Technology & Innovation
Four technological innovations are dramatically reshaping the clinical laboratory and will continue to do so for the foreseeable future. Successful hospital executives can plan for these changes and build their own labs into centers that promote cost savings and better patient care throughout their institutions.
The changes that clinical labs are undergoing were outlined in a recent webinar with the American College of Healthcare Executives featuring Tammy Germini, executive director of Health Systems Operations at Quest Diagnostics; Traci Hinkle, director of lab services, Clinical Labs and Pathology at West Virginia University Medicine; and Lynn Gott, system director, Laboratory Services at Lee Health in Florida.
Four key innovations
The 4 innovations that are driving changes in the lab, Germini said, are digital pathology, artificial intelligence, digital information flow, and automation. It wasn’t that long ago that samples had to be manually processed and moved from bench to bench for multiple tests. Now, those same samples are in many cases distributed and analyzed with little to no human contact. Artificial intelligence (AI) systems are “building knowledge bases within our computer systems,” for instance to catch instrument errors as soon as they occur, reducing errors. AI systems can also flag duplicate or redundant tests, reducing costs, and recommend follow-on testing based on abnormal results, all of which translate to better patient care, she said.
Digital pathology has transformed the practice of clinical pathology, Germini added, mitigating staffing challenges by allowing remote tissue analysis, improving collaboration between distant experts, and providing the basis for AI screening of samples before expert confirmation of diagnosis. “Digital pathology has improved the speed and accuracy of our diagnoses,” she said.
Strategies for success: standardization, flexibility, and great people
Germini cautioned that the most cost-effective use of technology will be specific to each institution; in the case of smaller hospitals, it may be more economical to send out more tests or partner with a reference lab, rather than building the capacity in-house.
Standardization across institutions within a health care system is critical for cost control, said Hinkle. WVU Health has quadrupled in size in less than a decade, and with 20 hospitals now in the system, “we can all use our combined volume to allow all of us to get the same pricing,” from the flagship academic hospital down to the smallest hospital in the system.
Technology upgrades also require a flexible lab layout, as new machines may require water, power, and floor space not accommodated by the original lab design, added Gott. Without that flexibility, “you have to jump through a lot of hoops and reconstruct in order to get the equipment to fit,” which may hinder an optimum workflow. Lee Health is in the initial stages of building a dedicated, stand-alone, centralized lab for most of its testing needs, she said, freeing up space within each hospital for other priorities while increasing the efficiency of the clinical lab functions that each requires. This project is expected to include fully automated microbiology testing, digital pathology, and other advances.
Staffing remains a critical challenge for every institution, the panelists agreed. Lee Health has had success partnering with Florida Gulf Coast University for training of medical technologists, but the risk of attrition from the pipeline after investing the time to train someone remains real. And finding, training, and retaining seasoned staff is even more of a challenge. “When a staff member leaves the laboratory, it takes half a year, approximately, to train a replacement,” Hinkle said. “And that's assuming you're able to get somebody to fill in right away. So, it's a significant impact to lose somebody in this field, and to be able to replace them in our working environment.”
When a health care system is planning a technology upgrade, it is critical to have staff on board, both in the lab and in the IT department, who are excited about the change and are ready to solve the challenges that come with implementation. “We have to find those champions, and those early adopters,” Gott said.
An overarching consideration in bringing the clinical lab into the future is to make the value proposition clear. The technology is not cheap, Hinkle said, “so you have to sell it in terms of, how is it going to affect value-based care? How is it going to impact the length of stay for other treatments, or medications that the patient may or may not need? I think you've got to paint a picture of how this new technology is really going to improve the overall care of our patients and benefit the system as a whole.”
View the full webinar below.
Use of the terms partner and partnership are not intended to imply that a legal business entity exists, the terms are used to connote a collaboration to achieve an objective.