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
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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.
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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.
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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.
Fall 2019 LAB MATTERS
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