What’s the “buzz” on physician-office and reference labs?

Feb. 1, 2011

A major trend in laboratory medicine that is still gaining momentum is the use of LEAN and similar process-improvement methods by clinical laboratories and pathology groups nationwide, according to a Dark Daily report. “As part of their LEAN effort, today’s top-performing clinical laboratories are breaking down the silos between departments and encouraging a cross-discipline approach and workflow throughout the laboratory,” Patrick Maul, MBA, MT(ASCP), principal consultant, BD Diagnostics, Franklin Lakes, NJ, told Dark Daily. “This is one proven way to unlock productivity and encourage more teamwork.”

Other upcoming trends in the clinical-laboratory industry include 1) continued emphasis on information management, automation, and consolidation; 2) lab-related continuing education delivered via the Internet as labs look for ways to continually educate staff without incurring travel expenses; and 3) regulatory agencies taking a more active role to ensure that lab diagnostics are safe and effective for patient care.

The clinical-laboratory services market, dominated by LabCorp and Quest, continues to grow as new competitors enter. Physician office labs (POLs) and reference labs both have unique niches and offerings in the clinical laboratory marketplace. Here is the current buzz on trends to watch for in these labs.

New healthcare-delivery models part of coming changes

“There are monumental changes on the horizon for the healthcare industry and diagnostic medical labs. Two major drivers are the economy and new healthcare legislation. In the big picture, we see the laboratory’s role evolving into a more central component of patient care. New healthcare-delivery models will reimburse based on value to the patient, not CPT codes. The lab, with its data-rich environment and its critical role in upstream diagnostic processes, is in a unique position to have a profound and positive impact. We look forward to new opportunities to help our hospital laboratory clients be increasingly active players in this new healthcare environment.”

—Khosrow Shotorbani
Senior Vice President, Sales
ARUP Laboratories

What a POL can offer doctors’ patients

“Large reference laboratories can always induce the lowest cost per laboratory test. But we discovered that by having our own POL, we could offer a more personal approach to patients. Compared to a reference lab, our POL has faster turnaround times on lab results, more timely diagnostic information for providers, fewer patient trips to the office or hospitals, and an additional vein of revenue for the practice. There are no more lost patient samples, delays in results, or return visits the following week to the office once the provider obtains the lab results. On-site specimen storage makes it easier for providers to add laboratory tests. With a turnaround time of less than an hour on most patients’ laboratory tests, providers now have more control over the patient-care process. We do use two large reference laboratories in the POL due to insurance requirements or for tests that are not run in-house.”

—Todd Norris, MT(ASCP)
Laboratory Manager
Nephrology Associates

Personalized medicine will distinguish reference laboratories

“A large growth opportunity for reference laboratories is testing for personalized diagnostics and prognostics. The ability to use genomic and epigenetic laboratory tests to diagnose disease, select or tailor initial therapy, and predict individual patient outcome, coupled with individualized, interpretive patient reports will distinguish reference laboratory providers.

Recent advances in chromosomal microarrays will become industry standards in the diagnosis of genetic disorders and malignancy.

Pharmacogenomics and cytochrome P450 arrays will help tailor drug therapy, while DNA methylation, micro-RNA, and gene expression arrays will help physicians to determine disease prognosis.

Reference laboratories that can rapidly develop testing to meet clinical needs in these areas will have an advantage, but providers with specialized pathologist expertise will be in the best position to help clients and their associated clinicians understand the clinical utility, interpretation, and utilization of personalized diagnostics.”

—Kandice Kottke-Marchant,
MD, PhD
Chair, Pathology
& Laboratory Medicine Institute
Cleveland Clinic Laboratories

POLS offer advantages to customers, physicians, patients

“Utility is the ability of a good or service to satisfy consumers’ needs. It is accepted wisdom in healthcare that the closer the service is to the patient, the more efficient the service and delivery of care will be. The POL satisfies the definition of utility by eliminating the need to make a phone call to patients to convey results and reducing the time to get a lab result. The patient is afforded the benefit of one office visit and can discuss the results face to face with the physician. Ultimately, a POL offers many advantages to customers, physicians, and patients.”

—Richard A. Kent, MS, MT(ASCP)
Laboratory Manager
Elkhart Clinic LLC

Hospital-affiliated POLs drive improved QC

“We see the rising number of hospital-affiliated POLs driving an increased need for flexible connectivity and advanced security options in the POL. Point-of-care managers are demanding better connectivity for POL-based analyzers to ensure automatic transmission of results to the laboratory information system, histology information system, and patient electronic medical records. The need for consistent quality-control (QC) regimens, operator, and QC lock-out features ensure compliance and reduce institutional risk.”

—Maria Peluso-Lapsley
Commercial Marketing Manager
Point of Care Urinalysis
and Diabetes
Siemens Healthcare Diagnostics
DCA Vantage HbA1c analyzer
and RAPIDComm data management system software

Karen Lynn is a medical freelance writer.

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