| R. Lewis Dark:
Two Healthcare Trends Collide on These Pages
THIS ISSUE OF THE DARK REPORT YOU NOW HOLD IN YOUR HANDS demonstrates
the perfect intersection of two trends. One trend, transparency in health outcomes
and a public expectation of reduced medical errors, is a direct threat
to laboratories which fail to deliver high-quality and accurate lab test results.
The other trend is the way quality management systems (QMS) are being
“pulled” into laboratory operations and healthcare.
This first trend is analyzed on pages 16-18, where you will read how the
widely-publicized deficiencies of several labs and pathologists in Canada has
become a public issue. To bolster public confidence in laboratory testing,
pathologists with the Canadian Association of Pathology (CAP) are creating
a voluntary proficiency testing program. It is starting with breast cancer testing
for estrogen receptors (ERs) and progesterone receptors (PRs). As an interesting
side note, Canada’s single-payer model health system has yet to step
forward and pay for this proficiency testing program.
The second trend—involving the use of quality management systems,
including "ISO:15189 Medical Laboratories"—is assessed on pages 3-5. This is
one of the lab industry’s first alerts to this emerging development. Our Editor,
Robert L. Michel, considers it important enough that he has assembled an
impressive panel of experts to speak on QMS at the upcoming Lab Quality
Confab http://www.labqualitycofab.com on September 24-25, 2008. That promises to be a revealing series of
presentations and I recommend that clinical labs and pathology groups
already confronting use of quality management systems be present at this
unique event. First, it is not likely that this same assemblage of experts on
ISO:15189 and similar quality management systems will be gathered at one
time and place again soon. Second, Robert has a knack for pulling together a
spectrum of experts, who, collectively, deliver an amazing amount of information
and unmatched strategic wisdom. That’s a lot of bang for your buck!
I will also step forward with another recommendation. I suggest that you use
the two intelligence briefings referenced above as discussion points for a strategic
session in your laboratory or pathology group practice. I’ll bet that, as your
leadership team talks through the implications of trend one—outcomes transparency
and public expectations—and contrasts that with trend two—use of
QMS to continuously improve quality, productivity, and performance—it is
going to agree on some surprising new directions for your laboratory.
First U.S. Labs Nearing ISO:15189 Accreditation
ISO:15189 likely to influence upcoming reform
and revisions to CLIA licensing requirements
CEO SUMMARY: Laboratories, hospitals, and other healthcare
providers in the United States will increasingly be
required to adopt quality management systems (QMS) as part
of their regular operational routine. This is consistent with
trends in other developed countries. Several U.S. laboratories
are in the process of gaining accreditation under "ISO:1519
Medical Laboratories." These developments will be discussed
at the upcoming Lab Quality Confab in Atlanta next month.
Independent Labs Won't Get
Medicare PQRI Bonuses
Independent labs learn they will not get same
Medicare PQRI payments as other pathologists
CEO SUMMARY: Medicare does not intend to make bonus
payments this year to independent labs currently reporting quality
information for breast and colon cancer cases. The federal claims
payment system is unable to pay independent labs for participating
in the federal physician quality reporting initiative (PQRI). But
physician pathology groups participating in PQRI will receive the
bonus payments as expected. CMS has yet to formally acknowledge
this problem, leaving labs with unanswered questions.
MT/MLT Distance Learning Goal of Collaboration
ARUP and Weber State team up to make
it easier for interested lab staff to advance skills
CEO SUMMARY: To encourage more students to pursue medical
technology (MT) and medical laboratory technician (MLT)
degrees, ARUP Laboratories and Weber State University (WSU) are
collaborating to promote the distance learning programs offered at
WSU. Online students can work any shift and take courses anytime
(day, night, or on weekends), thereby making education more
accessible to prospective students. Distance learning is likely to be
an important source of education for new technical staff for labs.
NEWSMAKER INTERVIEW: Successful Laboratories in the Future
Will Brand Themselves, Add Value
CEO SUMMARY: At the most recent Executive War College(see http://www.executivewarcollege.com), Kerry
Kaplan, President of Healthcare Connections in Natick, Massachusetts,
discussed the results of his national survey of managed care executives.
In part one of this interview, Kaplan described the results of his survey,
along with advice on how laboratories can build a positive, ongoing partnership
with local managed care plans. In part two, he explains what
steps pathologists and lab directors can take to become partners with
their health plan customers to improve the delivery of healthcare. He also
explains how labs have an opportunity to work more closely with payers
that are interested in saving money on complex, expensive cases. Kaplan
ends by stressing the need for labs to have a branding strategy.
Canadian Pathologists Start PT Testing for ER/PR
Voluntary proficiency testing program created
in response to public disclosure of test deficiencies
CEO SUMMARY: Experts point out that widely publicized episodes
of lab testing deficiencies in several provinces are signs that
chronic underfunding of lab testing services is a key factor in these
failures. To restore public confidence in breast cancer testing, the
Canadian Association of Pathologists is developing a voluntary
pro ficiency testing system for hospital labs to improve the accuracy
and reproducibility of breast cancer markers, including estrogen
receptor, progesterone receptor, and other clinical IHC tests.
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