To meet TAT goals, Vanderbilt builds ED lab

In a move expected to help meet accreditation standards on testing turnaround times for stroke and chest pain patients, Vanderbilt University Medical Center’s emergency department will gets its own satellite laboratory this month. The 333-square-foot space—dubbed “the nest” for its small size—comes after years of struggle with the turnaround time demands for certification as a Joint Commission Comprehensive Stroke Center and accreditation as a Chest Pain Center by the Society of Cardiovascular Patient Care.

My lede for this item in the “Put It on the Board” section. Read the whole shebang.

Lab studies new steps in urine and anemia screening

Despite the demonstrated value of implementing reflex testing algorithms to improve patient care and avert wasteful spending, the road from conceptual understanding to plan-in-action can be rocky.

A pathologist at one academic medical center recently talked about his experience with reflex testing algorithms in the areas of urine screening and preoperative anemia screening. His story illustrates the barriers to change as well as the enviable outcomes that could potentially be achieved.

My lede. Read the whole shebang.

Pay is up in Medicare proposal, but final picture unknown

After years of reading the latest news from the CMS with dread, pathologists and independent laboratories have some reason for revelry this summer as the agency’s proposed physician fee schedule offers an overall uptick in Medicare payment for 2016. Yet it is the final physician fee schedule, due in November, that will tell whether pathologists feel grateful toward the CMS when Thanksgiving rolls around.

My lede. Read the whole shebang.

AMP puts a cost — and value — to sequencing procedures

Amid excitement about the groundbreaking work of unlocking the human genome’s secrets to speed diagnosis and target oncologic treatment comes the unpleasant reality that much of this labor now goes unpaid. Getting the American Medical Association’s editorial panel to publish nearly two dozen new genomics-related CPT codes for molecular pathology was a vital step, as was having those codes accepted in the Medicare clinical laboratory fee schedule.

In CAP TODAY’s “Put It on the Board” section this month. Read the whole shebang.

Why Sonora Quest gave itself high marks for LIS conversion

For laboratory chief information officer David N. Moore, July marks a first anniversary worth celebrating. Twelve months ago, his employer, Phoenix-based Sonora Quest Laboratories, flipped the switch on its new laboratory information system, effectively turning it on site-wide with one click—and with barely a hitch or a glitch.

The lede to my piece in July’s “Newsbytes” section. Read the whole shebang.

Keep close eye on payments to physicians

Recent legal developments should give laboratories new cause to tightly monitor efforts to win physician referrals, attorney Jane Pine Wood said at last month’s Executive War College meeting.

In April, the federal government reached a settlement with cardiovascular-disease testing labs Health Diagnostic Laboratory and Singulex to resolve allegations that they violated the False Claims Act by paying doctors in exchange for patient referrals. The U.S. Justice Department also alleged the companies billed Medicare and Medicaid for medically unnecessary testing. HDL agreed to pay $47 million to settle the matter, while Singulex will pay $1.5 million.

My latest contribution for “Put It on the Board.” Read the whole shebang.

RFID keeps lab’s supplies on hand, just in time

Sharon Cox, MT(ASCP)SM, has a passion for the correct count.

Charged with managing the laboratory supply inventory as core lab supervisor at Saint Francis Health System in Tulsa, Okla., she knows the right tally matters. Get it wrong and the lab can wind up with too little of what is needed. That can mean big overnight shipping charges when things run out unexpectedly. To avoid that outcome, the lab may order more supply than necessary, which leads to a different kind of problem.

“All those reagents you have sitting in the refrigerator—that’s just wasted money sitting there that could be better used by the health system,” Cox said last month during a talk at the Executive War College in New Orleans.

My feature article in the June edition of CAP TODAY. Read the whole shebang.

In rare instances, NIPT finds mother’s cancer

Sequenom Laboratories, providers of MaterniT21 Plus and other lab-developed noninvasive prenatal tests, is telling the public about a tiny proportion of cases in which its best-known test has revealed a genetic profile suggestive of cancer in the mother. The cases highlight the importance of ob-gyns working with laboratories to order follow-up testing as well as proper genetic counseling, Sequenom officials say.

My latest in the “Put It on the Board” section of CAP TODAY. Read the whole shebang.

Labs solve price, space squeeze to welcome TLA

After several years of watching their European counterparts have all the fun, a handful of American microbiology laboratories are going live with systems touted as providing total automation of diagnostic bacteriology. The systems automate how specimens are barcoded, plated, and inoculated, then move the plates on a track to an incubator, photograph them at a preset incubation time, discard or keep the plates as appropriate, and offer up the digital images for interpretation by medical technologists viewing them on computer screens.

Leaders at American microbiology labs making the move to total automation say it marks a profound transition that dramatically improves turnaround times but also can be wrenching, hindered by technical and management challenges that come with adopting state-of-the-art technology.

My feature story in the May edition of CAP TODAY. Read the whole shebang.

Door opens on direct access to genetic tests

The FDA’s recent move to give 23and­Me permission to market this country’s first direct-to-consumer genetic test, for Bloom syndrome, goes beyond the one in 107 Jews of Ashkenazi descent who are carriers of the rare disorder. At the same time as the agency gave the Mountain View, Calif.-based personal genetics company the go-ahead on its Bloom syndrome carrier test, the FDA also moved to classify autosomal recessive carrier status tests as class II medical devices and exempt them from premarket review.

“We’re excited that they have created a regulatory path forward for direct-to-consumer genetic testing,” 23andMe chief medical officer Jill M. Hagenkord, MD, tells CAP TODAY. “Historically, this kind of model hasn’t existed. We’ve had other over-the-counter, home-use tests like the HIV test. This is the first time we’re doing it for genetic testing.”

My latest in CAP TODAY’s “Put it On the Board” section. Read the whole shebang.

Pressing questions in POC glucose testing

Sometimes major changes to a health care organization’s point-of-care testing system come from powerful regulatory agencies in Washington, D.C. Or they may arise when a child with diabetes objects to frequent venipuncture. In either kind of case, experts say, pathologists and laboratory professionals must form strong relationships with clinicians and build structural foundations to help them meet these and other demands.

My cover story in the April edition of CAP TODAY. Read the whole shebang.