The Symbiotic Solution to Point of Care and Traditional Hospital Lab Testing, Joe Bernardo, President, ThermoFisher Scientific and Brian Jackson, Managing Partner, Nexus
July 7, 2010
In the last decade the strategic roles of point of care (POC) testing and the high volume, automated core laboratory have come into full focus. Frequently, these two approaches to laboratory testing seem in conflict with each other, and are rarely discussed in the same article or seminar. In addition, it is the authors' opinion that hospitals tend to concentrate on one solution or the other. Although these technologies may have seemingly conflicting focus, their differences actually complement each other to create a very viable total hospital solution.
CONFLICTING FOCUS
Point of Care Testing: Advocates of point of care testing have justified the higher consumable costs by citing:
- Improved Patient Care: Bedside Testing provides a quicker turn-around time leading to faster treatment and earlier patient discharge.
- Decreased expenditures through core laboratory staff savings: By shifting work from the main lab to the nursing staff, labor costs are reduced in the core lab, thereby offsetting the increased cost of the POC test.
Detractors to POC testing are concerned about losing tests to the bed side, thereby decreasing core lab utilization and minimizing the impact of purchasing highly automated analyzers and lab automation systems.
The net result of moving testing from the main laboratory to the bed side also results in a higher cost per billible due to the larger burden of fixed costs, such as instrumentation and QC on a smaller amount of billable tests.
Highly Automated Analyzers or Lab Automation Systems: Advocates of these solutions have justified the high capital costs by citing:
- Improved Specimen Flow: By improving the processing and decreasing workstations the laboratory can decrease labor requirements and offset the higher capital costs. Improved workflow (usually coupled with Lean concepts) will also have a positive effect on turn-around time.
- Improved Capacity with Less Labor: Automated solutions can handle more testing with fewer FTEs which allows the laboratory to contract out for more testing to improve revenue.
Detractors to Core Lab testing point out that the lab is a dynamic environment. Spending millions of dollars on a fixed solution that is "bolted to the floor" requires significant and steady test volume to remain viable. Any testing siphoned from this solution will have a tremendous impact on the cost per test due to the large expense of capital to billable test ratios...
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