Change for Laboratories
This year’s Lab Quality Confab focused on the changes taking place in healthcare and how the lab needs to realign itself to support those changes. Robert Michel, Editor in Chief of The Dark Report, described four main sources of change for laboratories, listed below in Figure 1. Here is the link to Michel’s PowerPoint slides: Why Healthcare’s Evolution Creates Opportunity to Redefine the Value of Clinical Labs.
Discussion centered on the fact that laboratorians need to position themselves to respond appropriately to healthcare changes and find effective ways to create value and help clinicians achieve better patient outcomes.
Focus on Patient Outcomes
In his session Where Lab Medicine Creates Value in Healthcare: Getting Out of the Lab To Help Clinicians Achieve Better Patient Outcomes, Lee H. Hilborne, MD, MPH, FASCP, FCAP, DLM(ASCP)CM, Medical Director at UCLA, spoke of the need for laboratorians to reinvent themselves and focus on patient outcomes in order to be relevant to the value equation.
He reiterates a familiar statistic—while lab results have a direct impact on 70-80% of clinical decisions, they account for only 3% of healthcare costs. No other specialty touches so many clinical situations that impact patients.
Align Lab Goals with IOM Domains
In the past, labs have focused on perfecting the analytical phase of testing. Now, new opportunities lie outside that phase. Laboratorians are encouraged to reach outside the lab to find ways to help clinicians achieve better outcomes. The lab has been a strong leader in quality measurement; labs are data-centric and typically very aware of utilization patterns. Some of the lab’s prowess with quality systems now needs to be focused on the pre-and post-analytic phases of lab testing. In his session, Dr. Hilborne encouraged laboratorians to align lab goals with the six Institute of Medicine (IOM) quality domains (see Figure 2).
Labs are Data Savvy
Many sessions echoed a similar theme. In his keynote, Recognizing Healthcare’s Transformation and How the Lab’s Lean Team Can Contribute to Value Creation Outside the Lab, Matt Modleski, a consultant with Stovall Grainger Modleski Inc., pointed out that labs are data savvy, so measuring quality is a natural fit. Labs know who is utilizing what and how much they are utilizing. “Labs will be part of the transformation of healthcare so enjoy the different roles you will play,” advised Modleski. He also pointed out the benefits of developing collaborative relationships with other healthcare departments, such as finance, quality assurance, pharmacy, ED, nursing, etc.
Areas of Growth & Opportunities for Labs
Molecular and genetic testing is an exploding industry for labs. As personalized medicine continues to expand, the lab’s role continues to be of vital importance. Laboratory testing menus may shift as molecular and genetic tests become more available and can be incorporated into laboratory use.
Another area expected to continue growing is point-of-care (POC) testing. As new reimbursement structures demand faster turnaround time (TAT) and up-front diagnoses, and POC testing becomes more affordable, this non-centralized testing offers great benefit to providers. Laboratories must embrace this by assuming a consultative role, providing the necessary training and oversight, and developing guidelines for POC test use.
This demand for early diagnosis in order to develop effective therapies and treatments is on a constant rise. The wide range of diagnostic tests handled by the clinical laboratory along with increasing rates of infectious and chronic diseases is expected to continue to drive market growth.
Strategies for Success
Curt Johnson, COO of Orchard Software, and Dr. Kevin Breuel, Laboratory Director at East Tennessee State University Clinical Laboratory (ECL), led a session in which they pointed out that the lab must remember throughout this transition that it plays a central role because diagnostics become even more critical. Figure 3 outlines some of the strategies from their presentation. To review the specific examples put in place at ECL by Dr. Breuel, take a look at his PowerPoint presentation: Realigning Lab Focus Beyond Operational Efficiency to Laboratory Medicine that is Tightly Integrated into Patient Care and Clinician Support.
The clear “take-home” theme from LQC was that the role of laboratory professionals will evolve. In the future, there will be less focus on analytical skills, and many manual techniques will be replaced by automation. Laboratorians will need to be comfortable with advanced technology and automation with more focus on oversight and consultation, and be able to extend their reach outside the lab to make sure others know who they are, what they do, and why it is important and valuable.
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Kim Futrell, MT(ASCP)
Products Marketing Manager
Orchard Software Corporation