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Chapter 46 : Future Political, Social, Economic, and Regulatory Impacts on Pathology and Laboratory Medicine

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Future Political, Social, Economic, and Regulatory Impacts on Pathology and Laboratory Medicine, Page 1 of 2

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Abstract:

This chapter exams the current environment of healthcare with particular attention to political, social, economic, and regulatory factors. It attempts to identify trends within and external to that environment which are likely to influence future developments. A partial listing of four federal laws and regulations that are particularly pertinent to pathology and laboratory medicine services includes CLIA ‘88, HIPAA, the Occupational Safety and Health Administration (OSHA) standards for occupational exposure to blood-borne pathogens, and the Stark regulations. The chapter discusses the impact of the judicial system and medical liability concerns on laboratory practice. Employers are encouraged to commit to the Leapfrog Group’s healthcare purchasing principles. Efforts such as this-grounded in the belief that practice improvement can be achieved through benchmarking and performance-based ratings-are at present not well developed for pathology and laboratory medicine save for a few indicators, such as frequency of Pap smears, diabetes screening and monitoring, cholesterol screening, and screening for colon cancer. Although the progression may be less rapid than predicted by some, the author believes that the database of pathology and laboratory medicine-currently characterized by static and discontinuous phenotypic, quantitative, and morphological observations-will be superceded by an augmented and integrated continuum of morphological, immunophenotypic, genetic-proteomic, and clinical information.

Citation: Bachner P. 2004. Future Political, Social, Economic, and Regulatory Impacts on Pathology and Laboratory Medicine, p 763-770. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch46

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References

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1. Bachner, P.,, and W. B. Hamlin. 1993. Federal regulation of clinical laboratories and the Clinical Laboratory Improvement Amendments of 1988—Part I. Clin. Lab. Med. 13:739752.
2. Bachner, P.,, and W. B. Hamlin. 1993. Federal regulation of clinical laboratories and the Clinical Laboratory Improvement Amendments of 1988—Part II. Clin. Lab. Med. 13:987994.
3. Bierig, J. R. 2002. Liability and payment issues in the selection of pathology assays. Arch. Pathol. Lab. Med. 126:652657.
4. Kundera, M. 2002. The great return. The New Yorker, 20 May 2002.
5. Leape, L. L.,, D. M. Berwick,, and D. W. Bates. 2002. What practices will most improve safety? Evidence-based medicine meets patient safety. JAMA 288:501507.
6. Spackman, K. 2002. SNOMED CT unlocks the power of clinical data for pathologists. Lab. Med. 33:(3), Special Report, p. 14.
7. Wilson, M. L. 2002. Education and training: practice makes perfect. Am. J. Clin. Pathol. 118:167169.

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