Lab Matters Fall 2019 | Page 17

PARTNER PROFILE complicated and important to healthcare, and no signs indicate these trends are abating. Technological advances help explain why the volume of clinical laboratory testing is increasing. Molecular testing, high-throughput chemical analyzers and computational biology are examples of technologies that enable higher test volumes and faster turnaround times. Clearly, the genomics revolution has reached the clinical and public health laboratories, and, arguably, the government is struggling to keep up. How is DLS addressing rapid technology changes to better support clinical and public health laboratories? We are working to make the CDC Biorepository more available and responsive to the general public. First, we are improving our systems for quality and maintaining sample integrity, as well as policies and procedures to make CDC collections more accessible. This will take some time, but we are well on the way to making these invaluable, historical CDC resources more publicly available. Second, we have plans to transform the CDC Biorepository into a preparedness repository to facilitate access to specimens and materials that may be difficult to obtain during a response. These samples and materials would be used to improve rapid development and validation of new assays, including @APHL We are also thinking a lot about workforce development. For example, with support from CDC’s Center for Preparedness and Response, we’ve developed our first eLearning training course that incorporates virtual reality (VR) technology. How do you envision the future of public health laboratories interfacing with clinical laboratories? One priority we have in this space is to help adapt existing regulatory requirements and national guidance to facilitate the implementation of next- generation sequencing (NGS) in clinical and public health laboratories. We have a joint CDC-APHL project, funded by CDC’s Office of Advanced Molecular Detection, developing a quality management system that addresses challenges public health laboratories encounter when they implement NGS-based tests. At the same time, the Clinical Laboratory Improvement Advisory Committee and the broader clinical laboratory community have asked us also to help ensure that NGS and other critical advanced technologies can be integrated into the existing clinical laboratory regulatory framework. PublicHealthLabs Emergency Use Authorization tests during a response. For a few years now, PHLs have been offering biosafety and biorisk management training and outreach to their local clinical laboratories in an effort to strengthen overall public health emergency response. This is excellent work, and we need to think hard about how we can do more of it and make it even more impactful. Another opportunity is to improve two-way data transmission between clinical and public health laboratories, including CDC. And I think electronic test ordering and results reporting (ETOR) is one of the best ways to do that. ETOR establishes an electronic pathway for a healthcare facility to efficiently and effectively request tests to be conducted by a public health laboratory and for the results to be electronically reported back to the original requestor. Moreover, the standardized formatting of this data would make those test results much easier to share seamlessly with CDC for broader surveillance purposes. The two-way nature of this electronic laboratory exchange can help bridge the gap between clinical and public health communities. And by better integrating patient and laboratory testing data into existing and developing public health systems, we will inevitably enhance the value of the laboratory for disease detection, surveillance and emergency response. And that, in turn, will enhance the stature of public health laboratories. You recently completed a strategic plan to guide the work of CDC’s Division of Laboratory Systems through 2022. What are its major objectives? The new DLS Strategic Framework breaks down our division’s overall work and mission into four “buckets” or goals: 1) quality laboratory science, 2) a highly competent laboratory workforce, 3) safe and prepared laboratories and 4) accessible, usable laboratory data. We’re working to improve the quality and value of laboratory medicine and biorepository science for better health outcomes and public health surveillance. Another primary objective is to strengthen the clinical and PHL laboratory workforce. We’re also focusing on enhancing the safety, surveillance and response capabilities of clinical and PHLs. Finally, we’re making laboratory data more usable and accessible to support response, surveillance and patient care. How can APHL and its members assist with implementation of the plan? APHL and its members are well-positioned to inform CDC of public health laboratory needs and to help us understand how CDC can help address those “laboratory systems” issues. Looking through a non-disease-specific lens, how can we use science and innovation to prevent, detect and respond? How can we leverage the increasing capabilities of clinical laboratories—and break down historical barriers between the clinical and public health laboratory communities—to strengthen laboratory informatics and public health emergency response? Can we work together on surge testing and continuity of operations planning? How can we advance biosafety and biorisk management across the public health and clinical laboratory systems so we don’t have a repeat of the 2014 Ebola situation in the US? APHL and its members are our most important public health partners, and we are determined to be responsive to their concerns and priorities. 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