IN MY OPINION, THE ABILITY OF TWO ST. LOUIS HOSPITALS TO PROVIDE a sophisticated menu of reference testing for a developing nation located more than 12,000 miles away is remarkable. (See this article.) It provides compelling evidence that laboratory medicine is undergoing its own globalization process.
Couple the accomplishment of Washington University Medical School and Barnes-Jewish Hospital in serving the reference testing needs of Eritrea with the ongoing effort to understand and control the spread of SARS (severe acute respiratory syndrome), and the progress toward an internationalized system of laboratory medicine becomes easier to see.
I think this globalization process is supported by three fundamental developments. The first is overnight package delivery. Since Federal Express appeared on the scene in the mid-1980s, the overnight package delivery industry has grown steadily. It is constantly upgrading services, like package tracking capabilities. It is steadily opening new markets and expanding its geographical coverage. As a result, clinical laboratories find it easier and easier to economically serve clients located farther away than in the past.
The second fundamental development is telecommunications, including fax and Internet. There are a few of us still out there who remember when fax machines didn’t exist. Introduced in the early 1980s, fax machines have shrunk in size and give anyone with a basic telephone line the ability to send and receive documents, including test requisitions and lab test reports.
The third fundamental development is the ongoing consolidation among diagnostic manufacturers. All through the 1990s, the world’s largest diagnostic companies acquired companies and technologies that supported their strategic vision. This business activity crossed international borders and allowed labs almost anywhere in the world to have access to the same diagnostic assays.
Healthcare will always be local. But what is changing is the ability of clinical laboratories to provide the customized services needed by local providers across ever greater distances. Lab directors and pathologists should understand that this trend can be both a threat and an opportunity for their laboratory.