Expert Q&A: Lab and Pathology Industry 2023 Year in Review

Last year involved some familiar challenges for laboratories and pathologists, including ongoing staffing shortages. However, newer developments such as artificial intelligence (AI) have also come on the scene and will likely play an increasingly larger role in laboratory medicine going forward. Ali Brown, MD, FASCP, chief medical officer of the American Society for Clinical Pathology (ASCP), discusses key developments for the lab industry in 2023, how things may progress in 2024, and how ASCP plans to support its members this year and beyond.

Q: What, in your opinion, were the biggest developments in 2023 for the lab industry?

A: Something I saw more of in 2023, that I think is just as important as many of the technological developments involving artificial intelligence (AI), is the increase in the discussion around the benefit of patients communicating with pathologists and laboratory professionals. Pathologists and laboratory professionals are seeking opportunities to interact more with patients in any way that they possibly can and putting themselves more front and center as part of the patient care team.  

I’m a clinical informaticist—I am excited about developments in AI and digital pathology. But I’m a physician, first and foremost. Being able to demonstrate our value to patients and improve the lives of our patients, to me, is the greatest development. I love the increased dialogue around patient-pathology clinics or consultations—where pathologists meet with patients to discuss their diagnoses—and hearing the stories from patients about how much they value these interactions.

Q: What were the biggest challenges of 2023 for the industry?

A: The biggest challenge was, and is, the workforce shortage. It’s such a widespread problem. With every size of laboratory, every setting, there are tremendous shortages of qualified laboratory personnel. With ASCP’s Board of Certification (BOC), we are huge proponents of assuring eligibility and credentialing of laboratory personnel, and the value of certification. Still, many laboratories are having to explore alternative paths for professionals to enter the laboratory workforce. We’re taking steps to make sure that those people are qualified, that they have the skills, or are getting the skills they need to provide the best patient care possible. The ASCP BOC continues to optimize its operations to help with the workforce shortage, including a significantly reduced turnaround time for program-trained graduates to apply for their certification exams. This assures skilled, certified laboratory professionals are available to provide patients with answers more quickly and effectively.

To help with this staffing challenge, ASCP organized a coalition, the Medical Laboratory and Public Health Laboratory Workforce Coalition. We now have 28 members who have banded together to provide a unified voice to increase the visibility of laboratory occupations, improve workforce recruitment, development, and retention, and increase diversity in the laboratory. We need to think about the pipeline, where are these people [potential laboratory professionals] coming from? Both within this workforce coalition and with our internal ASCP Workforce Steering Committee, we’ve done a ton of work this year in trying to elevate the visibility of laboratory careers. We’ve been going to national high school counselor meetings and places where they’ve never seen anyone from the laboratory show up before and have been well received. That’s been very heartening.

We’re looking at when this exposure starts. I think it’s across the continuum, starting with children, and getting them interested in science and the lab, all the way up to people who are in college who might want to consider the foundation of their learning being in something around the medical laboratory sciences.

Q: What other ways does ASCP plan to help its members in 2024?

A: Our Leading Laboratories program is a recognition program that we’ve created in partnership with the Joint Commission, akin to a Magnet status for nursing. Laboratories apply for Leading Laboratories designation through a portfolio-based application where they demonstrate various things they’re doing among the different pillars of the Leading Laboratories program, which are: quality outcomes, professional development, trusted leadership, and laboratory visibility. It has nothing to do with accreditation; rather, this program highlights the soft skills that it takes [for a lab to go] from being a functional lab to being a high-functioning lab. [That involves] really supporting your staff, putting the good name of your laboratory out there, both within your hospital and within the community.

We’ve awarded three such designations thus far. A big part of the visibility piece comes with our partnership with the Joint Commission because every hospital C-suite knows the Joint Commission. It allows us to highlight the value of the laboratory and the awesome things labs are doing in these hospital systems directly to the C-suite. That program is something that we’re seeing take off more and more. We want to help our membership by giving them access to ways to elevate the profile of their lab through programs like Leading Laboratories.

Q: What were the biggest positives of 2023?

A: We’re continuing our efforts to elevate the profile of the laboratory and provide more resources, be that education, laboratory personnel certification, etc. And, of course, with our strong advocacy arm, we’re creating new programs that touch back to pathologists and laboratory professionals having more patient interaction. We have a program that’s been funded in part by AstraZeneca, to explore the need for developing a biomarker navigator position. That has involved creating job descriptions for such a position and piloting this position in a couple of sites, which has been really rewarding.

We often think of nurse navigators in cancer centers who help patients navigate through the system. This biomarker navigator role is a position that originates within the laboratory, and is someone who helps with biomarker ordering, determining the right tests to order, collecting ample specimens, submitting the correct specimen, following up on orders, making sure that the results are getting to the appropriate clinical colleagues, etc. It’s also another avenue for career advancement for a laboratory professional who’s looking into working more with a multidisciplinary team, and then that person, in turn, helps to highlight the visibility of the lab.

Q: How do you expect the key trends of 2023 to progress as we move into 2024?

A: I think you’re going see a lot more practices moving toward digital pathology for primary sign-out, which then allows for more AI algorithms to be developed as you have that image base getting larger and larger. I also think we’ll see more use of AI for patients, for navigating reports and things like that. I’d like to see AI be used, not just in diagnostics, but in our interactions with our patients to help them understand their pathology reports and what’s going on with them in relation to the laboratory. I think there are ways AI is going to help us elevate our profile, and then lead to more of a high-touch type method of dealing with patients. So not to replace anyone or to stifle that relationship, but to grow it.

Q: What advice do you have for lab professionals who are looking to get more involved in their professional societies/organizations in 2024, but are hesitant to do so?

A: I got involved with ASCP as a resident and came on as staff about seven years ago. I’ve been involved with ASCP for about 20 years in total. It was just taking that leap of faith to get out of your comfort zone to network and meet different people. I would encourage anyone who wants to enhance their career and to have another rewarding aspect that reminds them about why they do what they do, to get involved in a professional organization. We have such a wealth of different organizations in our specialty that there really is a place for everyone, depending on what your interest is.

At ASCP, we’re always looking for new faces and voices, and to enhance the diversity of our volunteers. But even if you’re not able to go to the annual meeting, or you’re not necessarily sitting on a committee, each member’s voice matters. Our numbers as far as membership have a direct impact when we are advocating for our profession. There are a lot of opportunities out there to become involved. Every way you can get yourself known and meet other people is so beneficial to your career. We’re always looking for members to get more involved.

Q: Based on the lessons of 2023, what other key advice do you have for other lab leaders?

A: Everything that we’re doing at ASCP right now, from our members to our committees, all the way up to the board of directors and our executive leadership, we’re always asking ourselves, is this what’s best for our patients? How does this impact our patients? Sometimes it might not be the thing that gives us the most glamor or recognition, but we know that if we center our purpose on what is best for patients, we feel like we’re doing our job and we’re doing a good job.

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Ali Brown, MD, FASCP, is the chief officer of medical quality at the American Society for Clinical Pathology (ASCP) and the medical director of ASCP’s National Pathology Quality Registry (NPQR). She leads product development and strategic initiatives for the ASCP Center for Quality and Patient Safety. She is an anatomic and clinical pathologist with fellowship training in surgical pathology and breast pathology, and is a diplomate of the American Board of Pathology in Anatomic Pathology, Clinical Pathology and Clinical Informatics. Dr. Brown has hands-on pathology practice experience in academic medicine, multihospital healthcare systems, rural community hospitals, and tertiary cancer center settings.