Nov 26, 2012 | Instruments & Equipment, Laboratory News, Laboratory Operations, Laboratory Pathology
Taking molecular biology into the field is a big step forward in moving molecular diagnostics to the gold standard of microbiology laboratory testing
An Australian pathologist is pioneering a new approach for showcasing the role of pathology and demonstrating the dramatic potential of mobile medical laboratories. His technique: take a molecular diagnostics laboratory on the road—in a suitcase!
High-tech Molecular Pathology Lab Goes Mobile
The concept is a portable molecular microbiology lab, consisting of a series of modules. Timothy Inglis, B.M., D.M., Ph.D., Clinical Microbiology Fellow of the Royal College of Pathologists of Australasia (RCPA) and fellow scientist, Adam J. Merritt, are demonstrating high-tech clinical laboratory equipment in a fully mobile laboratory expedition. Both are employees of PathWest Laboratory Medicine W.A.. A recent story published at virtualmedicalcentre.com reported on the program. (more…)
Nov 21, 2012 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Uncategorized
Nation’s smaller independent medical laboratories and pathology groups provide clinical lab testing services in many under-served communities
Nov. 21, 2012, WASHINGTON, DC—Last Thursday, owners of independent clinical laboratory companies fanned out across Capitol Hill to meet with their respective Senators and Representatives. Probably the number one concern of these lab owners was further cuts to the Medicare Part B Clinical Laboratory Test Fee Schedule.
Congress is preparing to tackle a host of spending issues, not the least which is the Medicare Sustainable Growth Rate sustainable growth rates(SGR). Earlier this year, in February, Congress raided Medicare Part B Clinical Laboratory Test Fees by $2.7 billion over 10 years to provide a source of funding to temporarily fix SGR. (See Dark Daily, “In Fixing Physician Medicare Pay, Congress Enacts Yet Another Cut in Clinical Laboratory Test Fee Schedule,” February 20, 2012.) (more…)
Nov 19, 2012 | Compliance, Legal, and Malpractice, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Medical laboratory professionals will be surprised to learn that some experts claim American healthcare will not see a return on investment from use of EHR systems
It is the popular wisdom today that universal adoption of electronic health record (EHR) systems will lead to significant improvements in patient outcomes, while also delivering substantial cost savings to the American health system.
However, this trend also requires clinical laboratories to spend substantial amounts of money to provide electronic interfaces between their laboratory information systems (LIS) and EHR systems of their client physicians.
Until recently, very little criticism of these federal EHR subsidies has appeared in the media. However, some experts now assert that tens of billions of dollars hospitals and physicians are spending to implement EHRs and integrate their information systems will never be recouped by downstream savings. (more…)
Nov 16, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Organized by the National Association of Independent Laboratories, this effort attempts to educate lawmakers about the negative impact of cuts to Medicare Part B Clinical Laboratory Test fees
November 16, WASHINGTON, DC—This week, an intrepid group of clinical laboratory owners gathered in the nation’s capital specifically to visit their Senators and Representatives. The goal was to educate these elected officials about the tenuous financial condition of independent medical laboratory companies.
In particular, ongoing budget cuts to the Medicare Part B Clinical Laboratory Test Fee Schedule are undermining the ability of medical laboratories to deliver top-flight lab test services. This is particularly true for smaller independent clinical laboratories, particularly these located in communities not well-served by national lab companies. (more…)
Nov 14, 2012 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
News accounts of medical laboratory test errors is one reason why patients and clinical laboratory professionals in developing nations are calling for corrective action
From Kenya to the Caribbean, clinical laboratory testing failures are making national news. It is both patients and professional associations of laboratory workers who are fueling public debate and government action in response to public disclosures about patient harm as a consequence of errors in medical laboratories testing.
Clinical Laboratory Stakeholder Conferences Calling For Change
In Nairobi, Kenya, pathologists and clinical laboratory professionals gathered recently for a first-of-its-kind meeting of the Medical Laboratory Stakeholders Forum (MLSF). (more…)
Nov 12, 2012 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Researchers looked at how physicians in ambulatory settings followed up on the results of medical laboratory tests
Studies performed in the United States show that, for ambulatory patients, doctors fail to follow up on as many as two-thirds of medical laboratory test results and up to one-third of radiology reports! A recent review of 19 of these studies also showed that these failures resulted in serious lapses in patient care.
It was researchers at the University of New South Wales (UNSW) who undertook a systematic review of evidence of failure to follow up on diagnostic test results and how this impacted ambulatory patients. The review was the first of its kind, internationally, according to a story published on UNSW’s Australian Institute of Health Innovation (AIHI) website.
Failure to Follow Up on Results of Clinical Laboratory Tests
“Failure to follow-up [on medical laboratory and radiology] test results for patients is a critical safety issue which requires urgent attention,” declared lead researcher Joanne L. Callen, Ph.D., in a story published by Medical Xpress. “Without knowledge of the size and effect of the problem, many clinicians may underestimate its extent and consequences.” Callen is an Associate Professor at UNSW and works as a Senior Research Fellow in the Centre for Health Systems and Safety Research. The Journal of General Internal Medicine published the review article.
The research team examined 19 studies that were conducted in the United States, where most of the research is being done, according to Callen. The U.S. studies quantified the extent of the failure to follow up clinical laboratory and radiology tests. Settings included ambulatory patients attending outpatient clinics, academic medical centers, community health centers, and primary care practices.
The investigators found that doctors in the United States fail to follow up as many as 62% of clinical pathology laboratory tests and up to 35% of radiology reports. This means that they are missing critical diagnoses. In turn, this causes delays in treatments for many conditions, including cancer, the AIHI story stated.
Researchers at the University of New South Wales (UNSW) found that doctors fail to follow up as many as 62% of clinical laboratory tests and up to 35% of radiology reports that they ordered for their patients. The UNSW study team reviewed 19 studies involving ambulatory patients conducted in the United States, where most of the research on this subject has been conducted. (Photo by advantagemedlab.com.)
The 19 studies included in the review reported a wide variation in the extent of diagnostic tests not followed up by the ordering physician. For medical laboratory tests, results varied from 6.8% (79/1163) to 62% (125/202). For radiology, the results varied from 1.0% (4/395) to 35.7% (45/126), according to the review abstract.
Studies Showed Improved Test Follow Up With Use of Electronic Systems
The practices and processes currently used are varied and unsystematic, the review authors wrote. They noted that most primary care practices are not using electronic health record (EHR) systems. Further, they stated that most are communicating with multiple clinical laboratories that are often not electronically connected.
“Quantitative evidence of the effectiveness of electronic test management systems was limited,” the authors observed in the abstract. However, they found that “there was a general trend towards improved test follow up when electronic systems were used.”
The researchers also pointed out that feedback on medical errors is essential in order to counteract overconfidence in decision making vis-à-vis diagnostic accuracy. “Without knowledge of the size of the problem, many clinicians may underestimate its extent and therefore fail to take any action to improve the process,” they stated in the abstract.
The researchers concluded that solutions to the problem of missed diagnostic test results require a multi-faceted approach. Their recommendations included addressing the following areas:
- policies relating to responsibility, timing and process of notification;
- integrated IT and communications technologies;
- consideration of the multidisciplinary nature of the process; and,
- the role of the patient as a possible safety net against error.
Pathologists Can Read the Original UNSW Paper
Pathologists and clinical laboratory managers may want to access the original paper published by Callen and her colleagues. The paper’s statistics and findings may be useful in educating physicians about why failure to follow up on medical laboratory test results is a bigger problem than currently acknowledged.
In fact, publication of this study creates another opportunity for medical laboratories to add value to clinicians by helping them avoid missing key lab test results that might be overlooked. Such assistance is particularly important at a time when an important component of physician reimbursement is based on improvement in patient outcomes.
—Pamela Scherer McLeod
Related Information:
Doctors failing to follow-up test results
Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review
Calls for patients to take charge of medical tests
Medical test results – why no news doesn’t mean good news
