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<br>Dr. Kroft

Dr. Kroft

Innovation a Key Factor to Shaping Future of Healthcare Delivery: ASCP President

Monday, October 21, 2013

ASCP President Steven Kroft, MD, FASCP discusses the challenges and opportunities facing pathology and laboratory medicine in this evolving climate.   

ASCP has several initiatives to address the workforce shortage. What more needs to be done? 

The laboratory professional pipeline tends to be local. If you have a shortage of training programs, you’ll have a shortage of lab professionals in certain areas. Addressing this requires a multipronged approach.  

“We need to function as clinical consultants and engage in discussions in our local hospitals about how to best use the tests. We need to demonstrate our local value to health systems. If we lose that, patients will suffer.”
— Steven Kroft, MD, FASCP, ASCP President

For example, we can learn from the Minnesota laboratory workforce initiative, which demonstrates that you need buy-in from health systems, industry, and policy makers. This initiative identified a source of federal funding and is developing innovative programs such as distance learning programs to increase access, building a state-of-the-art training laboratory, and expanding clinical site training. Today, Minnesota fixed its workforce issue. 

Also, we need documentation and a benchmark to identify what constitutes a shortage. If we go to policy makers and say we have a workforce shortage, they will ask us to prove it.

What will be the impact of the Physician Fee Schedule Proposed Rule, reimbursement, and other key legislative proposals? How can laboratory medicine weather these challenges?

The current Centers for Medicare and Medicaid Services (CMS) proposals are largely applicable to non-facility based services. The real danger with the proposed fee schedule changes relates to independent labs that are not embedded in a hospital and have only a traditional model under which to practice. They have proportionately larger overhead and incremental costs than a larger hospital or system-based lab and don’t have the ability to level costs across a variety of services.  

Ultimately, the market will drive a lot of business to the large commercial reference labs and lab testing will become a commodity, eliminating the service element. We need to function as clinical consultants and engage in discussions in our local hospitals about how to best use the tests. We need to demonstrate our local value to health systems. If we lose that, patients will suffer. 

What is the potential impact that clinical informatics can have on improving healthcare delivery? How is ASCP positioning itself to be on forefront of the informatics revolution?   

We sit on this enormous pile of information, yet there is so much more we could be doing: linking lab results for individual patients to Meta tests to analyze patterns and derive patterns to interpret results; building robust decision support to help physicians order the right tests. This doesn’t even take into account the coming genome revolution. This will all require tremendous investment in informatics. Medical directors and pathologists will need to learn how to interface this with informaticians.

ASCP has established an informatics committee, led by Dr. Feldman, to bring together the people with the information technology expertise and medical expertise and bridge that gap.

You have said that the international work ASCP is engaged in is integrally tied to our own domestic program. Please explain.  

Through ASCP’s Global Institute and the Board of Certification, ASCP is expanding its influence to improve health care around the globe. The PEPFAR activities are very exciting, yet we need to get more people to understand that local health care and global health care are integrally linked. In a world that is growing progressively smaller, emerging health issues in developing nations don’t stay in developing nations; they cross borders. Building a sustainable infrastructure, access, and treatment can help us prevent catastrophic issues.  

Why is it is important to be involved in a professional society such as ASCP?

ASCP needs to get as broad a representation of our members as possible so that we really understand the issues that concern them. To achieve our goals, we need to get more people involved. Finally, the benefits of getting involved are enormous.