Prognostic versus Diagnostic Lab Medicine

MOST OF YOU ARE FAMILIAR WITH THE RACE TO DEVELOP effective laboratory tests and pharmaceuticals based on rapidly-developing genetic and molecular knowledge. We all ask the same question: when will my laboratory have to buy this technology and offer these new tests?

For most of us, the answer is “not soon.” There is lots of neat stuff happening in research laboratories, but precious little is ready for widespread clinical use. For the time being, it’s business as usual. However, this respite may not last long as many of us think. In our interview on pages 9-14 with Ameripath, Inc. Chairman and CEO James C. New and Inform DX, Inc. Chief Executive Officer Brian C. Carr, I found several of their comments to be quite provocative.

Specifically, New mentions that genetics-based lab testing will shift the main emphasis of laboratory medicine away from diagnosis-then-treatment toward early detection-then-prevention. Certainly most of us in the lab world have heard these predictions. But what piqued my interest was the fact that both AmeriPath and Inform DX think that genetics-based diagnostic testing is close enough that they are ready to spend millions of dollars to prepare their lab companies for the upcoming “genetics revolution.”

Each executive considers that genetics, molecular pathology, and tissue banking will be essential components of laboratory medicine. The glue that holds this together will be sophisticated pathology information systems. That is why laboratory informatics is to remain a key strategic initiative after the two companies merge into one.

This leads me to the original question I posed at the beginning of this story. “When will my laboratory have to buy this technology and offer these new tests?” I think one clue to the right answer is to watch the investments and efforts of the public laboratory companies, including the two Blood Brothers, to prepare their organizations for genetic testing and molecular pathology. The more money they spend to acquire people, technology, and information processing capability, the closer the time approaches when any competent laboratory organization will need to make similar investments to remain competitive and state-of-the-art. Because “money talks,” this may be the most relevant benchmark to use in determining an accurate timeline for the introduction of new diagnostic technology.