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American Society for Clinical Pathology Website Was Hacked Last Year, Possibly Exposing Credit Card Information of Members and Online Shoppers

Thousands of pathologists and medical technologists may have had their private data stolen, though ASCP investigators did not confirm this as having happened

For a “limited time period” in 2020, the American Society for Clinical Pathology (ASCP) was the target of a cyberattack that “potentially exposed payment card data as it was

being entered” on the ASCP website, according to a letter sent by McDonald Hopkins PLC to then Attorney General of the New Hampshire Department of Justice (DOJ) Gordon MacDonald.

In “World’s Largest Pathologists Association Discloses Credit Card Incident,” Bleeping Computer, an information security and technology news publication, reported that on March 11 of this year, ASCP employees discovered their system had been hacked. They discerned that between March 3, 2020, and November 6, 2020, the attackers had access to personal information being entered on the ASCP website.

Bleeping Computer noted that “[the ASCP’s] member list includes over 100,000 medical laboratory professionals, clinical and anatomic pathologists, residents, and students.”

In a statement, the ASCP said, “We have recently been informed that our e-commerce website was the target of a cybersecurity attack that, for a limited time period, potentially exposed payment card data as it was entered on our website.”

The information that may have been stolen includes data pertaining to individual credit cards, names, credit or debit card numbers, expiration dates, and security codes (CVV) associated with the cards.

“We engaged external forensic investigators and data privacy professionals and conducted a thorough investigation into the incident,” the ASCP said in the statement.

What Type of Cyberattack?

Evidence collected regarding the ASCP data breach indicates the attack was part of a web-skimming assault. This involves installing malicious software, such as Magecart, onto an e-commerce website. The software acts like a credit card skimmer enabling hackers to steal the payment and personal information of customers who are actively inputting data on the attacked website. The data is then sent to remote servers where it is used for identity theft or sold to others.

ASCP says it does not permanently store any of its customers’ payment card data on its servers, Bleeping Computer reported, which greatly reduces the potential risk of data exposure. In addition, the ASCP has implemented extra security measures to prevent similar incidents from happening in the future.

“We resolved the issue that led to the potential exposure on the website. We implemented additional security safeguards to protect against future intrusions. We continue ongoing intensive monitoring of our website, to ensure that it exceeds industry standards to be secure of any malicious activity,” the ASCP said in a statement, Bleeping Computer reported.

Peter-Blum-Group-Product-Manager-Google
In an interview with TechRepublic, Peter Blum (above), Group Product Manager at Google, discussed steps companies can take to proactively manage the threat of Magecart cyberattacks. “The best defense against Magecart attacks is preventing access,” Blum said. “Online companies need a solution that intercepts all of the API [application programming interface] calls your website makes to the browser and blocks access to sensitive data you have not previously authorized. This prevents any malicious script, or any non-critical third-party script, from gaining access to information your customers enter on your website. This same system should also have a monitoring component to alert companies when a third-party attempts to access sensitive information.” (Photo copyright: LinkedIn.)

Federal Rules and Regulations Concerning HIPAA and PHI

The ASCP stated they have no evidence that any customer data was misused after the incident occurred. As of May 14, the organization has not made an official, public statement regarding the situation on their website, but affected individuals and jurisdictions were sent letters to inform them of the data breach.

With over 130,000 current members, Chicago-based ASCP is the largest professional organization for pathologists and clinical laboratory professionals in the world. The organization did not respond to Dark Daily’s inquiries regarding the data breach.

Although no reported violations under the Health Insurance Portability and Accountability Act (HIPAA) occurred in this ASCP data breach, it should be noted that there are rules under HIPAA for data breaches where Protected Health Information (PHI) may have been compromised.

Under the HIPAA Breach Notification Rule, entities that were hacked must perform the following steps:

  • Notify affected individuals within 60 days of the discovery of the breach. Notification should include a brief description of the breach, the types of information that may have been compromised, steps affected individuals should take to protect themselves from potential harm, and a description of what the organization is doing to investigate the breach, mitigate the harm, and prevent further breaches.
  • Hacked entity must inform the Secretary of Health and Human Services (HHS) within 60 days of the breach discovery if 500 or more individuals were affected. For breaches affecting less than 500 people, the breached entity may notify the Secretary of such breaches on an annual basis.
  • For breaches affecting more than 500 individuals, the hacked entity must also provide a notification to prominent media outlets, typically via a press release, that serve the state or jurisdiction.

This breach of credit card information belonging to a sizeable number of pathologists and clinical laboratory professionals using the ASCP website should be a warning to all clinical laboratories and anatomic pathology groups—along with colleges, societies, and associations—that their websites and digital systems can be attacked at any time. As well, clinical laboratory and pathology professionals should be on the alert and take all necessary precautions to minimize the possibility of data breaches.

—JP Schlingman

Related Information:

World’s Largest Pathologists Association Discloses Card Incident

American Society for Clinical Pathology—Incident Notification

ASCP Disclosed Payment Card Web Skimming Incident

Magecart Attack: What It is, How it Works, and How to Prevent It

What is Magecart? How This Hacker Group Steals Payment Card Data

A Deep Dive into Magecart: What Is Magecart?

Compliance Perspectives: State Enforcement Raises Liability Risks of Data Breaches

Three Federal Agencies Warn Healthcare Providers of Pending Ransomware Attacks; Clinical Laboratories Advised to Assess Their Cyberdefenses

University of California San Diego Researchers Demonstrates How Easily Medical Laboratory Systems and Devices Can Be Compromised, Putting Patient Lives at Risk

WannaCry Ransomware Holds Critical Data Hostage Worldwide, Including UK’s National Health Service and Russia’s Interior Ministry

Clinical Laboratory Scientist in British Columbia Gets Recognition for Identifying the Province’s First Case of COVID-19

Medical technologists and clinical laboratory professionals are the unsung heroes of the COVID-19 pandemic and the public is beginning to notice

Medical technologists (MTs) and clinical laboratory scientists (CLSs) are the foundation of every successful clinical laboratory. But they seldom make the news. Therefore, it is worth noting, during this COVID-19 pandemic, when clinical laboratory professionals receive public recognition for the important role they play in fighting the disease.

A news story published by the Canadian Broadcasting Corporation (CBC), titled, “Lab Tech Who Found B.C.’s 1st Case of COVID-19 Recalls ‘Sheer Terror’ of Discovery,” describes a laboratory technologist’s experience in British Columbia when she discovered the Canadian province’s first positive case of COVID-19 in January of 2020.

Finding COVID-19 for the First Time

On January 27, 2020, Rebecca Hickman, Public Health Laboratory Technologist, Molecular Biology and Genomics at BC Centre for Disease Control (BCCDC) was carefully monitoring samples for COVID-19 and fearing a positive result for the SARS-CoV-2 coronavirus when her worst fear appeared before her eyes.

“I actually started to see it get positive within a few seconds,” Hickman recalled. “My first feeling was sheer terror, from a personal point of view.”

When Hickman realized a sample was going to test positive, she called Tracy Lee, Technical Coordinator at BC Centre for Disease Control and co-designer of the BCCDC’s COVID-19 test. Hickman had to interrupt Lee in a meeting, who then hurried to the lab to watch the test complete. It was a definite positive, the first confirmed case in British Columbia.

“To design, validate, and implement a molecular laboratory test usually takes months if not years, and so to do that in the span of days is a huge achievement,” Hickman told the CBC.

The following day, it was announced to the residents of BC that the COVID-19 coronavirus was in their province and that they needed to start taking necessary precautions. “This is the first time in my life I’ve ever found things out before I read it in the news,” Hickman said.

Supply Shortages Challenge British Columbia Clinical Laboratories

Hickman noted there have been several challenges in dealing with COVID-19 over the past year. “The instability and craziness of it all has been the hardest part,” she said. Last spring, the BC lab, like most labs, had to deal with a shortage of supplies and personal protective equipment.

According to BC Centre for Disease Control (BCCDC) data, as of March 2, 2021, there have been 81,367 confirmed cases of COVID-19 in the province of British Columbia. A total of 75,255 of those individuals have recovered from the coronavirus, more than 300 patients remain hospitalized, and 1,365 British Columbians have perished due to COVID-19. The population of the western Canadian province is approximately 5.1 million.

Today, Hickman, spends a majority of her time in the laboratory doing whole genome sequencing of confirmed COVID-19 cases. The data she collects is used for outbreak response and for tracking new variants of the SARS-CoV-2 coronavirus that are appearing in different parts of the world. “It has been easily the most difficult year of my life, but also the most fulfilling,” she told the CBC. “What we have achieved here over the last year is huge.”

B.C. Centre for Disease Control in British Columbia, Canada, researchers Tracy Lee and Rebecca Hickman
In their laboratory at the B.C. Centre for Disease Control in British Columbia, Canada, researchers Tracy Lee (above left) and Rebecca Hickman (above right) “are designing new tests to quickly identify variants of the COVID-19 virus,” North Shore News (NSN) reported. Now, wrote NSN, “the pair are working on a new type of ‘rapid test’ that will be able to detect ‘variants of concern’—particularly the U.K., South African, and Brazilian variants—at the same time as determining if a test is positive for COVID-19. When it’s finalized, that test is expected to dramatically speed up the process of hunting the variants.” (Photo copyright: North Shore News.)

Clinical Laboratories on the Front Lines

Last year, the American Society for Clinical Pathology (ASCP) produced a docuseries titled, “Laboratories on the Front Lines: Battling COVID-19” which highlighted the critical work clinical laboratories are doing to care for patients during the SARS-CoV-2 pandemic. The five-part series interviewed medical laboratory professionals across the US about their experiences during the pandemic.

In one episode, Stephanie Horiuchi, Clinical Microbiology Specialist at UCLA Health Systems, discussed how challenging and rewarding it has been working on the pandemic.

“Very long days. I’m not going to lie. Very, very long days, but it’s rewarding. I know the importance of what I am doing, and I know the importance of what needs to be done,” she said. “So, the time that I am here, it does go by very fast. You look up at the clock and you’re like oh, its 9pm. And then when I go home, it’s just eat and go to sleep and then rinse and repeat.

“I feel that this is a really important area of work that we all do as microbiologists,” Horiuchi continued. “And to just serve patients every day and to know that I am helping someone, it really warms my soul.”

In another episode of the docuseries, Professor of Pathology and Laboratory Medicine Alyssa Ziman, MD, Division Chief, Clinical Laboratory Medicine at UCLA Health, was interviewed regarding how they are coping with the increased demand for medical laboratory services.

“It’s been a really difficult and challenging time for our health system, for our laboratories, for our staff that are working through to provide the best possible patient care,” she said. Ziman is also Medical Director, Transfusion Medicine, at UCLA Health and Medical Director, Clinical Laboratories, at Ronald Reagan UCLA Medical Center. “Every day is a new challenge and a new way to adapt to changing rules from the CDC and from the LA County Public Health Department and to really evolve, so that we can continue to provide the testing that we have and continue to support our staff and our patients.” 

Unsung Heroes of COVID-19

The COVID-19 pandemic has placed a strain on medical resources throughout the world. Clinical laboratory professionals are emerging as the unsung heroes of the crisis and the entire medical laboratory profession is receiving much deserved positive recognition for the crucial role laboratories are playing in fighting the pandemic.  

—JP Schlingman

Related Information:

Lab Tech Who Found B.C.’s 1st Case of COVID-19 Recalls ‘Sheer Terror’ of Discovery

Who is Doing All Those COVID-19 Tests? Why you Should Care about Medical Laboratory Professionals

Laboratories on the Front Lines: Battling COVID-19

BC COVID-19 Data

Variant-Hunting Researchers on the Cutting Edge of B.C.’s Race Against COVID

ASCP and CAP Support New Legislation That Bars Surprise Medical Billing

The No Surprises Act, passed as part of the COVID-19 relief package, ensures patients do not receive surprise bills after out-of-network care, including hospital-based physicians such as pathologists

Consumer demand for price transparency in healthcare has been gaining support in Congress after several high-profile cases involving surprise medical billing received widespread reporting. Dark Daily covered many of these cases over the years.

In “Are Clinical Laboratories Prepared to Cope with Outrage Over Surprise Medical Billing? Patient Access Management May Be an Effective Solution,” we reported on how some early-adopter medical labs and pathology groups were using Patient Access Management (PAM) platforms to address new federal transparency policies, change patient expectations about billing, and increase revenue by lowering denial rates.

And in “Balance Billing Under Increased Scrutiny at Both State and Federal Levels: Clinical Laboratory Tests Top List of Surprise Bills Received by Patients,” we reported on how clinical laboratory testing topped the list of the surprise bills received by patients, according to a survey conducted by the National Opinion Research Center (NORC) at the University of Chicago.

Now, after initial opposition and months of legislative wrangling, organizations representing medical laboratories and clinical pathologists have expressed support for new federal legislation that aims to protect patients from surprise medical bills, including for clinical pathology and anatomic pathology services.

The new law Congress passed is known as the No Surprises Act (H.R.3630) and is part of the $900 billion COVID relief and government funding package signed by President Trump on December 27.

“While this legislation is not perfect (no law is), it serves as a compromise where patients ultimately win,” stated the American Society for Clinical Pathology (ASCP) in its ePolicy News publication.

The law addresses the practice of “balance billing,” in which patients receive surprise bills for out-of-network medical services even when they use in-network providers. An ASCP policy statement noted that “a patient (consumer) may receive a bill for an episode of care or service they believed to be in-network and therefore covered by their insurance, but was in fact out-of-network.” This, according to the ASCP, “occurs most often in emergency situations, but specialties like pathology, radiology, and anesthesiology are affected as well.”

Most portions of the No Surprises Act take effect on January 1, 2022. The law prohibits balance billing for emergency care, air ambulance transport, or, in most cases, non-emergency care from in-network providers. Instead, if a patient unknowingly receives services from an out-of-network provider, they are liable only for co-pays and deductibles they would have paid for in-network care.

New Law Bars Pathologists from Balance Billing without Advance Patient Consent

The law permits balance billing under some circumstances, but only if the patient gives advance consent. And some specialties, including pathologists, are barred entirely from balance billing.

The law also establishes a process for determining how healthcare providers are reimbursed when a patient receives out-of-network care. The specifics of that process proved to be a major sticking point for providers. In states that have their own surprise-billing protections, payment will generally be determined by state law. Otherwise, payers and providers have 30 days to negotiate payment. If they can’t agree, payment is determined by an arbiter as part of an independent dispute resolution (IDR) process.

Early Proposal Drew Opposition

An early proposal to prohibit surprise billing drew opposition from a wide range of medical societies, including the ASCP, CAP, and the American Medical Association (AMA).

All were signatories to a July 29, 2020, letter sent to leaders of the US Senate and House of Representatives urging them to hold off from enacting surprise billing protections as part of COVID relief legislation. Though the groups agreed in principle with the need to protect patients from surprise billing, they contended that the proposed legislation leaned too heavily in favor of insurers, an ASCP news release noted.

“Legislative proposals that would dictate a set payment rate for unanticipated out-of-network care are neither market-based nor equitable, and do not account for the myriad inputs that factor into payment negotiations between insurers and providers,” the letter stated. “These proposals will only incentivize insurers to further narrow their provider networks and would also result in a massive financial windfall for insurers. As such, we oppose the setting of a payment rate in statute and are particularly concerned by proposals that would undermine hospitals and front-line caregivers during the COVID-19 pandemic.”

Hospital groups, including the American Hospital Association (AHA), raised similar concerns in a July 30 letter to congressional leaders.

On December 11, leaders of key House and Senate committees announced agreement on a bipartisan draft of the bill that appeared to address these concerns, including establishment of the arbitration process for resolving payment disputes.

However, in a letter sent to the committee chairs and ranking members, the AHA asked for changes in the dispute-resolution provisions, including a prohibition on considering Medicare or Medicaid rates during arbitration. “We are concerned that the IDR process may be skewed if the arbiter is able to consider public payer reimbursement rates, which are well known to be below the cost of providing care,” the association stated. However, legislators agreed to the change after last-minute negotiations.

AHA President and CEO Rick Pollack headshot in suit and tie
“The AHA is pleased that Congress rejected approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills and impact access to hospital care,” AHA President and CEO Rick Pollack (above) said in a statement. “We also applaud Congress for rejecting attempts to base rates on public payers.” (Photo copyright: American Hospital Association.)

Dispute Resolution for Pathologists

The CAP also expressed support for the final bill. In a statement, CAP noted that “As the legislation evolved during the 116th Congress, CAP members met with their federal lawmakers to discuss the CAP’s policy priorities.

“Through the CAP’s engagement and collaboration with other physician associations, the legislation improved drastically,” the CAP stated. “Specifically, the CAP lobbied Congress to hold patients harmless, establish a fair reimbursement formula for services provided, deny insurers the ability to dictate payment, create an independent dispute resolution (IDR) process that pathologists can participate in, and require network adequacy standards for health insurers.”

As laboratory testing was identified by thousands of respondents to the University of Chicago survey as the top surprise bill, it is likely that billing and transparency in charges for clinical pathologist and anatomic pathologist will continue to be scrutinized by law makers and healthcare associations.

—Stephen Beale

Related Information:

Detailed Summary of No Surprises Act

H.R.3630 – No Surprises Act

Are Clinical Laboratories Prepared to Cope with Outrage Over Surprise Medical Billing? Patient Access Management May Be an Effective Solution

Balance Billing Under Increased Scrutiny at Both State and Federal Levels; Clinical Laboratory Tests Top List of Surprise Bills Received by Patients

The No Surprises Act: Implications for States

AHA Statement on COVID Relief Package and Government Funding Bill

AHA Letter on No Surprises Act

How the CAP Shaped Surprise Billing Legislation with its Advocacy

Success on Surprise Medical Bills

Congress Curbs Surprise Billing in Omnibus Coronavirus Relief Bill

ASCP Joins AMA on Surprise Billing Letter

ASCP Continues Patient Advocacy Efforts on Surprise Billing Legislation

Surprise Medical Bills Cost Americans Millions. Congress Finally Banned Most of Them

Multiple Pathology and Other Healthcare Organizations Request CDC Include Clinical Laboratory Personnel in First Round of COVID-19 Vaccinations

CAP president maintains medical laboratory staff are ‘indispensable’ in pandemic fight and should be in ‘top tier’ for vaccination

As COVID-19 vaccinations continue to roll out, the College of American Pathologists (CAP) is lobbying for clinical pathologists and medical laboratory staff to be moved up the priority list for vaccinations, stating they are “indispensable” in the pandemic fight.

In a news release, CAP’s President Patrick Godbey, MD, FCAP argued for the early vaccination of laboratory workers, “It is essential that early access to the vaccine be provided to all pathologists and laboratory personnel,” he said. “Pathologists have led throughout this pandemic by bringing tests for the coronavirus online in communities across the country and we must ensure that patient access to testing continues. We must also serve as a resource to discuss the facts about the vaccine and answer questions patients, family members, and friends have about why they should get the vaccine when it is available to them.”

In a phone call following a virtual press conference, pathologists and CAP President Patrick Godbey, MD (above), told MedPage Today that even if medical laboratory staff are not directly in contact with patients, they should be considered “top tier” (designated as Phase 1a) for getting the vaccine. “I think they [clinical laboratory workers] should be considered in the same tier as nurses,” said Godbey, who also is Laboratory Director at Southeastern Pathology Associates and Southeast Georgia Health System in Brunswick, Ga. “They’re indispensable. Without them, there’d be no one to run the tests.” (Photo copyright: Southeast Georgia Health System.)

Who Does CDC Think Should Be First to Be Vaccinated?

According toThe New York Times (NYT), there are an estimated 21 million healthcare workers in the United States, making it basically “impossible,” the NYT wrote, for them all to get vaccinated in the first wave of COVID-19 vaccinations.

A December 11, 2020, CDC Morbidity and Mortality Weekly Report, titled, “ACIP Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine—United States, 2020,” notes that “The [federal] Advisory Committee on Immunization Practices (ACIP) recommended, as interim guidance, that both 1) healthcare personnel and 2) residents of long-term care facilities be offered COVID-19 vaccine in the initial phase of the vaccination program.”

The ACIP report defines healthcare personnel as “paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials.”

However, a CDC terminology guidance document listed at the bottom of the ACIP report states, “For this update, HCP [Healthcare Personnel] does not include dental healthcare personnel, autopsy personnel, and laboratory personnel, as recommendations to address occupational infection prevention and control (IPC) services for these personnel are posted elsewhere.”

On December 16, the American Society for Clinical Pathology (ASCP) called attention to this discrepancy by sending a letter to CDC Director Robert R. Redfield, MD. The letter was co-signed by the:

In part, the letter stated, “We are convinced that ACIP did not intend to exclude any healthcare workers from its recommendation to offer vaccinations to healthcare personnel in the initial phase of the COVID-19 vaccination program (Phase 1a). However, we would hate for jurisdictions to overlook dental, autopsy, and laboratory personnel because of a minor footnote in [CDC] guidance that was developed for an entirely different purpose (i.e., infection control).

“We respectfully ask CDC to clarify,” the letter continues, “… that all healthcare workers—including dental, autopsy, and laboratory personnel—are among those who should be given priority access to vaccine during the initial phase of the COVID-19 vaccination program.”

Forgotten Frontline Healthcare Workers?

Clinical laboratory professionals continue to maintain they should be in the first priority grouping, because they are in direct contact with the virus even if they are not directly interacting with patients. In the CAP virtual press conference streamed on Dec. 9, 2020, Godbey; Amy Karger, MD, PhD, faculty investigator at the University of Minnesota and Medical Director of MHealth Fairview Point-of-Care Testing; and Christine Wojewoda, MD, FCAP, Director of Clinical Microbiology at the University of Vermont Medical Center, made their case for early vaccination of medical laboratory workers.

“In the laboratory, they are encountering and handling thousands of samples that have active live virus in them,” said Karger, who called clinical laboratory staff and phlebotomists the “forgotten” frontline healthcare workers. “We’re getting 10,000 samples a day. That’s a lot of handling of infectious specimens, and we do want [staff] to be prioritized for vaccination.”

Karger continued to stress the vital role clinical laboratories play not only in COVID-19 testing but also in the functioning of the overall health system. She added that staff burnout is a concern since laboratory staff have been working “full throttle” since March.

“From an operational standpoint, we do need to keep our lab up and running,” she said. “We don’t want to have staff out such that we would have to decrease our testing capacity, which would have widespread impacts for our health system and state.”

Testing for Post-Vaccine Immunity

The CAP panelists also highlighted the need to prepare for the aftermath of widespread COVID-19 vaccinations—the need to test for post-vaccine immunity.

“It’s not routine practice to check antibody levels after getting a vaccine but given the heightened interest in COVID testing, we are anticipating there is going to be some increased in demand for post-vaccine antibody testing,” Karger said. “We’re at least preparing for that and preparing to educate our providers.”

Karger pointed out that clinical pathologists will play an important role in educating providers about the type of antibody tests necessary to test for COVID-19 immunity, because, she says, only the SARS-CoV-2 spike protein antibody test will check for an immune response.

With the pandemic expected to stretch far into 2021, clinical laboratories will continue to play a crucial role in the nation’s healthcare response to COVID-19. As essential workers in the fight against infectious disease, clinical pathologists, clinical chemists, and all medical laboratory staff should be prioritized as frontline healthcare workers.

—Andrea Downing Peck

Related Information:

Pathologists Want First Crack at COVID Vaccines

The Rapidly Changing COVID-19 Testing Landscape

Some Health Care Workers Getting the Vaccine. Other’s Aren’t. Who Decides?

The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine–United States, 2020

CDC Appendix 2-Terminology: Infection Control in Healthcare Personnel

ASCP Letter: COVID-19 Vaccination Playbook for Jurisdictional Operations

Prioritizing the COVID-19 Vaccine to Protect Patient Access to DiagnosticsCMS Changes Medicare Payment to Support Faster COVID-19 Diagnostic Testing

Clinical Laboratories Need Creative Staffing Strategies to Keep and Attract Hard-to-Find Medical Technologists, as Demand for COVID-19 Testing Increases

Critical shortages in medical laboratory workers and supplies are yet to be offset by new applicants and improved supply chains. But there is cause for hope.

Medical laboratory scientists (aka, medical technologists) can be hard to find and retain under normal circumstances. During the current coronavirus pandemic, that’s becoming even more challenging. As demand for COVID-19 tests increases, clinical laboratories need more technologists and lab scientists with certifications, skills, and experience to perform these complex assays. But how can lab managers find, attract, and retain them?

The Johns Hopkins Coronavirus Resource Center reports that as of mid-October more than one million tests for SARS-CoV-2 were being performed daily in the US. And as flu season approaches, the pandemic appears to be intensifying. However, supply of lab technologists remains severely constrained, as it has been for a long time.

An article in the Wall Street Journal (WSJ), titled, “Help Wanted at COVID-19 Testing Labs: Coronavirus Pandemic Has Heightened Longstanding Labor Shortages in America’s Clinical Laboratories,” reported that to address staff shortages “labs are grappling at solutions,” such as:

  • using traveling lab workers,
  • automation,
  • flexible scheduling, and
  • salary increases.

Still, qualified medical technologists (MT) and clinical laboratory scientists (CLS) are hard to find.

Demand for COVID Tests Exceeds Available Clinical Lab Applicants

“I can replace hardware and I can manage not having enough reagents, but I can’t easily replace a qualified [medical] technologist,” said David Grenache, PhD, Chief Scientific Officer at TriCore Reference Laboratories, Albuquerque, N.M., in the WSJ.

Another area where demand outstrips supply is California. Megan Crumpler, PhD, Laboratory Director, Orange County Public Health Laboratory, told the WSJ, “We are constantly scrambling for personnel, and right now we don’t have a good feel about being able to fill these vacancies, because we know there’s not a pool of applicants.”

In fact, according to an American Association for Clinical Chemistry (AACC) Coronavirus Testing Survey, 56% of labs surveyed in September said staffing the lab is one of the greatest challenges. That is up from 35% in May.

Are Reductions in Academic Programs Responsible for Lack of Available Lab Workers?

Recent data from the US Bureau of Labor Statistics (BLS) show 337,800 clinical laboratory technologists and technicians employed by hospitals, public health, and commercial labs, with Job Outlook (projected percent change in employment) growing at 7% from 2019 to 2029. This, according to the BLS’ Occupational Outlook Handbook on Clinical Laboratory Technologists and Technicians, is “faster than average.”

“The average growth rate for all occupations is 4%,” the BLS notes.

Medical laboratories have the most staff vacancies in phlebotomy (13%) and the least openings in point-of-care (4%), according to an American Society for Clinical Pathology 2018 Vacancy Survey published in the American Journal of Clinical Pathology (AJCP).

Becker’s Hospital Review reported that “Labor shortages in [clinical] testing labs have existed for years due to factors including low recruitment, an aging workforce, and relatively low pay for [medical] lab technicians and technologists compared to that of other healthcare workers with similar education requirements.

“In 2019, the median annual salary for clinical laboratory technologists and technicians was $53,000, according to the US Bureau of Labor Statistics. The skills required for lab workers also are often specialized and not easily transferred from other fields.”

At the “root” of the problem, according to an article in Medical Technology Schools, is a decrease in available academic programs. Laboratory technologists require a Bachelor of Science (BS) degree and technicians need an associate degree or post-secondary certificate.

Lisa Cremeans, MMDS, CLS(NCA), MLS(ASCP), Clinical Assistant Professor at University of North Carolina
“(The programs) are expensive to offer, so when it comes to cuts and budgets, some of those cuts have been based on how much it costs to run them. That, and they may not have high enough enrollments,” said Lisa Cremeans, MMDS, CLS(NCA), MLS(ASCP), Clinical Assistant Professor at University of North Carolina at Chapel Hill, in the Medical Technology Schools article. (Photo copyright: University of North Carolina.)

AACC has called for federal funding of these programs, which now number 608, down from 720 programs for medical laboratory scientists in 1990.

“The pandemic has shone a spotlight on how crucial testing is to patient care. It also has revealed the weak points in our country’s [clinical laboratory] testing infrastructure, such as the fact that the US has allowed the number of laboratory training programs to diminish for years now,” said Grenache, who is also AACC President, in a news release.

Creative Staffing Strategies Clinical Labs Can Take Now

Clinical laboratory managers need staffing and related solutions now. As Dark Daily recently reported in, “Three Prominent Clinical Laboratory Leaders Make the Same Prediction: COVID-19 Testing Will Be Significant Through 2020 and Throughout 2021,” prominent clinical labs are gearing up for dramatic increases in COVID-19 testing. This e-briefing was based on a 2020 Executive War College virtual session that covered how labs should prepare now so they can prosper clinically and financially going forward. That session can be download by registering here.

The final session of the 2020 Virtual Executive War College, titled “What Comes Next in Healthcare and Laboratory Medicine: Essential Insights to Position Your Clinical Lab and Pathology Group for Clinical and Financial Success, Whether COVID or No COVID,” took place on Thursday, Oct. 29, 2020. Given the importance of sound strategic planning for all clinical laboratories and pathology groups during their fall budget process, this session is being provided free to download for all professionals in laboratory medicine, in vitro diagnostics, and lab informatics.

To register for free access:

How Some Clinical Labs are Coping with Staff and Recruitment Challenges

The Arizona Chamber Business News reported that Sonora Quest Laboratories in Tempe earlier this year launched “Operation Catapult” to help with a 60,000 COVID-19 test increase in daily test orders. The strategy involved hiring 215 employees and securing tests with the help of partners:

Meanwhile, students in the UMass Lowell (UML) medical laboratory science (MLS) program, see brighter skies ahead.

“The job outlook even before COVID-19 was so amazing,” said Dannalee Watson, a UML MLS student, in a news release. “It’s like you’re figuring out a puzzle with your patient. Then, we help the doctor make decisions.”

Such enthusiasm is refreshing and reassuring. In the end, the SARS-CoV-2 pandemic and the resultant demand for clinical laboratory testing may call more students’ attention to careers in medical laboratories and actually help to solve the lab technologist/technician shortage. We can hope.

—Donna Marie Pocius

Related Information:

Help Wanted at COVID-19 Testing Labs

AACC COVID-19 Testing Survey: Full Survey Results

The American Society for Clinical Pathology’s 2018 Vacancy Survey of Medical Laboratories in the United States

Labs Squeezed for Staff to Meet COVID-19 Testing Demand

Medical Lab Scientist: Interview Clinical Worker Shortage

AACC Urges Congress to Fund Lab Training Programs to Prepare U.S. for Future Pandemics

Sonora Quest Pulls Out All Stops to Put Arizona in Front of COVID-19 Testing

Diagnostic Labs Eager to Hire UML Medical Lab Science Majors

Three Prominent Clinical Laboratory Leaders Make the Same Prediction: COVID-19 Testing Will be Significant Through 2020 and Throughout 2021

Expert Panel—What Comes Next in Healthcare and Laboratory Medicine: Essential Insights to Position your Clinical Lab and Pathology Group for Clinical and Financial Success, COVID or No COVID

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