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ADAPTING TO CHANGE: HOW
RESILIENT IS YOUR LABORATORY?
By Irwin Z. Rothenberg, MBA, MS, CLS(ASCP), Technical Writer /Quality Advisor, COLA Resources, Inc.
The 21st century challenge is to redesign healthcare
systems to be safe, efficient, effective, timely, equitable
and patient-centered. Laboratory medicine is integral to
many of these objectives, involving disease prevention,
diagnosis, treatment, and management.
As a result, the laboratory profession continues to
undergo rapid change. Not only is there an impact
through advances in technology, with new tests and test
methodologies, new modes of communication, and new
capacities for storage, retrieval and analysis and
dissemination of data, but through emerging socio-
political trends resulting in changes to the very structure
of organized medicine, and how medical care is
delivered. These include major legislation such as the
Affordable Care Act which encourages shifts from private
practice to integrated healthcare networks; and the
development of new models of healthcare delivery such
as Accountable Care Organizations, which mandate
value-based compensation models. These changes,
whether on a macro institutional level, or micro
departmental level, impact our laboratories. Millions
more insured will lead to significantly increased demand
for laboratory services at the same time that baby
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boomer staff (who have been the backbone of laboratory
staffing since the 1960’s) are retiring in large numbers,
but with fewer schools training replacements.
Exacerbating this is the continuing growth of tests
available (currently at least 3500 tests), new specialties,
new global health issues (i.e. Opiod epidemic),
accelerating the increase in workload.
Challenges and Changes Forecast for the
Laboratory Profession
The two main forces directly affecting laboratory
operations are rapid technological advances (e.g. total
laboratory automation, molecular diagnostics techniques,
digital technology; point-of-care and remote testing, etc.)
and resultant increased economic pressures, with the
need to align to increasingly limited budgets
One major outcome of the introduction and growth
of digital technology, in particular, is the huge increase in
the generation and utilization of data, both for
immediate patient care needs as well as population
health management and trend analysis. This has resulted
in the laboratory becoming “information central” within
the greater healthcare environment, touching almost
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