ASCP 2019: Laboratory Stewardship and the Drive to Improve Quality and Effectiveness

How can we most efficiently use the medical laboratory tests we have—especially with an ever-expanding library of them—to find out everything we need to know about a particular patient or disease without expending resources on things we don’t need? How can we diagnose and treat patients who need it without spotting, testing, or treating people who don’t?

These questions are now part of everyday laboratory medicine conversations. Yet, the answers remain elusive.

Join us for an energizing panel debate on Test Utilization on September 11 during the scientific general session at the ASCP 2019 Annual Meeting in Phoenix. Moderated by Michael Schubert, editor of The Pathologist magazine, this session will bring together six experts who’ll vie to convince live and virtual audiences that their approach to testing is the right one.

A Need for Caution

“The more we learn about laboratory medicine, the more testing options we have to offer patients – from basic diagnostic tests to precision genome analyses. With this proliferation of tests comes a need for caution,” says Schubert. “Not every test is necessary in every situation. In fact, they can sometimes be detrimental.”

The panelists comprise professionals who have dedicated a significant amount of their professional time to test utilization management and laboratory stewardship, and have published widely on this topic. Each will be assigned to debate the pros and cons of different approaches to test utilization management at random.

There are a variety of different perspectives on test utilization worth considering, all of which hold value,” says Gary W. Procop, MD, MASCP, who will be a panelist for this session. “Traditionally, the primary driver for improving test utilization has been to address overutilization in order to decrease unnecessary healthcare costs. Although being good stewards of financial resources remain important, especially in the era of decreasing reimbursements and capitation, there are a number of other drivers for the increased interest in improving test utilization. When laboratory professionals become more highly engaged in systems-based healthcare delivery, there are opportunities to improve patient care, increase patient satisfaction, and improve quality, while decreasing healthcare costs.”

Finding a Balance

“Ultimately, the issue of test utilization goes beyond the binary; there’s no universal right answer to how much testing is appropriate, and it’s not just a debate between ‘test less’ and ‘test more.’ Where opinions differ is in where along the spectrum best practices fall, and when to question those best practices. Every institution has a different policy for when to implement certain tests. We hope that this session will help our attendees to discover where does that balance lie and how can we establish best practices on intelligent test utilization,” Schubert says.

Panelists include:

Dr. Procop, medical director and co-chair of the Enterprise Laboratory Stewardship Committee for Enterprise Medical Operations, and director of Molecular Microbiology, Virology, Mycology and Parasitology at the Cleveland Clinic, OH. He holds several board-level committee positions and is a diplomate of the American Board of Pathology in Anatomic and Clinical Pathology, and Medical Microbiology.

Geoffrey S. Baird, MD, PhD, a clinical pathologist and associate professor in the Department of Laboratory Medicine at the University of Washington in Seattle, WA. He serves as the interim department chair and co-director of the Clinical Chemistry Fellowship program. His clinical interests include toxicology, clinical chemistry and developing interventions to encourage rational utilization of laboratory tests.

Adam L. Booth, MD, a fourth-year resident of anatomic and clinical pathology residency at the University of Texas Medical Branch–Galveston, where he is past chief resident. He holds numerous leadership positions, including chair of the College of American Pathologists’ Residents Forum Executive Committee. His awards and honors include being named an AASLD Emerging Liver Scholar, the College of American Pathologists’ 2018 Resident of the Year, and recipient of the Texas Society of Pathologists’ Presidential Award.

John Eckman, PA(ASCP)^CM, is chair of the Board of Trustees of the American Association of Pathologists’ Assistants. A former medical technologist, he has 25 years of experience as a pathologists’ assistant (PA) in both community hospital and academic center settings. His particular interests include resident education in gross pathology, continuing education for PAs, gross photography, and pathology and social media.

Nicole Riddle, MD, FASCP, is a staff pathologist at Tampa General Hospital for Ruffolo, Hooper & Associates. She joined the group in early 2017 and provides all anatomic pathology services, including frozen, cytopathology, and autopsies. Dr. Riddle is also associate professor, associate residency program director, and research liaison for the Department of Pathology and Cell Biology at the University of South Florida Morsani College of Medicine. Her research interests focus heavily on patient safety and building a culture of quality.

Ronald B. Schifman, MD, is professor of Pathology at the University of Arizona College of Medicine and has served for 20 years as chief of Pathology and Laboratory Medicine at the Southern Arizona VA Healthcare System. He has made numerous academic contributions to scientific journals and laboratory medicine book chapters dealing with quality assurance, informatics utilization management and medical microbiology.

Learn more about education sessions at ASCP 2019 Annual Meeting here.