THESE ARE INTERESTING TIMES IN HEALTHCARE AND LABORATORY TESTING both here and across the globe. In the United States, elected officials in Congress are busy assembling 1,000-page bills to make over the nation's entire healthcare system under the guise of extending coverage to those who are currently uninsured.

Overseas, the healthcare systems of other developed countries are showing cracks caused by a demand for health services that exceeds existing capacity, along with a rate of growth in health spending that is not only unsustainable, but is causing fiscal and political crises in some nations.

The American public remains oblivious to these many important stories about healthcare crises, innovations, and issues-and the analysis needed to understand them-because today's media outlets have migrated to milking the spectacular pop culture story of the moment, whether it is the death of Michael Jackson or the revelations concerning David Letterman's blackmail threats and his philandering with interns and other younger females on his staff.

For our part, THE DARK REPORT is working to fill that information vacuum by offering our clients and regular readers coverage of events outside the United States that directly touch pathology and laboratory medicine in both negative and positive ways. It is my view that pathologists and laboratory managers in this country can benefit from knowledge about how other health systems are handling laboratory testing in their own country.

Two notable examples are featured in this issue of THE DARK REPORT. On pages 3-5, you will read about the latest developments in Auckland, New Zealand, involving the troubled start-up of Labtests, the new monopoly lab granted an eight-year contract by the region's District Health Boards.

Patients and physicians are unhappy with Labtests' service deficiencies. But because it is the only lab provider in the metropolitan area, they have no other option. Similarly, on page 16, we provide an update to the Irish pap smear outsourcing program. In recent weeks, flaws in the design of the government plan for cervical cancer screening have surfaced. Many physicians are publicly criticizing these deficiencies. But since it is the only major source for cervical cancer screening in Ireland, they and their patients lack the ability to choose another solution.

My message from these two stories is that "choice" is an important element in our American health system. As both patients and providers, each of us benefits from how choice fosters competition, which encourages good service!

Auckland Health Boards Give DML Some Testing

Responding to problems at Labtests, officials return 10% of testing to Diagnostic Medlab

CEO SUMMARY: Auckland's chaotic lab testing situation just became more complicated. Today the Auckland District Health Boards announced a four-year contract to allow Diagnostic Medlab to perform 10% of the area's test volume, primarily for private hospitals and private specialists. Its purpose is to take some pressure off Labtests by having Diagnostic Medlab perform the more complex and sophisticated assays.

Expert Says Time is Now For Labs to Adopt QMS

Growing number of reasons argue in favor of labs embracing a quality management system

CEO SUMMARY: Laboratories in the United States are knowledgeable about the use of quality control (QC) and quality assurance (QA) programs. But QC and QA represent only two small parts of a comprehensive quality management system (QMS), says Lucia Berte, an expert in lab quality. One benefit for clinical laboratories using a QMS is that it can become easier to meet the requirements of multiple regulatory bodies. Use of the QMS will also help the laboratory respond more effectively to unannounced inspections.

Scripps' Tumor Board Finds Value in Digital Imaging of Slides

Surprise Hit with Other Participating Physicians

CEO SUMMARY: When the Pathology Department at Scripps Memorial Hospital in La Jolla, California, was considering the purchase of a digital imaging system, it gained unlikely allies. Non-pathologist physicians participating in the department's tumor boards advocated for the purchase after seeing a demonstration. Pathologists at Scripps are preparing for a future in which digital imaging systems will encourage more interaction with referring physicians. These systems also could foster a move away frombatch processing in pathology and toward real-time continuous flow.

Global Lab Update: Bureaucratic System in Ireland Affects Access to Pap Testing

GSK and Abbott Team up For Companion Diagnostic

Example of companion diagnostic strategy demonstrated by GlaxoSmithKline and Abbott

CEO SUMMARY: Although GlaxoSmithKline PLC is several years away from having a deliverable product from its Antigen Specific Cancer Immunoassay (ASCI) Program, it has a development deal with Abbott Laboratories to produce a companion diagnostic test for ASCI-based products. The interesting twist in this arrangement is that the resulting companion diagnostic assay will be designed to run on Abbott's m2000 molecular system. That would allow an expanded number of labs to run this test kit.

INTELLIGENCE: Late & Latent

CARIS ADDS 22 PATHOLOGISTS

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