Nov 12, 2008 | Laboratory News, Laboratory Pathology
Pathology is not a passive observer in the debates about the effectiveness of virtual colonoscopy versus standard colonoscopy. After all, at some point, tissue collected by gastroenterologists as a result of either procedure must be examined by pathologists to confirm the presence of colon cancer and other diseases.
It has been argued that virtual colonoscopy, because it is a non-invasive procedure, would encourage more adults to undergo the test. That would increase screening rates for colon cancer. Proponents of virtual colonoscopy got a boost with new research published in the September 18, 2008 issue of New England Journal of Medicine [Vol 359:1207-1217], moving this test a step closer to acceptance by the medical community, as well as insurers.
In the largest study yet of this controversial test for colorectal cancer, lead researcher C. Daniel Johnson, M.D., of the Mayo Clinic in Scottsdale, Arizona, reported that virtual colonoscopy, which involves a CT scan of the lower body, proved effective in detecting both large and medium-size polyps, which can lead to colon cancer.
The study involved 2,600 men and women at 15 medical sites, including academic centers and community medical centers. All participants received both virtual and standard colonoscopy, 99% of which received both tests on the same day. Virtual colonoscopy successfully identified 90% of polyps or cancers 10 mm (one centimeter) or larger detected with traditional colonoscopy. “These findings augment published data on the role of CT colonography in screening patients with an average risk of colorectal cancer,” concluded Dr. Johnson.
Virtual colonoscopy eliminates the discomfort associated with standard colonoscopy, as well as the need for anesthesia and risk for bowel perforations, which occur in 1 of 1,000 patients. This new research may cause insurers to get onboard, as CT colonography: 1) costs about half as much as standard colonoscopy; 2) because it is performed on an outpatient basis; and, 3) does not require the services of an anesthesiologist.
Researchers believe a simple, non-invasive test like this would overcome barriers to screening people for colon cancer and save many lives. This noninvasive test still requires patients to prepare by taking a bowel cleanser, but does not involve the discomfort or embarrassment associated with the invasive procedure, which involves inserting a camera mounted on a flexible tube into the lower intestine.
Approximately 4% of patents screened will have polyps one centimeter (10 millimeters) or larger, which must be removed to prevent cancer, and 12% of patients have polyps six millimeters or larger. Virtual colonoscopy has a 14% false positive rate and proponents note that this is comparable to other accepted screening tests.
It is estimated that only about half of the 70 million people at risk for colon cancer have been screened. This huge market for colon cancer screening is recognized by the nation’s two largest laboratory companies. Each has introduced proprietary tests for colorectal cancer screening into the market. Anatomic pathologists would benefit from an increased number of case referrals should a growing number of consumers decided to take advantage of virtual colonoscopies as a colon cancer screening tool.
Related Information:
Study “Validates” CT Scans for Colon Cancer Screening, but Worries Linger
Accuracy of virtual colonoscopies validated
Both real and virtual colonoscopies work: report
Jun 28, 2007 | Laboratory Management and Operations, Management & Operations
Over the past month, your Dark Daily editors have been busy talking to lab directors and pathologists who are at the cutting edge of the most powerful trend unfolding in clinical laboratory management. These are the lab industry’s first movers and early adopters who actively use Lean, Six Sigma, and other quality management methods to turbocharge the performance of their laboratory organizations.
Anecdotally, these conversations reveal several useful insights about the trend to adopt quality management methods. First, any laboratory which has deployed Lean and Six Sigma with proficiency tells us they are achieving paradigm-shifting benefits. Improvements range from a 50% reduction in average test turnaround times for inpatient testing (following a 14-week implementation project) to productivity gains in pre-analytical and analytical processes of between 40% and 60%.
Second, and not surprisingly, outcomes like these tend to energize the lab, causing excitement and genuine enthusiasm to take hold, sometimes across the entire laboratory staff. Third, when a laboratory is the first clinical service within a hospital or health system to implement a Lean or Six Sigma project, it is common for hospital administration to ask the laboratory to contribute their experience to quality management projects in other areas of the hospital, particularly emergency departments, surgery, pharmacy, and radiology. Lab managers and staff find that they gain new respect and admiration for blazing a quality management path within the hospital.
Fourth, a goodly number of these first mover and early adopter laboratories tell Dark Daily that the quality management initiatives have often generated dramatic improvements in clinical service and customer service performance—so dramatic, in fact, that it has helped their laboratory outreach programs pick up new clients at a faster rate. That outcome multiplies the financial benefits from these quality management projects.
To provide more information about these projects, DARK Daily and The Dark Report are inviting the lab industry’s “best of class” leaders in quality management to gather in Atlanta on September 19-20, 2007. It will be the first-ever gathering devoted exclusively to Lean, Six Sigma, ISO, and similar quality management systems and their use in clinical laboratories, hospitals, and pathology groups.
The first annual Lab Quality Confab on Quality Management in Diagnostic Medicine will be conducted at the Westin Peachtree Hotel in Downtown Atlanta. The presentation topics and confirmed speakers are about to be released. Lab Quality Confab will feature more than 40 sessions. It will include an exhibition to showcase the companies and consulting firms which currently provide products and services to aid laboratories on their quality management programs.
You can get updated information about Lab Quality Confab’s speakers, exhibitors, registration, and the full range of activities by visiting the Lab Quality Confab Site (if you cannot click on that link, simply paste this URL into your browser: http://www.labqualityconfab.com). We hope you make plans to join us in Atlanta on September 19-20 and be first in the lab industry to hear from the experts about how Lean, Six Sigma, and similar quality management systems are boosting the clinical performance and operational efficiency of the nation’s most progressive labs!
LabQuality Confab on Quality Management in Diagnostic Medicine
September 19-20, 2007
Westin Peachtree Hotel
Atlanta, Georgia
For full details about Lab Quality Confab:
http://www.labqualityconfab.com
Jun 20, 2007 | Laboratory News, News From Dark Daily
It’s a deal that is likely to trigger significant changes in the relationship between the laboratory outreach programs of major health systems and the two national laboratories. It was announced yesterday that Laboratory Corporation of America (NYSE: LH) will acquire DSI Laboratories, Inc. of Fort Meyers, Florida.
The parent of DSI Laboratories is NCH Healthcare System. It owns two hospitals in the Naples area, along Florida’s west coast. DSI was founded in 1984 as a stand-alone enterprise owned by NCH. DSI Laboratories manages the consolidated laboratory services for NCH. It also is a major provider of laboratory testing services to office-based physicians and has enjoyed steady growth in specimen volume and revenue in recent years.
What makes LabCorp’s pending acquisition of DSI Laboratories significant is that the parent health system is willing to “take the money and run” by selling the outreach component of its business. NCH will “retain internal, patient laboratory testing at its Downtown Naples and North Naples campuses, with LabCorp assuming the remainder of the operation.”
If, in fact, if NCH is motivated to sell its lab outreach testing business primarily to realize the capital value of that business, then it is the third health system nationally to take this step in recent years. In 2005, the health system owners of Spectrum Laboratory Network, in Greensboro, North Carolina, sold a majority interest in this laboratory company and its outreach testing business, to Apax Partners, LP. Dark Daily estimates that the health system owners realized more than $100 million cash in that sale. (See The Dark Report, November 14, 2005.) Another similar transaction was the sale by Cincinnati, Ohio-based Health Alliance of its laboratory outreach business to LabOne, Inc. (now part of Quest Diagnostics Incorporated). The sale, which occurred in early 2004, brought the selling hospital organization $43.9 million in cash. (See The Dark Report, February 23, 2004.)
In the upcoming issue of The Dark Report, which goes to press next Monday, we will provide more detailed analysis of LabCorp’s acquisition of DSI Laboratories. This unfolding story should be of keen interest to laboratory administrators and pathologists who are currently leading laboratory outreach programs in different regions across the country.
Related articles:
Laboratory Corporation of America(R) Holdings Agrees to Acquire DSI Laboratories from NCH Healthcare System
May 14, 2007 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Management & Operations
For Dark Daily readers who didn’t make it to the Executive War College in Miami, Florida last week, you missed the first public appearance to the laboratory community by David King, now CEO of Laboratory Corporation of America. King took over as LabCorp’s new CEO on January 1, 2007. In his presentation, King spoke about a number of important trends unfolding across the American healthcare system, along with several insights about changes occurring within the managed care industry and how these changes are likely to alter contracting practices for laboratory testing services.
King stated that, if laboratories wanted to be innovative in creating value, it was time for them to recognize the specific ways that laboratory services in today’s marketplace are a commodity. High volume, routine testing is treated by purchasers as a commodity because, among other reasons, each laboratory’s testing services can be quite similar because of regulatory mandates and accreditation requirements. In fact, this is one reason why King argued that it is detrimental to the laboratory industry for smaller labs to badmouth the largest ones.
The only way that laboratories can differentiate themselves to physicians, to payers, and to patients, according to King, is by providing a superior level of service. Local and outreach labs, he continued, are often the better choice for local patients. One reason this is true is because local laboratories can often provide a continuous record of laboratory test data over the years. This enables physicians to see trends in a patient’s test results over time. By contrast, national laboratories, which are unlikely to perform laboratory tests on the same individuals year after year, have a more difficult time providing the cumulative record of test results on individual patients that allow physicians to identify trends that may indicate a developing problem with that patient.
Dark Daily notes that regional health information organizations (RHIOs) have the potential to close the gaps in the individual patient’s cumulative record of test results. That would help fix this weakness of national laboratories over time. As each individual in the United States has an electronic health record (EHR) that follows him or her around from state to state and through the years of his or her lifes, laboratory results from year to year will be readily available, regardless of which lab performed the tests. Indeed, laboratory test results are generally targeted to be among the first types of information stored in RHIOs and EHRs.
One suggestion that emerged from King’s presentation at the Executive War College was that, as a strategy to counter the commoditization of laboratory testing, small and large laboratories could work together to develop the types of value propositions that would encourage higher reimbursement from managed care companies. In a not-so-distant future, King hints, the large, national laboratories in the United States may call upon small and outreach laboratories for help with their workload, as well as develop new ways of adding value to laboratory testing services.
More substantial details about David King’s presentation at the Executive War College last Friday will be in today’s issue of The Dark Report, now at the printer. As a speaker, King came prepared and engaged the audience in a positive manner. If one of King’s goals in making a major address at the Executive War College was to open the door to further dialogue between his company and regional laboratories, then he certainly succeeded in catching the interest of a significant number of lab directors and pathologists sitting in the audience last Friday.
One thing was obvious about King’s participation at the Executive War College. He was most willing to spend time at the social events to meet people and hear their comments. He may be the type of leader who ends the long-standing isolation of the national commercial lab industry executives from their hospital laboratory counterparts. If he does, that can only have positive consequences for the entire laboratory profession.
Related Articles:
LabCorp Announces Succession Plan; David P. King To Succeed Thomas P. Mac Mahon As CEO On January 1, 2007
May 4, 2007 | Laboratory News, News From Dark Daily
To our Loyal, Enthusiastic Readers,
We are pleased to announce that Dark Daily sent out its 100th briefing on Wednesday! We pride ourselves in bringing you breaking clinical laboratory and pathology news and important trends to help you keep your laboratory ahead of its competitors.
Our goal with Dark Daily was to share wisdom and insights gathered by the founders of The Dark Report with a targeted e-briefing service to laboratory industry professionals. As regular readers of Dark Daily, you have different needs and interests than the clients who pay for The Dark Report Intelligence Service. We constantly monitor which e-briefings you find most interesting and useful. That information guides us in selecting subjects for news briefings and analysis for Dark Daily readers.
Now, we make a call to you, our readers, to help us improve the quality and content of Dark Daily. We created a brief Dark Daily Subscriber Survey with questions about how you value Dark Daily, who you are, and how you think we can make our publication better. We promise to share the results with you in a future edition of Dark Daily. If you can’t click through the link above, simply paste this URL into your browser: http://www.surveymonkey.com/s.asp?u=513343814804
Expect to see some changes in Dark Daily in the coming year, not only in the content but also in the breadth of Dark Daily offerings. We hope to provide you with useful special reports, product reviews, and more in-depth analysis from leading figures in the laboratory industry.
Thanks in advance for sharing your responses and comments with us and we look forward to sharing many more hundreds of briefings with you in the future!
Your Editors,
Robert & Sylvia
