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Clinical Laboratory

A clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.

Clinical laboratories are at the forefront of the personalized medicine trend. However, they are also targets for cost-cutting measures by payers, and increased regulation by CMS and FDA, making the industry a challenging one in which to succeed.

Laboratory medicine is generally divided into two sections, each of which being subdivided into multiple units. These two sections are:

  • Anatomic pathology: Units included here are histopathology, cytopathology, and electron microscopy. Other disciplines pertaining to this section include anatomy, physiology, histology, pathology, and pathophysiology.
  • Clinical pathology, which includes:
    • Clinical Microbiology: This encompasses five different sciences. These include bacteriology, virology, parasitology, immunology, and mycology.
    • Clinical Chemistry: Units under this section include instrumental analysis of blood components, enzymology, toxicology and endocrinology.
    • Hematology: This section consists of automated and manual analysis of blood cells.
    • Genetics is also studied along with a subspecialty known as cytogenetics.
    • Reproductive biology: Semen analysis, Sperm bank and assisted reproductive technology.

Credibility of medical laboratories is paramount to the health and safety of the patients relying on the testing services provided by these labs. The international standard in use today for the accreditation of medical laboratories is ISO 15189. Under their respective approaches to laboratory licensure and accreditation, many countries have legal requirements that medical laboratories must be accredited to ISO 15189. This is not true in the United States.

In the United States, there are federal and state laws that address the licensure and accreditation of medical laboratories. Accreditation is done by the Joint Commission, College of American Pathologists, AAB (American Association of Bioanalysts), and other state and federal agencies. CLIA 88, the Clinical Laboratory Improvement Amendments, also dictate testing and personnel.

In addition, many clinical laboratories have adopted quality management programs such as Six Sigma and Lean quality to improve clinical quality, reduce turnaround time, cut costs, and boost productivity. Lean and Six Sigma are both process improvement methodologies. At a very basic level, Lean is about speed and efficiency, while Six Sigma is about precision and accuracy, leading to data-driven decisions. Lean and Six Sigma methods are finding numerous applications in anatomic pathology laboratories and pathology group practices.

Michel Wins Investigative Reporting Award from Peers

IN A PRESTIGIOUS JOURNALISM CONTEST conducted by NEPA (Newsletter and Electronic Publishers Association), THE DARK REPORT’S Editor-In-Chief, Robert L. Michel, was recognized last month in the category of “best investigative reporting” for his story series on anatomic pathology …

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Baylor University Lab Serves ED Needs With STAT Lab

CEO SUMMARY: Throughout the United States, hospital laboratories are working to meet ever-increasing lab testing demands by emergency department physicians. In response, many labs debate the benefits of a point-of-care testing (POCT) solution versus operating a rapid response lab in or ne…

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British Early-Adopter Labs Respond to New Trends

CEO SUMMARY: On which side of the Atlantic are clinical labs better operated? This February will be the third consecutive year that progressive lab leaders from the USA and the United Kingdom convene in England to explore each country’s laboratory best practices, to swap innovations, an…

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HPV Vaccine Developers Racing to Marketplace

CEO SUMMARY: At least ten companies are working on an HPV vaccine that can prevent cervical cancer. The leading two companies have Phase III clinical trials under way and expect to earn regulatory approval within the next 24 to 30 months. The speedy arrival of an HPV vaccine in the market…

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LabOne, Humana, Pathology Reference Services of Maryland

LABONE AND HUMANA INK NATIONAL CONTRACT FOR LAB SERVICES IN A MOVE THAT REINFORCES its intention to compete as a national laboratory, LabOne, Inc., signed an expanded national agreement with Humana Inc. The contract, announced on August 31…

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Esoterix & UnitedHealth Sign National Test Pact

CEO SUMMARY: Just when it is assumed that the two blood brothers have a lock on national lab testing contracts with the nation’s biggest payers, Esoterix inks an agreement with UnitedHealth Group. This now positions Esoterix to offer its higher-end reference and esoteric testing to hosp…

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UnitedHealth’s Decision Reveals Lab Market Shift

CEO SUMMARY: News that UnitedHealth Group, Inc. added Esoterix, Inc. to its national laboratory services contract is a big story. UnitedHealth’s decision to expand the laboratory panel demonstrates that factors other than lowest price played an important role. The move to supplement its…

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Congress Holds Hearing On Hospital Lab Fiasco

CEO SUMMARY: Problems at the laboratory of Maryland General Hospital came under scrutiny at a recent Congressional hearing. There was plenty of criticism and embarrassment for several entities which should have detected the problems and reacted to the situation more effectively. Serious q…

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CalPERS Drops 38 Hospitals From Its Preferred Network

IF CALPERS HAS ITS WAY, 38 hospitals and 17 physician groups will no longer be able to provide services to its healthcare network. On May 19, 2004, the California Public Employees’ Retirement System (CalPERS) announced a list of providers that it was excluding from its provider n…

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Baltimore Hospital Lab Problems Put Spotlight On CAP Inspections

CEO SUMMARY: Here’s an exclusive peek into a three-year battle between medical technologists wanting to do the right thing and a laboratory manager—backed by hospital administration—who aggressively stifled well-justified dissent. It is an inside look at one of the most grievous fai…

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