Despite the seeming persistency of the pandemic, history has shown this crisis will pass. However, when it does, the demands placed on medical laboratories will not disappear. In fact, market studies expect laboratories will experience an increase in demand for more services. Hospital and independent laboratory administrators need to reflect now on how to take advantage of future healthcare market needs.
Laboratories have become the center of activity in the Covid-dominant world existing today. The attention is not entirely rooted in the hard-won acknowledgment of the necessity and dedication of laboratory workers; it is often of late, more derision stemming from the inability to get a test or from the delay getting test results.
What does the laboratory need to consider to recover from the instability wrought by the pandemic? What does the future hold for the laboratory market? For certain, the population will still need the laboratory data on which 70% of medical decisions are based.
One undeniable truth about the future is that the laboratory will be asked to meet the testing requirements of the nation—whatever the pathogen. It is critical for hospitals and independent medical laboratories to use the lessons learned and opportunities generated by the current pandemic to prepare for future operations. New viruses causing new, unfamiliar infections will continue to evolve and require quick and precise identification.
Laboratories must be prepared to identify and test for novel viruses and have well-developed contingency plans for supply chain interruptions. An unfortunate and obvious pandemic-taught lesson is that testing can not be performed if there are no swabs to collect and transport the sample or reagents and materials to run the test.
When evaluating any new testing platform, higher priority must be given to acquiring necessary reagents and supplies. Often, the driving force of any equipment purchase decision is the upfront or total cost of procurement. Perhaps it is the result of living in a first-world country that simple items like swabs and masks were taken for granted. That is no longer the case. Supply chain availability and resiliency must also be part of the evaluation process.
Molecular testing will experience exponential growth in the future. The ability to target specific genetic sequencing in viruses and bacteria has proved invaluable in developing treatment strategies. Molecular diagnostics is the solution to the increased need for rapid and accurate tests.
Molecular tests can quickly determine the nature of the infection and offer screening for asymptomatic carriers. Inside the laboratory, identification of pathogens in positive blood cultures by molecular testing platforms has significantly reduced the time needed to initiate appropriate antibiotic treatment.
Many vendors offer respiratory tract, gastrointestinal, and central nervous system packages or syndromic panels that amplify and detect a set list of target pathogens in a specific sample type. This type of testing is extremely attractive to healthcare providers because it can confirm or eliminate a number of potential causes from one swab. Multiple tests from one swab equal lower costs.
Though some caution has been advised for rapid adoption of molecular testing1, increasing the molecular testing footprint in the laboratory will increase the laboratory's value to the health system and its patients.
Combined with molecular testing, flow cytometry and cytogenetics are additional service lines laboratories should invest in to further develop their personalized medicine capabilities.
Flow cytometry can correctly identify bone marrow malignancies through differences in cell surfaces. Cytogenetics identifies abnormalities in the patient's genome. The effect of these two disciplines working in tandem is that physicians can develop treatments targeting problem areas. Precision medicine increases the likelihood that developed drug regimens will be effective.
The rise of chronic medical conditions contributes to the demand for anatomic pathology (AP) services. The continued expansion of the immunohistochemistry (IHC) library of antibodies fuels the growth of AP as pathologists can more precisely identify malignancies. Again, as seen with molecular testing, the targeting or identifying malignant processes on the molecular level opens up new areas of discovery and investigation for the laboratory.
The healthcare market is primed for bringing laboratory-quality testing directly to consumers. Today, many laboratories offer direct-to-consumer testing allowing the patient to request and pay for a test without an order from a doctor. The downside is that most of these require a patient to drive to the laboratory or other collection site.
There are an increasing number of at-home tests. However, often the tests have lower sensitivity and specificity than those in the laboratory and are subject to the variability inherent in having consumers perform tests. Opportunities exist to capitalize on the need for at-home-laboratory-quality testing that delivers results immediately.
Large healthcare systems and independent laboratories would be wise to enter and fully embrace on-demand consumer testing. Many laboratories already provide direct-to-consumers testing, but it has not been an area of substantial focus for traditional laboratories.
Door Dash-type Diagnostics
Several healthcare systems have laboratories and other diagnostic services in neighborhoods, but often, these are fixed locations. A well-prepared mobile laboratory gives the laboratory the flexibility to go where the testing is needed. There are companies already providing this service to homebound patients and retirement homes.
There are numerous articles and news reports detailing the long lines at Covid testing centers. A mobile laboratory can go to any neighborhood and provide testing beyond covid. American consumers have demonstrated they are willing to pay a premium for convenience. Boosted by the pandemic, delivery companies like Door Dash, Uber Eats, and Grubhub have seen phenomenal growth because of demand for convenience. Imagine bringing high-quality testing performed by qualified personnel to the consumer's front door (or at least to the end of the driveway).
Though the government has begun distributing four Covid tests to each address that requests them, those will likely get used rather quickly. Convenient, accurate testing will continue to be demanded by consumers.
The Future Market
Dynamic and in-demand is the future of the laboratory testing market. It will be highly impacted by the need for quick diagnosis and prevention plans as part of the strategy to manage COVID-19 and any other emerging global pathogen. Supply chain stability, reliability, and resilience will be paramount in procuring new platforms or service lines. Emerging compact molecular testing platforms will be leading the way in precision medicine development.
Laboratories across the nation suffer from a lack of qualified, experienced laboratory personnel. There is only a trickle coming out of the lab tech college pipeline. Older techs are retiring or simply just leaving the field. What's a laboratory to do? In the second part of this two-part series, I will discuss the most critical component in the future success of any laboratory—the staff.
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