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Chapter 4 : Current Challenges to Financial Stability within the Diagnostic Laboratory

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Current Challenges to Financial Stability within the Diagnostic Laboratory, Page 1 of 2

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Abstract:

The economics of healthcare today challenge clinical laboratories nationwide to provide quality service and patient results in spite of decreasing resources. Decreasing reimbursement for patient testing and dwindling staff resources require the laboratorian to “do more with less.” One must be aware of one’s professional environment and be creative to utilize the existing resources effectively and efficiently. In many cases, this will require a laboratory environment of constant and major change. This chapter addresses some of these issues and their financial implications. Automation, computerization, point-of- care testing (POCT), and robotics will allow a more integrated, systemwide approach to providing high-quality laboratory services in support of patient care. Laboratory networks and multi-hospital systems may achieve economies of scale. There has been a steady increase in regulatory control of the healthcare industry by both federal and state governments. This increase in regulation extends to all clinical laboratories supporting both inpatients and outpatients. Government compliance regulations as well as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules have resulted in unplanned expenses for clinical laboratories and hospitals to modify existing computer systems and even add personnel to help meet the regulations.

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4

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Figures

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Figure 4.1

Number of National Accrediting Agency for Clinical Laboratory Sciences–accredited CLS programs by year. doi:10.1128/9781555817282.ch4.f1

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
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Image of Figure 4.2
Figure 4.2

Relationship of satellite laboratories to the main laboratory. Turnaround time–sensitive tests are performed near the patient and providers. High-volume, more complex, and less time-sensitive tests are performed in the main (central) laboratory. doi:10.1128/9781555817282.ch4.f2

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
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Image of Figure 4.3
Figure 4.3

Deployment of POCT. It maybe possible to achieve rapid turnaround of key laboratory test results by using POCT technology under the supervision of the main (or central) laboratory in lieu of satellite laboratories. Consolidation of key testing into a “core” laboratory may facilitate rapid turnaround time for most analytes, with only a few critical areas needing POCT capability. doi:10.1128/9781555817282.ch4.f3

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
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Image of Figure 4.4
Figure 4.4

Organization of an integrated laboratory services delivery network. Several healthcare service delivery sites developed an integrated network to deliver laboratory services. The bulk of high-volume testing is consolidated at one site, the core laboratory. Other sites may offer rapid response testing or just phlebotomy services. doi:10.1128/9781555817282.ch4.f4

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
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References

/content/book/10.1128/9781555817282.chap4
1. Barrow, B. 2000. CLMA spearheads fee schedule updates. Vantage Point 4:89.
2. Cearlock, D. 2009. NAACLS programs, graduates, pass rates and placements: findings from the 2009 Annual Survey of Programs. NAACLA News 103:3.
3. Clark, G. B., 1998. Laboratory regulation certification and accreditation, p. 369393. In J. R. Snyder,, and D. S. Wilkinson (ed.), Management in Laboratory Medicine, 3rd ed. Lippincott-Raven, Philadelphia, PA.
4. Coryelyou-Ward, K.,, B. Ramirez,, and T. Rotarius. 2011. The laboratory workforce shortage. A managerial perspective. Healthcare Manag. 30:(2):148155. [PubMed][CrossRef]
5. Crolla, L. J.,, and P. W. Stiffler,. 2000. Reimbursements and finance, p. 97103. In A. S. Kurec,, S. Schofield,, and M. Wattens (ed.), The CLMA Guide to Managing a Clinical Laboratory. Clinical Laboratory Management Association, Inc., Wayne, PA.
6. Curren, D. J. 2000. HCFA proposes rule on lab test coverage, payment. Natl. Intell. Rep. 21:3.
7. Curren, D. J. 2000. Outpatient reimbursement: final countdown to July 1 prospective payment launch. Natl. Intell. Rep. 21:36.
8. Dadoun, R. 2000. Automation strategies to improve personnel utilization. Adv. Adm. Lab. 9:5862.
9. Dilts, T. J. 1998. Point of care testing: a step to the future. Lab Notes 8:17.
10. Eggert, A. A.,, K. A. Emmerich,, E. R. Quam,, and K. L. Bowers. 2000. The LIS as process manager. Save money and reduce tech fatigue. MLO Med. Lab. Obs. 32:3233, 3638, 40 passim. [PubMed]
11. Falcone, D. M. 2000. Basic financial management for laboratorians. MLO Med. Lab. Obs. 32:3034, 3637. [PubMed]
12. Felder, R. A. 1997. Automation: innovative and inevitable. Clin. Lab. Manag. Rev. 11:365367. [PubMed]
13. Forsman, R. W. 2001. Joint venture versus outreach: a financial analysis of case studies. Clin. Leadersh. Manag. Rev. 15:217221. [PubMed]
14. Foster, K.,, G. Dispotis,, and M. G. Scott,. 2001. Point-of-care-testing: cost issues and impact on hospital operations, p. 269284. In K. Lewandrowski (ed.), Clinics in Laboratory Medicine: Point of Care Testing. W. B. Saunders Company, Philadelphia, PA.
15. Garikes, R. W.,, and S. Maxwell. 2001. Flexible and functional: a case study in efficient laboratory design. MLO Med. Lab. Obs. 33:2833. [PubMed]
16. Glenn, D. 2008. Higher pay reduces costs. Crit. Values 1(4):11.
17. Grider, M.,, and K. Boles. 2002. Managing your revenue pipeline. Clin. Leadersh. Manag. Rev. 16:211214. [PubMed]
18. Ho, D. K. H. 2000. Mission (almost) impossible: merge 2 hospital labs in 6 months. MLO Med. Lab. Obs. 32:4652. [PubMed]
19. Hunter, L.,, J. Lien,, J. R. Snyder,, and R. Teixeira. 2000. Competencies in clinical systems management. Clin. Leadersh. Manag. Rev. 14:166172.
20. Kibak, P. 2008. The worsening shortage of lab staff. Clin. Lab. News 34(5).
21. Kilgore, M. L.,, S. J. Steindel,, and J. A. Smith. 1999. Cost analysis for decision support: the case of comparing centralized versus distributed methods for blood gas testing. J. Healthcare Manag. 44:207215. [PubMed]
22. Kost, J. G.,, and H. Clifford,. 1996. In vitro, ex vivo, and in vivo biosensor systems, p.717722. In J. G. Kost (ed.), Handbook of Clinical Automation, Robotics, and Optimization. John Wiley and Sons, Inc., New York, NY.
23. Labeau, K. M.,, M. Simon,, and S. J. Steindel. 2001. Clinical laboratory test menu changes in the Pacific Northwest: an evaluation of the dynamics of change. Clin. Leadersh. Manag. Rev. 15:1622. [PubMed]
24. Lehmann, C.,, and A. M. Leiken. 2000. Diagnostic technology for laboratories in an integrated delivery system. Clin. Leadersh. Manag. Rev. 14:118123. [PubMed]
25. McPherson, R. A. 1998. Robotics, automation, and the new role of process control. Clin. Lab. Manag. Rev. 12:339346. [PubMed]
26. Mooney, B. 2000. Staffing problems top concerns plaguing phlebotomy supervisors. Adv. Med. Lab. Prof. 12:1417.
27. O'Brien, J. A. 2000. Point-of-care testing. MLO Med Lab. Obs. 12:3843.
28. Pearlman, E. S.,, L. Bilello,, J. Stauffer,, A. Kamarinos,, R. Miele,, and M. S. Wolfert. 2002. Implications of autoverification for the clinical laboratory. Clin. Leadersh. Manag. Rev. 16:237239. [PubMed]
29. Root, J. M., 1996. Competitive strategies for regional laboratory systems, p. 2127. In J. W. Steiner,, J. M. Root,, and D. K. Watt (ed.), Road Map for Laboratory Restructuring. Washington G-2 Reports, Washington, DC.
30. Smythe, M. H. 1997. Automation: triumph or trap? Clin. Lab. Manag. Rev. 11:360364.
31. Steiner, J., 1995. Regionalization of laboratory services to consolidate? To network? To do both? p. 79. In J. W. Steiner,, R. L. Michel,, and D. K. Watt (ed.), Case Studies for Laboratory Reconstructing. Washington G-2 Reports, Washington, DC.
32. Thornton, K. 2010. Spread the word: laboratory professionals are vital. www.MLO-online.com, accessed July 30, 2012.
33.U.S. Certification. ASCP Board of Certification. http://www.ascp.org/certification, accessed May 30, 2012.
34. Watson, K.,, and J. F. Boothe. 2001. Government study calls for change in Medicare reimbursement. Vantage Point 5:15.
35. Weissman, D. W. 2000. Hospital profits continue to fall. Lab. Ind. Rep. IX: 1, 57.
36. Wilkinson, D. S.,, and T. J. Dilts. 1999. Role of medical, technical, and administrative leadership in the human resource management life cycle: a team approach to laboratory management. Clin. Lab. Manag. Rev. 13:301309. [PubMed]
37. Wright, J. H. U. 1998. Rethinking point-of-care-testing. Adv. Adm. Lab. 7:2320.

Tables

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Table 4.1

Annual certification of medical technologists by the American Society for Clinical Pathology

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
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Table 4.2

Comparison between accredited training programs and on-the-job training programs

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
Generic image for table
Table 4.3

Recruitment strategies

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
Generic image for table
Table 4.4

Potential negative outcomes from staffing shortages

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
Generic image for table
Table 4.5

Recruitment and retention indicators

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
Generic image for table
Table 4.6

POCT procedures

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4
Generic image for table
Table 4.7

Tests approved by the FDA for home testing

Citation: Mercer R, Wilkinson D. 2014. Current Challenges to Financial Stability within the Diagnostic Laboratory, p 71-83. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch4

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