Expert Q&A: Recent Trends in the Clinical Lab

Clinical labs are facing many challenges and changes, including standardization of job titles, the rise of artificial intelligence (AI), and an increase in genetic testing.

Stephanie Whitehead, MBA, MPH, MLS (ASCP), serves as the executive director of pathology and laboratory services at a large health system in San Antonio, TX. Whitehead serves on the Board of Directors for the American Society for Clinical Pathology (ASCP) as the chair elect of the Council of Laboratory Professionals (CLP) committee and is an ASCP and American Society for Clinical Laboratory Science professional mentor. In addition, Whitehead is the co-host of a popular, weekly laboratory podcast called “eLABorate Topics.” Whitehead is the winner of Lab Manager’s 2023 Influential Impact Award, as part of the G2 Intelligence partner brand’s Leadership Excellence Awards program.¹ She discusses some of the key trends and challenges affecting clinical labs, and how organizations can address them.

Q: What key recent trends have you seen in the medical/clinical lab space?

A: There are three main trends: (1) The universal standardization to align the professional names of educational programs, credentials, and job titles in laboratory medicine; (2) The laboratory’s role in the adoption of AI and machine learning (ML); and (3) The increase of genetic testing and the laboratory’s role in genetic test utilization.

Q: How are those trends impacting the labs you manage?

A: Regarding the first trend, for laboratory professionals, the historical changes and inconsistency in titles for those with either a baccalaureate or associates degree (i.e., medical technologist, clinical laboratory scientist, medical laboratory scientist) and certifications has been a source of confusion for many years. These inconsistences have also inhibited the community from leveraging visibility and advocacy to assist with chronic challenges such as workforce shortage, salary evaluations, and lack of recognition from other healthcare professionals. There has been substantial focus recently by our professional organizations to standardize our professional identity and move toward supporting the job title “medical laboratory scientist.”

Regarding the second trend, many laboratory sectors (in recent years) have moved toward using AI/ML to improve quality and safety but also to keep up with the growing demand on laboratory test automation and digitization. However, the specific overall knowledge of AI and ML in the medical laboratory community varies and many more publications, best practices, and strategies are needed for the entire lab community to understand what can be done with these technologies, how to evaluate and implement them, and what the clinical limitations are.

Regarding the third trend, my lead genetic counselor, Megan Maxwell, and I previously did an interview on this in 2021 for a Today’s Clinical Lab article.² That article discusses how getting reimbursed for genetic tests, due to the increase in genetic testing and the number of tests available, is a major challenge for clinical labs and pathology groups. We solved this challenge by hiring Megan to ensure that the right genetic tests are ordered and billed properly. Since bringing Megan on board, we’ve gone from having almost none of our genetic testing covered to having roughly 99 percent reimbursed.

Q: What are the biggest challenges faced by clinical labs today?

A: A severe workforce shortage for all laboratory professionals. This issue is very well documented with several reasons cited, such as high retirement rates, shortage of qualified professionals, fewer academic programs, and lower salary (compared to other healthcare professionals), as well as increased demands on the laboratory to support growing healthcare trends. No matter the reason, most labs can feel the immediate impact of having more vacancies than candidates. Increased vacancies have led to more concerns for staff burnout, stress, and quality of training/testing, which only build on the issue.

Q: How are you and your team tackling those challenges?

A: We have a few strategies: (1) Increase efforts to recognize staff and embracing/implementing strategies that focus on staff retention such as career progression ladders and succession planning. (2) Partnering with academic programs to be a clinical training site for students. This creates a continuous feed of graduating students that can fill positions. (3) Actively support and investigate ways to be a visible professional in this field to promote recognition and reinforce laboratory medicine as a vital part of health care.

Q: What advice do you have for other lab leaders to address staffing and burnout issues?

A: (1) Increase communication with staff through rounding, huddles, or touchpoint meetings.³ (2) Investigate opportunities to lighten the load on your staff through sending out testing (where appropriate for turnaround time and budget) or cross-training current staff. (3) Monitor staff morale and look for ways to improve work culture and employee engagement. (4) Leverage diversity, equity, and inclusion (DE&I) approaches. (5) Investigate ways to offer work-life balance such as atypical schedules, working from home (in specific job roles), and offering wellness activities.

Q: What are some of the most exciting science and technology-related changes you’ve seen recently in the lab?

A: (1) An increase in the availability and variety of point-of-care/at-home testing. (2) Improvements/advancements in laboratory automation in all phases of testing (preanalytical, analytical, and postanalytical) (3) Advances in data analytics and the use of data to assist with test utilization, strategic planning, and improving operations.

Q: What do you look for when choosing new technologies for your labs?

A: Cost, ease of use, relevance to the future, and opportunities for growth. When choosing new equipment or technologies for the lab, it is important to answer three main questions: (1) What is the purpose of the new equipment? (2) What is the clinical need, and (3) What is the big picture impact of the new technology or equipment?

Q: What do you wish existed that you could introduce to your lab to make things better?

A: Anything further would be mythical at best and have the potential to “magically” improve efficiency. This mythical product would be LEAN, optimize processes, and conserve resources as well as be provided at a low cost.

Q: What advice do you have for those who are new to the clinical lab science field?

A: (1) Network, network, and network—this helps with professional growth, career opportunities, and provides professional support. (2) Consider being a mentor to another emerging professional. (3) Get involved and volunteer in a professional organization.

Q: How will the profession of laboratory medicine change going forward?

A: As the landscape of medicine continues to transform from “disease care” to “health care,” the laboratory medicine profession is shedding its reputation of being “behind the scenes” and transforming into a position that is patient-facing alongside the medical team. The importance of the laboratory perspective in battling the COVID-19 pandemic is a prime example of how including laboratory medicine in every healthcare conversation is pivotal to our overall success.

The laboratory is often the first to identify an issue with a patient through critical values and other test results. As new generations of point-of-care monitoring devices continue to emerge, the laboratory medicine team will be at the forefront of this evolution, assisting the industry in testing instruments, implementing new technology, and advising on the use of these devices. However, in order to reach these goals, we must have confident, competent, and capable leaders in laboratory medicine to lead and sustain these changes in health care.

References:

1. https://www.labmanager.com/leadership-and-staffing/lab-manager-announces-2023-leadership-excellence-awards-winners-29823
2. https://www.clinicallab.com/trends/clinical-lab-business-management/investing-in-a-genetic-counselor-is-a-worthwhile-option-25890
3. https://www.clinicallab.com/trends/laboratory-training/the-impact-of-burnout-on-clinical-lab-staff-25911