LabMind

When Elissa Passiment studied medical laboratory science decades ago, she believed physicians would appreciate her advice on testing strategies. This didn’t always turn out to be true. Yet, she never backed down from her conviction that lab professionals should play a much larger clinical role than simply performing tests. In our interview, this former executive VP of the American Society of Clinical Laboratory Science discusses the history of clinical labs and medical lab scientists, and why she is optimistic about the profession’s future.

Dr. Ila Singh, director of clinical laboratories at Texas Children’s Hospital, recently launched a collaboration with a broad set of clinical, IT and pathology stakeholders to improve the clarity of laboratory test names. She discusses why it is so challenging to create clear and helpful test names for physicians, given all of the informational goals and IT constraints. She also explains the importance of professional and geographic inclusivity for this project.

Ron Weiss, MD, MS, MBA, served as president and COO of ARUP Laboratories in the early 2000s. He was one of the principle authors of ARUP's Five Pillars statement of ethical principles. He pulls from his experiences growing up with a family business to explain how ARUP's early success required both business acumen and patient-centered values. Weiss also discusses why he's optimistic about the future of U.S. healthcare.

Ana Stankovic recently retired as senior VP of Worldwide Medical Affairs at BD, one of the best known in vitro diagnostic companies. Prior to her employment at BD, she worked as a basic science researcher, blood banker, reference lab clinical pathologist, and public health officer. In this interview, Dr. Stankovic describes what science looks like from the inside of the IVD industry, specifically how the selection process and character of projects differ from those of academic labs while scientific norms and patient-centered goals remain the same.

Few people understand clinical genetic testing—from biology to technology to ethics to regulatory issues—better than Dr. Elaine Lyon. Over her long academic and clinical career, she has made many important contributions to the development, use, and interpretation of genetic tests. In this conversation, Dr. Lyon discusses what makes genetic testing different from other areas of laboratory medicine, and what she sees as the greatest challenges in the regulatory, ethical, and clinical landscapes.

The Evidence-Based Medicine (EBM) Movement gained traction in the mid-1990s, spurring a paradigm shift in how we view the relationship between science and clinical care. While EBM was percolating, clinical pathologist Rita Horvath was beginning her medical career at the University of Oxford—a hotbed for EBM thinking. Since then, she has become a thought leader in how EBM principles should apply to laboratory medicine and what that looks like.

Curiosity, grit, and persistence over the course of many decades allowed Dr. Harry Hill to master many roles: pediatrician, immunodeficiency expert, laboratory director, NIH-funded researcher, business leader, and mountain climber. In this interview, he discusses the critical role of diagnostic test development in caring for patients with immunodeficiency syndromes. Dr. Hill also talks about the challenges and successes of blending an academic model within a commercial laboratory operation in co-founding ARUP, and then later developing the ARUP Institute for Clinical and Experimental Pathology.

In the 1990s, Dr. Mike Laposata created the world's first Diagnostic Management Team (DMT) at Massachusetts General Hospital, in order to better care for patients with coagulation disorders. In this interview, he discusses the distressing and all too common issue of diagnostic errors, and how a collaborative, team-based approach can make a vital difference. Laposata also addresses the systemic barriers to team-based diagnosis such as the lack of insurance reimbursement, and suggests ways to surmount these barriers and scale up DMTs.

Dr. Carl Wittwer, inventor LightCycler™, is a well-recognized name in clinical laboratory diagnostics. In this interview, he describes what drove him to push the limits of PCR beyond the biotechnology industry of its time. His own invention story reflects what Thomas Edison once said about this process: It’s 1 percent inspiration, 99 percent perspiration. Dr. Wittwer shares his vision of how environment, people, and organizational policies all contribute to fostering entrepreneurial innovation.

In this broad-ranging interview, long-time lab industry executive Khosrow Shotorbani asserts that laboratories should be actively engaged in population health management. He emphasizes that impacting health outcomes is what matters (e.g., shorter hospital stays, reduced emergency room visits, fewer complications) and not just the efficient delivery of test results. Shotorbani points out opportunities for the laboratory to impact cost savings from improving health outcomes which will far exceed savings achieved through efficient internal lab operations alone. He argues that by outsourcing lab operations, some health systems are squandering a huge opportunity. To promote these ideas, under the title of “Lab 2.0”, he’s teamed up with some of the most forward-thinking laboratory leaders in the nation’s largest health systems.