratory information system—and extort ransomware payments. Similar attacks are happening to clinical laboratories and other providers, although not with the same frequency.

Recently, hospitals in Illinois, Idaho, Vermont, Indiana, and other states had their ability to treat patients severely reduced and, in some cases, completely shut down by cybercriminals, endangering lives and costing millions of dollars in damages.

Today’s hospitals rely on information technology (IT) for patient care workflow, internal/external communication, billing, and medical laboratory testing. It’s this reliance on computer/internet technology combined with the vast quantities of protected health information (PHI), that makes hospitals such ripe targets for attack.  

In June, a US cancer center had to take its digital services offline which “significantly reduced patient treatment capability” following a ransomware attack by a group of hackers known as the TimisoaraHackerTeam (THT), MedCity News reported.

“Patients don’t stop getting sick just because a hospital is hit by a ransomware attack,” Christian Dameff, MD, emergency physician at UC San Diego Health and lead author of a study that looked into how cyberattacks affect other hospitals in the area, told ABC News. “They have to go somewhere. So, what this research shows is that those patients go to neighboring hospitals that can be overwhelmed.” Clinical laboratories can also become overwhelmed with test orders when nearby hospitals lose their ability to distribute the results of critical lab tests. (Photo copyright: UC San Diego Health.)

In its “Healthcare and Public Health Sector Cybersecurity Notification” on the event, the federal Division of Critical Infrastructure Protection (CIP) wrote, “Little is known about the obscure group of hackers, but when its ransomware is deployed, their rarely used and very effective technique of encrypting data in a target environment has paralyzed the health and public health (HPH) sector.”

The CIP operates within the US Department of Health and Human Services’ (HHS) Office of the Administration for Strategic Preparedness and Response (ASPR) and Health Sector Cybersecurity Coordination Center (HC3).

Here is a list of other cyberattacks on healthcare providers and the consequences of these crimes.

Recent Cyberattacks Close Hospitals, Disrupt Clinical Laboratory Testing

The 44-bed St. Margaret’s Hospital in Spring Valley, Illinois, was forced to close its doors in June due in part to a 2021 ransomware attack, NBC News reported. 

“The attack halted the hospital’s ability to submit claims to insurers, Medicare or Medicaid for months, sending it into a financial spiral,” Linda Burt, RN, Vice President of Quality and Community Services at St. Margaret’s, told NBC News. “We were down a minimum of 14 weeks. And then you’re trying to recover. Nothing went out. No claims. Nothing got entered. So, it took months and months and months.”

Meabwhile, 88-bed Idaho Falls Community Hospital experienced a cyberattack in May that required it to divert ambulances to other hospitals for 24 hours, CNN reported. The provider’s sister healthcare facility, MountainView Hospital in Las Vegas, which shares the same computer system, was also affected.

The Idaho Falls attack “forced nurses and doctors … to use pen and paper rather than computers for patient charts,” a hospital spokesperson told CNN.

At the University of Vermont Medical Center (UVM), Burlington, Vermont, a ransomware attack affected healthcare services for 28 days, costing the provider $50 million to recover, and preventing healthcare workers from accessing critical treatment plans for cancer patients, ABC News reported.

UVM’s President and Chief Operating Officer, Stephen Leffler, MD, an emergency medicine physician, told ABC News that the 2020 cyberattack significantly disrupted clinical laboratory operations at UVM.

“When the laboratory had a critical lab result on someone, they couldn’t put it in the electronic medical record,” he explained. “They couldn’t call the floor. And so, we literally had our administrators start going in the lab, standing there and running a paper result to the floors.

“Everything that we do and rely on was down,” he added. “We actually sent some staff to Best Buy to buy Walkie Talkies!

“It can happen to you—even when you think it’s impossible,” Leffler warned.

And at Johnson Memorial Health, Franklin, Indiana, clinical laboratory tests took two hours to perform instead of 30 minutes, NPR said in its report on cyberattacks affecting Indiana providers. The lab had to use “runners” to share handwritten test results with caregivers and patients, NPR explained. 

“You ask many CEOs across the country, ‘What keeps you up at night?’ Of course, they talk about workforce, financial pressures, and they say, ‘the possibility of a cyberattack,” John Riggi, National Advisor for Cybersecurity and Risk at the American Hospital Association (AHA), told NPR.

Cyberattacks Affect Surrounding Hospitals

To make matters worse, cyberattacks have a “blast radius” that impacts the healthcare community around an attacked provider, Christian Dameff, MD, Assistant Professor, Emergency Medical Services, University of California, San Diego, told ABC News. Dameff was lead author in a study that looked at how healthcare providers nearby to an attacked provider are affected.

“Hospitals adjacent to healthcare delivery organizations affected by ransomware attacks may see increases in patient census and may experience resource constraints affecting time-sensitive care for conditions such as acute stroke,” Dameff and co-authors wrote in a JAMA Open Network article titled, “Ransomware Attack Associated with Disruptions at Adjacent Emergency Departments in the US.”

“Healthcare cyberattacks such as ransomware are associated with greater disruptions to regional hospitals and should be treated as disasters,” they wrote.

Vigilance Is Required as Cyberattacks Increase

Ransomware attacks on hospitals climbed from 43 to 91 annually during the years 2016 to 2021, a separate study in JAMA Health Forum reported, adding that large organizations with multiple facilities were increasingly targeted.

The US experienced a 57% increase in cyberattacks in 2022 compared to 2021, according to a Check Point Research (CPR) report. Healthcare ranked second on the list of attacked industries due, according to Check Point, to the quantity and availability of personal and sensitive information, such as social security numbers and medical data.

“We expect the increase in cyber activity to only increase. With AI [artificial intelligence] technologies such as ChatGPT readily available, it is possible for hackers to generate malicious code and emails at a faster, more automated pace,” the CPR report noted.

For its part, the AHA said in a statement it plans to:

  • Make available cybersecurity services to members.
  • Work with federal agencies to mitigate cyber threats.
  • Advocate for increased government cybersecurity assistance.

Hospital clinical laboratory leaders need to be vigilant and work with colleagues to prevent cyberattacks. Check Point’s report advises, for example, avoiding malicious links and unexpected electronic attachments as well as verifying software is legitimate before downloading it. These are standard warnings, but they only work if staff members actually heed these actions.

Also important for diagnostics professionals is having a plan for performing clinical laboratory and anatomic pathology tests and distributing the results in the event of an attack.    

—Donna Marie Pocius

Related Information:

An Illinois Hospital Is the First Health Care Facility to Link Its Closing to a Ransomware Attack

Feds Warn Healthcare Providers about “Obscure” Ransomware Gang

Healthcare and Public Health Sector Cybersecurity Notification

TimisoaraHackerTeam Ransomware Attacks US Cancer Center

St. Margaret’s Health—Spring Valley Breached by Cyber Security Attack

Cyberattack Forces Idaho Hospital to Send Ambulances Elsewhere

Cyberattacks Are Growing Threats to Patient Safety, Experts Say

Cyberattacks on Healthcare Are Increasing: Inside One Hospital’s Fight to Recover

Ransomware Attack Associated with Disruptions at Adjacent Emergency Departments in the US

Trends in Ransomware Attacks on US Hospitals, Clinics, and Other Healthcare Delivery Organizations, 2016-2021

Check Point Research Reports a 38% Increase in 2022 Global Cyberattacks

Keeping Hospitals and Patients Safe against Cyberattacks

City of Baltimore, University of Maryland Create Pilot Program to Train People to Work in Clinical Laboratories

Funded by the CDC, the program hopes to alleviate personnel shortages in Baltimore area clinical labs while also producing a knowledge base for lab managers nationwide

Clinical laboratory managers struggling to fill vacant phlebotomy and accessioning positions will be interested to learn about a pilot program being conducted by the City of Baltimore and the University of Maryland School of Medicine to train people “for employment in hospital laboratories, phlebotomy draw sites, and reference laboratory processing centers,” according to The Elm, a publication of the University of Maryland, Baltimore.

The 14-week “Mayor’s Workforce Development Program” began on April 19 and will continue through the end of July. Participants meet twice a week for lectures and experience working with specimens in actual medical laboratories or in a “hybrid learning environment,” The Elm reported.

“I came up with the idea of doing cross-training for laboratory people and public health people in case there is another pandemic,” explained Lorraine Doucette in an exclusive interview with Dark Daily. Doucette, who is managing the pilot program, is an Assistant Professor and Medical Laboratory Science Program Director, Department of Medical and Research Technology, University of Maryland School of Medicine.

“There is already a huge shortage of laboratory people, but an enormous amount left in droves during the pandemic because they got physically burned out. Some just could not do the work anymore because of things like carpal tunnel syndrome and repetitive stress injuries,” she added.

Lorraine Doucette

“I’m confident that all 15 or 16 students who complete this workforce program will be employed within weeks of finishing as accessioners,” said Lorraine Doucette (above), Assistant Professor and Medical Laboratory Science Program Director, Department of Medical and Research Technology, University of Maryland School of Medicine, in an exclusive interview with Dark Daily. “This has been so successful. This is making a difference in people’s lives. This is changing them from being unemployed to actually having a career in a clinical laboratory. They love it. They are so proud of themselves.” (Photo copyright: LinkedIn.)

CDC Funding Part of National Program to ‘Enhance’ Clinical Lab Workforce

Doucette and her team met with people from the Baltimore Mayor’s Office of Employment Development (MOED) to discuss a possible partnership. They were interested and Doucette eventually became a recipient of funding through a cooperative agreement with the federal Centers for Disease and Control Prevention (CDC).

The collaboration is part of a CDC project titled, “Enhancing US Clinical Workforce Capacity.’ Doucette will receive a total of one million dollars over the course of three years to facilitate the program in stages.

“It is not necessarily an old-fashioned grant where they just gave me a pile of money,” Doucette told Dark Daily. “The CDC works with me constantly via reports and Zoom meetings.”

This CDC project is designed to both cross train clinical laboratory professionals in public health, clinical chemistry, microbiology, and hematology, as well as to train individuals in the workforce development program to become laboratory accessioners.

“They are going to be qualified to work as an accessioner in any local hospital,” Doucette noted. “The people who pick up the lab samples out of the tube system are the accessioners and there is a huge shortage of them also. We’re teaching them the basics so the more advanced lab personnel can perform the higher-level work.”

Students in the program learn all about lab safety and the proper handling of lab samples as well as proper data entry, professionalism, and how to communicate with medical and laboratory personnel. They work with urine and blood samples and fabricated spinal fluid samples. 

“They are taught about the different tubes, what the anticoagulants are, what makes each tube unique, why you can’t mix samples, balancing a centrifuge, and how to properly put on and remove safety gear like lab coats, gloves, and goggles,” Doucette explained. 

The Mayor’s Workforce Development Program is free for Baltimore residents looking for employment via the workforce office. The only requirements for enrolling are having a high school education and being fully vaccinated.

Phlebotomy and Additional Cross-training to Be Added

Doucette would eventually like to add a phlebotomy segment to future training sessions. “We would like to develop an additional partnership with BCCC (Baltimore City Community College) for the phlebotomy piece. That would definitely increase the people and the program’s marketability,” she said. “They could not only draw the blood, but they could also process the sample.”

After assessing the success of the current program and determining what did and did not work, there will be an additional training session held in the fall. Next year, there will be more sessions held for individuals in the workforce program and cross-training classes for current clinical laboratory professionals.

The strategy for the third year of the grant includes sharing the specifics of the program with medical laboratory professionals via the CDC’s free OneLab REACH platform. This portion includes the online delivery of documentation such as training sheets, lab exercises, Microsoft PowerPoint presentations, and videos used in both the accessioning and cross-training coursework.

“We’re going to do the OneLab REACH,” Doucette said. “I’m going to be putting it all online and marketing it all around the country in stages and increments. I will be going to a lot of professional society meetings and talking to lab managers to help them understand the concept of how this all benefits them.”

This unique collaboration between the City of Baltimore and University of Maryland School of Medicine, funded by the CDC, should help alleviate some of the clinical laboratory worker shortages that exist in the Baltimore area. Hopefully, the effort will result in additional knowledge, resources, and tools to assist medical lab managers across the country to recruit and retain talented, highly-skilled workers.   

JP Schlingman

Related Information:

Enhancing US Clinical Laboratory Workforce Capacity

What Is an Accessioner and How to Become One

Enhancing US Clinical Laboratory Workforce Capacity

93.322: CSELS Partnership: Strengthening Public Health Laboratories

NOFO OE22-2202: Enhancing US Clinical Laboratory Workforce Capacity—Frequently Asked Questions

NOFO OE22-2202: Enhancing US Clinical Laboratory Workforce Capacity—Q/A Session Transcript

Forbes Senior Contributor Covers Reasons for Growing Staff Shortages at Medical Laboratories and Possible Solutions

Medical Technologist Demand Exceeds Supply by Large Margin Across the United States as Clinical Laboratories Scramble to Stay Fully Staffed

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