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Chapter 55 : Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration

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Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration, Page 1 of 2

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Abstract:

Health care in the United States has seen dramatic changes over the last decade, including an increasing emphasis on the cost of delivering care. Although it has been estimated that approximately two-thirds of health care decisions are based on laboratory results (Silverstein M, An approach to medical errors and patient safety in laboratory sciences, White paper presented at Quality Institute Conference, 23 January 2003), according to the Congressional Budget Office, the laboratory accounts for only 4% of health care expenditures (1, 2). Nonetheless, this amount approaches $60 billion annually and is constantly a target for reduction. Thus, in this era of Accountable Care, hospital administrators are facing significant revenue shrinkage from all payers. As revenues dry up, so does internal funding for new capital initiatives and internal competition for scarce capital dollars becomes fierce.

Citation: Marlowe E, Novak-Weekley S, Larocco M. 2016. Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration, p 799-802. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch55
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Figures

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FIGURE 1

Use of SJI and EJI for overall project justification. From Hamilton, SD. Justifying laboratory automation. LA invited article. www.labautopedia.org/mw/index.php/justifying_laboratory_automation, 30 November 2011. (This content is available under GNU free documentation License 1.2).

Citation: Marlowe E, Novak-Weekley S, Larocco M. 2016. Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration, p 799-802. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch55
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References

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1. Brill S. 2013. Bitter pill: how outrageous pricing and egregious profits are destroying our health care. Time 181:1624, 26, 28 passim.[PubMed]
2. White House Council of Economic Advisers. 2013. Trends in health care cost growth and the role of the Affordable Care Act. Washington, DC. https://www.whitehouse.gov/sites/default/files/docs/healthcostreport_final_noembargo_v2.pdf
3. de Brantes F. 16 June 2013. Should physician pay be tied to performance? Wall Street Journal. http://www.wsj.com/articles/SB10001424127887323528404578454432476458370.
4. State of Victoria. 2014. Public Record Office Victoria Guideline: Writing a Business Case. (Version 1.0). 7-19-2010. 7-14-2014. http://prov.vic.gov.au/wp-content/uploads/2011/05/1010g4.pdf.
5. Marlowe EM, Novak-Weekley S, LaRocco M. 2015. Affordable health care and the business of clinical microbiology: it's all in the delivery. Clin Microbiol Newsl 37:1721[CrossRef].
6. Dressen J. 2013. SWOT analysis in health care—how to make your practice more profitable. J.D. Media Surge LLC, Minneapolis, MN.
7. Novak SM, Marlowe EM. 2013. Automation in the clinical microbiology laboratory. Clin Lab Med 33:567588[CrossRef].[PubMed]
8. Hamilton SD. 2011. Justifying laboratory automation. LabAutopedia. The SLAS Knowledge Network. http://www.labautopedia.org/mw/index.php/justifying_laboratory_automation.
9. Hamilton SD, Kramer GW, Russo MF. 2011. An introduction to laboratory automation. Short course presented at the Lab Automation 2012 Annual Conference, San Diego, CA.
10. Huang AM, Newton D, Kunapuli A, Gandhi TN, Washer LL, Isip J, Collins CD, Nagel JL. 2013. Impact of rapid organism identification via matrix-assisted laser desorption/ionization time-of-flight combined with antimicrobial stewardship team intervention in adult patients with bacteremia and candidemia. Clin Infect Dis 57:12371245[CrossRef].[PubMed]
11. Perez KK, Olsen RJ, Musick WL, Cernoch PL, Davis JR, Land GA, Peterson LE, Musser JM. 2013. Integrating rapid pathogen identification and antimicrobial stewardship significantly decreases hospital costs. Arch Pathol Lab Med 137:12471254[PubMed]

Tables

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TABLE 1

ROI of mass spectrometry identification of bacteria and yeast

Citation: Marlowe E, Novak-Weekley S, Larocco M. 2016. Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration, p 799-802. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch55
Generic image for table
TABLE 2

Executive summary of outcomes: integration of mass spectrometry identification with antibiotic stewardship for patients with sepsis

Citation: Marlowe E, Novak-Weekley S, Larocco M. 2016. Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration, p 799-802. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch55
Generic image for table
TABLE 3

ROI of mass spectrometry identification of bacteria and yeast with outcome analysis

Citation: Marlowe E, Novak-Weekley S, Larocco M. 2016. Improved Diagnostics in Microbiology: Developing a Business Case for Hospital Administration, p 799-802. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch55

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