IN REAL TIME, PATHOLOGISTS ACROSS THE GLOBE CAN WATCH the meltdown of the Irish Health Service Executive's ambitious effort to revamp cervical cancer screening services in the country. It reorganized these screening services in order to achieve its declared goal of reducing death rates in Ireland from cervical cancer to rates at or below the average of the European Union.

So far, the new cervical cancer screening program, called CervicalCheck, has found few supporters within the Irish healthcare profession. In 2008, it alienated pathologists and laboratory scientists by outsourcing all the nation’s Pap testing to Quest Diagnostics Incorporated in the United States. That act also set an international precedent, as itmarked the first time that a government health program in a developed country chose to send all its specimens for an important diagnostic test to an overseas laboratory.

Since the fall of 2009, the CervicalCheck program has alienated general practitioners (GP) in Ireland. That happened when the government unilaterally changed both the way GPs are paid for providing cervical cancer screening services and by requiring GPs to deny free screening services to women who show up in their medical clinic, but who are unregistered with CervicalCheck. Ireland has the same challenge as every developed nation in the world.

Demand for healthcare services increases year-by-year at a rate which exceeds the ability of the government health program to adequately pay providers for this care. Thus, how elected officials and health department bureaucrats set policies for coverage guidelines and reimbursement in such situations gives us a hint of how politicians in other nations may respond to this same situation.

There is additional irony to the Irish Pap test situation. Irish health bureaucrats justified the Pap test outsourcing and the creation of CervicalCheck by stating that the average Pap result turnaround time of sixmonths was intolerable. Its chosen lab vendor, Quest Diagnostics, would have to meet a 10-day turnaround time for Pap results. However, now CervicalCheck requires women to register— then wait as long as six months-for the "invitation" which allows them to then make an appointment to see their doctor for their screen. Thus, newly-registered women are now forced to wait as long as six months for their invitation! Plus, women who are unregistered, but show up in the doctor's office, will be denied the free cervical cancer screening service. I don't think thiswas supposed to be the way any nation’s promise of universal healthcare was to be kept.

In South Carolina, TC/PC May Be "Misconduct"

South Carolina Board of Medical Examiners sends advisory memo to all doctors in the state

CEO SUMMARY: Last month, the South Carolina Board of Medical Examiners advised all physicians in the state that certain arrangements for technical component/professional component (TC/PC) services between referring physicians and pathologists may be in violation of state law. These actions came in response to a letter from the South Carolina Society of Pathologists. The letter explained the TC/PC arrangements and asked whether they violate state law, constitute illegal fee splitting, compromise patient care, and are unethical.

SC Pathologists Question Legality of TC/PC in State

South Carolina Society of Pathologists asks for review of the legality and ethics of TC/PC

CEO SUMMARY: Recently the South Carolina Society of Pathologists (SCSP) requested that the state's Board of Medical Examiners review the legality, under state law, of certain technical component/professional component (TC/PC) arrangements between referring physicians and pathologists. SCSP asked that the Board assess how TC/PC arrangements might violate state law, constitute illegal fee splitting, compromise patient care, and be unethical. State law in South Carolina has specific language that applies to some forms of TC/PC.

New Criticisms in Ireland About Cervical Screening

Physicians report how CervicalCheck's restrictions reduce women’s access to Pap testing

CEO SUMMARY: Pathologists worldwide are witnessing how a government health service can erode its nation's pathology capabilities in cytology. Ireland's experiment in off-shoring all its Pap testing even as it requires women to register in a national database in order to get free cervical cancer screening is not turning out well. A growing number of credible critics is turning up the heat on government health officials in the Emerald Isle.

Patient Privacy Laws Create Legal Risk for Labs

Laboratories must comply with a patchwork of federal and state requirements for patient privacy

CEO SUMMARY: Before the nation's healthcare system can achieve the integrated universal EHR, it must fix the crazy contradictions in state and federal laws governing patient privacy. There is discordance between federal law and state law that defines the role and responsibility of the clinical laboratory which performs a laboratory test and reports those results to the referring physician. The federal Centers for Medicare and Medicaid Services (CMS) did publish revised language this March, but more needs to be done.

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Better Blood Utilization Reduces Costs by 29%

Hospital slashes annual blood costs through physician engagement and donor recruitment

CEO SUMMARY: Use of an innovative two-pronged approach helped University of Alabama at Birmingham Hospital rein in runaway cost increases in blood products. Not only did it achieve annual savings of $3.5 million in three years—a 29% reduction—but it increased blood donations from 200 units per year to more than 6,000 units per year. Education and physician engagement were two cornerstones of this hospital-wide effort to improve utilization of blood products in ways that improved patient safety and outcomes.

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INTELLIGENCE: Late & Latent

FTC IS REVIEWING SALE OF WESTCLIFF TO LABCORP

MAX PLANCK INSTITUTE BUILDING LAB IN FLORIDA

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