LabMind
ARUP Laboratories
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Join Dr. Brian Jackson, associate professor of pathology at the University of Utah and a medical director at ARUP Laboratories, as he interviews some of the top minds in diagnostic laboratory medicine. Listeners are privy to personal anecdotes and creative insights into important challenges facing laboratories and clinicians.
Available episodes
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Nov 29, 2023
Why Quality Management Is Critical to the Long-Term Success of Healthcare AI
A public debate is raging around the regulation of artificial intelligence (AI). One side argues that AI is potentially dangerous and needs to be carefully controlled, whereas the other side argues that any regulation would slow innovation. In this interview, Dr. Ryan Metcalf, section chief of Transfusion Medicine and medical director of Transfusion Service/Blood Bank at ARUP Laboratories, makes a strong case for a safety-first approach to healthcare AI. He also explains why embedding AI development and use within a strong quality management framework could actually lead to more innovation over the long term, even as it prevents patient harm in the short term.
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Nov 6, 2023
How FDA Restrictions on Laboratory-Developed Tests Will Harm Patients and Increase Costs
The FDA recently announced a plan to regulate laboratory-developed tests (LDTs) as medical devices. In this interview, Dr. Meghan Delaney from Children’s National Hospital and Dr. Eric Konnick from the University of Washington explain why many tests that are critical to patient care, particularly in the areas of pediatrics, transplantation, and rare diseases, may become unavailable if the rule the FDA has proposed is enacted. Other tests may remain available, but at a significantly increased cost. Dr. Jonathan Genzen, ARUP’s chief medical officer and cohost of this episode, describes how laboratory professionals can provide public feedback to the FDA before the rule takes effect.
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Oct 18, 2023
What the TRUU-Lab Initiative Has Taught Us About Laboratory Test Names
Dr. Ila Singh, chief of laboratory medicine at Texas Children’s Hospital, founded the Test Renaming for Understanding and Utilization in the Laboratory (TRUU-Lab) initiative several years ago to tackle challenges related to the nonstandardized and uninformative naming of laboratory tests. In this interview, Dr. Singh describes the surveys her CDC-funded collaborative has conducted with hundreds of physicians and other providers, and she shares insights about how to improve the ordering of tests through more effective naming.
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Aug 30, 2023
Blunt Advice for Navigating a Career in Academic Medicine
Individuals pursue careers in academic medicine for many reasons. A love of organizational politics is rarely one of them, but faculty need to understand potential landmines if they are to avoid them. In this interview, Dr. Michael Cohen, a professor emeritus of pathology at Wake Forest University, draws on his experiences serving on faculty and in senior leadership at multiple institutions to explain how to thrive within the paradoxes of academic medicine.
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Aug 16, 2023
Sustainability in Healthcare Organizations
Sustainability is a hot topic for American corporations, and health systems are no exception. In this interview, Glen Garrick, system sustainability director for Intermountain Healthcare, explains how his and other healthcare organizations are addressing their environmental, social, and governance responsibilities. He also describes how clinical laboratories can make the most positive impact.
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Aug 1, 2023
Keys to Laboratory Success in the Next Pandemic
Three and a half years after the emergence of COVID-19 is a good time to reflect on the capabilities of U.S. laboratories to respond to future pandemics. In this interview, Dr. Marc Couturier, medical director of Emerging Public Health Crises at ARUP Laboratories, explains how the U.S. laboratory sector has improved in its ability to respond quickly to emerging and reemerging infections, but he emphasizes the need to go further. He specifically explains why testing can’t be rapidly scaled up unless there’s tight coordination between public health labs and clinical labs (particularly reference labs and large academic labs).
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Jul 23, 2023
Optimizing Laboratory Testing for Autoimmune Neurologic Disease
Laboratory testing can either lead to the correct diagnosis or take a clinician down a blind alley, depending on how carefully the tests are selected and performed. In this interview, a practicing neurologist (Dr. Tammy Smith) and a clinical laboratory immunologist (Dr. Lisa Peterson) explain some of the complexities of laboratory diagnosis of autoimmune neurologic disease, and how to ensure good diagnostic outcomes.
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Jul 11, 2023
Bridging the Cultural Divide Between Nursing and Laboratory Medicine
Nurses and laboratory professionals rely on each other to ensure accurate test results, but their relationships are sometimes challenging. As president of St. Alphonsus Medical Center in Nampa, Idaho, as well as a registered nurse with a doctorate degree in nursing practice, Clint Child often mediates when these two professional cultures collide. In this interview he explains why nursing practice is less predictable and requires greater flexibility than laboratory practice. He also shares his perspective on why it’s valuable for hospital leaders to have strong ties to their local communities.
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Jun 19, 2023
Why Different Platforms Can Give Different Results for the Same Test, and What Can Be Done About It
Physicians and patients expect laboratory tests to produce the same results, regardless of where they are performed. Unfortunately, that’s not always the case, even for FDA-approved assays. As the current chair of the College of American Pathologists committee for accuracy-based proficiency testing, Dr. Andy Hoofnagle is an authority on this industrywide problem. In this interview, he explains the root causes of inconsistent results across platforms, and how manufacturers, regulators, and professional societies might work together to solve it.
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May 1, 2023
Lessons Learned From Automating a Hospital Laboratory
The key to successful clinical lab automation doesn’t lie in the instruments or the conveyor belt. It lies in clarifying what the organization most needs to improve (labor efficiency? turnaround time? reliability?) followed by optimizing those factors through modeling and planning. In this interview, Dr. Lauren Pearson, ARUP’s chief medical officer for University of Utah Health, shares lessons she has learned from her recent automation projects.
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Apr 3, 2023
What Laboratory Leaders Aren’t Discussing With Hospital Administrators, But Should Be
For her doctoral dissertation, Dr. Susan Edralin dove into the issue of communicating the value contribution of pathology and laboratory medicine to healthcare administrators. What she found in her conversations surprised her. In this interview, she lists some of the misunderstandings regarding laboratory value and describes how lab directors can raise the status of their laboratory operations and expert staff.
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Mar 20, 2023
Understanding the U.S. Patent System
You know what a patent is, but do you know what’s patentable in the field of laboratory diagnostics? Or how patent law has changed over the years? In this interview, Dr. Bert Ley, a registered patent agent with decades of experience in the clinical laboratory industry, unpacks some of the mysteries of the U.S. patent system and how it ultimately benefits society.
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Dec 19, 2022
Amplifying the Voice of the Patient
Within our current healthcare institutions, patients’ voices are often drowned out by the voices of providers, scientists, and industry. Andrea Downing’s life work is to fix this. As a BRCA1 cancer previvor and a patients’ rights activist, she was a spokesperson for one of the plaintiffs in the U.S. Supreme Court case that ultimately overturned gene patenting. Years later, while moderating an online patient support group, she discovered a major privacy vulnerability in Facebook, which led her into cybersecurity research. In this interview, she chronicles her journey and lays out her vision for patients as cocreators within medicine and medical science.
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Nov 22, 2022
‘Think Different’ About Quality Control
To most laboratorians, quality control is all about rules, metrics, and thresholds. To Dr. Fred Strathmann, on the other hand, it’s about gaining understanding of the underlying processes. In this interview, he shares examples of ways to think more deeply about measurements in order to drive organizational improvement.
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Oct 5, 2022
How to Create a More Welcoming Workplace for Women
ARUP Laboratories was recently recognized by Forbes Magazine as being among the country’s best workplaces for women. In this interview, ARUP’s president, Dr. Tracy George, explains how companies can create healthier models of work-life balance that support women (and men) in their personal and professional roles.
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Aug 24, 2022
A Legacy of Leadership in Clinical Pathology
The curricula of pathology and laboratory medicine training programs are heavily weighted toward technical and medical knowledge. In this interview, Dr. Wayne Chandler makes the case for more emphasis on leadership training, and he shares experiences from his 40-year clinical pathology career that illustrate the impact of people skills.
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Jul 26, 2022
A Sensible Approach to LDT Regulation
The VALID Act currently being debated in Congress would increase the regulatory burden on clinical laboratories. In this interview, Dr. David Grenache from TriCore Laboratories and the University of New Mexico, together with Dr. Vince Stine from the American Association for Clinical Chemistry, explain why VALID would slow down innovation while it raises costs, and why VALID appears to be designed to benefit a particular industry sector rather than patients.
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Jul 6, 2022
Keys to Recruiting and Retention in a Tough Labor Market
In 2022, laboratory professionals have more choices about whom to work for and whether to even continue working in laboratory medicine. In this discussion, Stephanie Whitehead, MBA, MPH, MLS(ASCP), executive director of pathology and laboratory services at University Health, San Antonio, describes what managers should be doing to recruit and retain exceptional staff.
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May 18, 2022
An Organizational Strategy for Workplace Mental Health
Despite their explicit healthcare mission, clinical laboratories often fall short when it comes to employee mental health. Laboratory managers know how to troubleshoot an assay or write a procedure, but how many know how to support an employee with crippling anxiety or de-escalate an emotional crisis? In this discussion, Brysen Bocchino, CMHC, NCC, ARUP’s newly hired mental health clinician, describes an innovative model for recognizing and addressing mental health needs in the workplace.
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Apr 14, 2022
A Look Into the Future of Lab Medicine
How will lab testing be different a decade from now? Many answers are likely to be found in the numerous projects championed by the roughly 200 medical directors and scientists of the ARUP Institute for Clinical and Experimental Pathology. In this discussion, Dr. Adam Barker, chief scientific officer for ARUP Laboratories, explains how and why these R and D scientists are prioritizing the practical needs of patients and their providers.
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Mar 22, 2022
Nudging Physicians Toward Better Use of Diagnostic Tests
Improving physicians’ use of laboratory tests is not usually a problem of motivation. They’re already motivated to deliver high-quality care to their patients. More often, it’s about choice architecture, i.e., making sure that correct choices are easier to make than incorrect ones. In this discussion, Dr. Valerie Vaughn explains the science behind nudging and choice architecture. She also explains how her own research convinced her that improving the use of diagnostic tests is often the key to improving therapeutic outcomes.
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Feb 4, 2022
How Transgender Medicine Is Changing Laboratory Practices for the Better
The needs of transgender and nonbinary patients are compelling laboratories to reexamine historic practices in areas such as patient demographics, reference intervals, and terminology. In this discussion, Drs. Joely Straseski and Jenna Rychert express confidence in the laboratory community's ability to meet the needs of both patients and clinicians by embracing fundamental principles of biology and respect for individuals.
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Jan 19, 2022
The Challenge of Newborn Drug Testing
Many hospitals test newborn babies for exposure to drugs of abuse. Although this sounds fairly straightforward, in practice it has been difficult to standardize testing protocols, let alone keep up with substance use trends. Compared with other areas of laboratory medicine, drug testing is also associated with unique social and legal ramifications, specimen collection processes, and result reporting decisions. In this interview, Dr. Gwen McMillin describes current academic perspectives on these issues, and where she sees the field heading.
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Dec 17, 2021
Vision for Responsive Certification in Pathology
Many physicians see board certification as a one-time hurdle along their career pathway. Dr. Gary Procop, incoming CEO of the American Board of Pathology, sees it instead as a longitudinal partnership “to help make great pathologists, and make great pathologists greater.” In this discussion he explains how ABPath and other specialty boards are using adult learning theory to make their programs more adaptive and relevant to real world clinical practice.
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Nov 16, 2021
Using Genetics to Solve Medical Cold Cases of Hemolytic Anemia
It’s surprisingly common for individuals to harbor undiagnosed genetic conditions. For example, newborns with abnormally high bilirubin levels often reach adulthood without any discovery of the biologic cause. In this discussion, Dr. Archana Agarwal delves into the value of using focused genetic panels to end the diagnostic odysseys for about half of these patients while potentially avoiding risky and expensive diagnostic workups down the road.
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Nov 1, 2021
Stories of Ingenuity, Creativity, and Grit (Part II)
When most people think of laboratorians, they picture introverts following rigid processes to perform technical tasks. These stereotypes sell laboratory professionals short. True, laboratory testing does involve technical chemistry and biology tasks, and some scientists might be introverts, but our field is far broader than this picture suggests. In this two-part episode, Stephanie Whitehead from the University Health System San Antonio and Kathy Sakas from NW Laboratory (Part I), and Chris Bradley from Wisconsin Diagnostic Laboratories, along with Charles Daniels and Karen Corson from Adventist Health (Part II), shatter these stereotypes with their stories of ingenuity, creativity, and sheer grit.
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Oct 14, 2021
Stories of Ingenuity, Creativity, and Grit (Part I)
When most people think of laboratorians, they picture introverts following rigid processes to perform technical tasks. These stereotypes sell laboratory professionals short. True, laboratory testing does involve technical chemistry and biology tasks, and some scientists might be introverts, but our field is far broader than this picture suggests. In this two-part episode, Stephanie Whitehead from the University Health System San Antonio and Kathy Sakas from NW Laboratory (Part I), and Chris Bradley from Wisconsin Diagnostic Laboratories, along with Charles Daniels and Karen Corson from Adventist Health (Part II), shatter these stereotypes with their stories of ingenuity, creativity, and sheer grit.
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Aug 26, 2021
The People of Pathology
Dennis Strenk, PA(ASCP)CM, has interviewed more than 70 people in pathology and laboratory medicine for his podcast, “People of Pathology.” We discuss the remarkable range of backgrounds, professional interests, and career paths he’s encountered, and why it’s never too late to pursue a laboratory career.
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Jul 30, 2021
Person-Centric Innovation to Improve Diagnostic Testing in Global Health
Global health is ultimately achieved by meeting the health needs of people in diverse real-world settings. Creative innovations developed to meet the needs of lower-resourced countries can often benefit wealthy countries as well. In this discussion, Dr. Karen Heichman, director of diagnostics for the Bill and Melinda Gates Foundation, explains the need for fast, inexpensive testing that is easy to perform in any location. She also discusses the value of bringing large corporations, government agencies, and nonprofits together to accomplish these breakthroughs and, in the Foundation’s words, “help all people live healthy, productive lives.”
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Jul 9, 2021
How Do You Continue Building a Great Company?
Andy Theurer recently became the seventh CEO in ARUP’s almost 40-year history. In this interview, he reflects on lessons learned from all six of his predecessors, shares why he’s been skipping to work almost every day for the more than 30 years he’s been with ARUP, and talks about how he hopes to guide the future of ARUP.
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Jun 18, 2021
The Cultural Legacy of a CEO
Dr. Sherrie Perkins never planned, nor aspired, to become CEO of a large clinical laboratory business. But after a long and successful career as an academic hematopathologist, she was tapped as the sixth chief executive in ARUP Laboratories’ nearly 40-year history. In this interview, she describes her journey from art student to pathologist, how every CEO leaves a distinctive mark on a company, and why diversity and inclusion are so important to ARUP’s future.
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Jun 14, 2021
Where is Pathology Heading?
Few guests on LabMind have been as attuned to broad technologic trends in pathology as Dr. Joseph Anderson. He has worked in multiple settings, including private practice, academia, and industry, and is currently engaged in with several early-stage pathology companies. Anderson also hosts a podcast in which he interviews leaders in the domain of digital pathology. In this interview, we discuss his insights into what’s required for successful innovation, and why he’s optimistic about pathology’s future.
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May 25, 2021
A Patient Perspective on Diagnostic Testing
Patients’ needs and preferences don’t always match the preconceived notions of laboratory and medical professionals. In this interview, Heidi Wallis, president of the Association for Creatine Deficiencies, shares her family’s diagnostic odyssey. She also provides insights about how the biomedical establishment could better serve families like hers. Ms. Wallis has two children with GAMT deficiency, an inherited disorder that prevents the body from producing creatine. Her children were diagnosed in very different ways, with very different consequences.
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May 10, 2021
Personalizing Transfusion Medicine
Transfusion medicine has arguably led other pathology subspecialties in improving patient safety through industrial quality management and standardization methods. However, standardization practices, such as the use of transfusion triggers, are in some respects a one-size-fits-all approach. And as we undoubtedly know, real patients aren't standardized. In this discussion, Ryan Metcalf, section chief for transfusion medicine in the University of Utah Department of Pathology, describes the development of data visualization tools to help surgeons and anesthesiologists optimize their transfusion decisions based on individual patient needs.
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Mar 29, 2021
A Distinctive Diagnostic Partnership in Pediatrics
When Dr. Nicola Longo, professor of Pediatrics at the University of Utah, encounters a child with an undiagnosed syndrome, he has a unique resource: Dr. Marzia Pasquali, professor of pathology and section chief of Biochemical Genetics at ARUP Laboratories. Their connection extends back to high school in Parma, Italy, and grew through years of medical and scientific training, marriage, and clinical practice. In our discussion, they describe their combined life’s work to solve diagnostic mysteries and develop diagnostic tools to enable long, healthy, and productive lives in children who might otherwise face neurologic decline and early death.
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Feb 22, 2021
The Pandemic Year in Review
As an infectious disease physician and medical microbiologist, Dr. Kim Hanson has had a busy year. In this interview, she reflects on some of the successes during the COVID-19 era, such as the collaboration among rival regional health systems to provide testing for our communities. She discusses how COVID-19 testing needs are evolving, pointing to the pressing need for a national variant surveillance system in which academic medical center laboratories could play a large role. Finally, she offers some predictions for the coming year.
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Jan 25, 2021
Why Every Health System Needs Doctors of Clinical Laboratory Science (DCLSs)
Nadine Fydryszewski is program director for the world’s first Doctor of Clinical Laboratory Science (DCLS) program at Rutgers University. Modeled after other health professional degree programs, including those for pharmacy and physical therapy, this doctorate-level role for clinical laboratorians was developed to complement interdisciplinary patient care teams. Brandy Gunsolus, the program’s first graduate, currently practices at Augusta University Medical Center in Georgia. In this conversation, the two explain what it took to get the DCLS program off the ground and why clinicians are so enthusiastic about including DCLSs on their care teams and hospital committees.
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Jan 5, 2021
Bringing Phlebotomy Services to the Home and Workplace with LabFly
A restaurant delivery or car ride can be ordered easily from your smartphone. Why not phlebotomy services when you need your blood drawn? This is the question Mike Eller asked a colleague back in 2018. Then, with some tech and marketing collaboration, they made it happen. In this discussion, Jim Crawford, Eller, and Chris Zavala explain the origin of their LabFly mobile phlebotomy service, its critical role in supporting telemedicine during the COVID-19 pandemic, and how it positions Northwell Health Laboratories for the patient-centric care of the future.
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Dec 2, 2020
How Laboratories Can Reduce the Total Cost of Care
Health systems wishing to reduce overall healthcare costs would do well to focus less on direct laboratory costs and more on the meaningful ways laboratories can impact clinical efficiency. In this interview, Rick Panning, who served as Senior Administrative Director for Laboratory Services at HealthPartners in Minnesota, describes his work to reduce the total cost of care through improved testing service levels, saving money while improving the patient experience.
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Nov 16, 2020
Finding Meaning Through a Career in Clinical Laboratory Science
Clinical laboratory science might just be the most invisible of all the healthcare professions. Maddie Josephs, president of the American Society for Clinical Laboratory Science, is trying to change that. In this interview she explains why many Millennials and Gen Z individuals feel drawn to this field, and describes some of the barriers to expanding the ranks of clinical laboratory scientists to meet this country’s growing healthcare needs.
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Nov 5, 2020
The Lab Must Go On, Despite the Disruption of a Pandemic
Clinical laboratories were hit hard when COVID-19 erupted in the United States last spring. Labs scrambled to develop and ramp up COVID-19 testing while facing PPE shortages, the need to keep staff infection free, and sharp drops in revenue due to patients delaying routine care and elective procedures. In this interview, Dr. Jon Genzen, COO of ARUP Laboratories, describes a few of the many ways ARUP quickly and successfully adapted to this unfamiliar and challenging environment.
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Oct 12, 2020
Recruiting the Next Generation of Clinical Laboratory Scientists
Despite what the general public seems to think, laboratory tests don’t just run themselves. They require an educated workforce of clinical laboratory scientists. Maintaining this highly skilled workforce is challenging, especially since few young people are even aware of the laboratory science career path. In this interview, Diana Wilkins and Takara Blamires share their experiences recruiting young people into the medical laboratory science program at the University of Utah, and Misty Smith explains the intricacies of recruiting for a national reference laboratory.
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Sep 28, 2020
Convalescent Plasma Therapy for COVID-19
Antibody therapy, which encompasses convalescent plasma, hyperimmune globulin, and monoclonal antibodies, is an intriguing and potentially important component of COVID-19 therapeutics. In this conversation with Dr. Ryan Metcalf, director of the University of Utah’s transfusion services, we discuss the current thinking around convalescent plasma therapy and why we need more formal clinical trials of therapies for emerging diseases.
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Sep 14, 2020
Protecting ARUP’s Workforce Members and Their Families During the Pandemic
COVID-19 presented ARUP’s Family Health Clinic with two major challenges: First, find ways to safely continue delivering the full range of primary care medical and wellness services. And second, set up a comprehensive infection control and contact tracing program for ARUP’s approximately 2,500 on-site workforce members. In this discussion, Dr. Kathryn Gibson, medical director for the clinic, describes how she collaborated with staff from the clinic, Wellness Center, Safety department, and others to succeed on both fronts.
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Sep 1, 2020
Primary Care the Way It Was Meant to Be at the ARUP Family Health Clinic
Primary care in the United States is in crisis. Fee-for-service payment models cause clinics to maximize the volume of visits, leaving doctors feeling like hamsters running on a wheel, and patients feeling rushed and ignored. Medical and preventive health needs are shortchanged, resulting in poor health outcomes and enormous downstream costs. A decade ago, Dr. Peter Weir decided to solve this problem for ARUP’s employees and their dependents. He took ARUP’s employee health clinic and transformed it into a full-service medical home, untethered from fee-for-service reimbursement. Not only is the clinic enormously popular with ARUP’s workforce and their families, but it also reduces ARUP’s overall healthcare costs.
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Aug 3, 2020
How the COVID-19 Pandemic Has Upended Laboratory Purchasing
Supply shortages, from collection kits to reagents to personal protective equipment, have been a major bottleneck for COVID-19 testing. Join the ARUP supply chain management team and me as we take you behind the scenes of clinical laboratory supply sourcing. Michael Bevan and his team describe how purchasing processes and vendor-supplier relationships have dramatically changed in the era of COVID-19, and tell you why those processes and relationships may never be the same again.
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Jul 28, 2020
Lab-Developed vs FDA-Regulated Tests — Separating Fact from Fiction
A lot of misinformation has been propagated about the FDA’s role in regulating laboratory tests. Some have advocated for FDA regulation of all lab-developed tests as “medical devices,” which could be a death knell for many of these tests and put a stranglehold on the laboratory's ability to respond to certain patient care needs. In this conversation with Dr. David Grenache, chief scientific officer for TriCore Reference Laboratories, he discusses why laboratory-developed tests play an important clinical role, how they’re currently regulated, and how to best modernize those regulations.
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Jul 14, 2020
Personal Insights on Leading a Laboratory During a Pandemic
Crises such as COVID-19 have a way of compressing a lifetime of leadership preparation into a single intense performance. Dr. Julio Delgado has worked as a primary care physician, immunology researcher, laboratory director, and chief medical officer of ARUP Laboratories. In this discussion he explains how his philosophy of leadership, which is based on valuing and connecting with individuals, has been tested in the context of the COVID-19 pandemic.
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Jun 24, 2020
Patient- and Science-Centered Support for Patients with Autoimmune Disease during the COVID-19 Pandemic
Patients with autoimmune disease have faced some distinct challenges during the COVID-19 pandemic. These challenges include tough decisions about whether to stop their immunosuppressant therapy and difficulties refilling their regular prescriptions for hydroxychloroquine. Dr. Tracy Frech, director of the Systemic Sclerosis clinic at the University of Utah, describes how she's supporting her patients during this difficult time. She also describes her research collaboration with clinical laboratorians and other academic colleagues to find answers to key questions that are important for this patient population.
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Jun 16, 2020
Delving into the Sensitivity of SARS-CoV-2 Diagnostic Testing
How much do we really know about the sensitivity of COVID-19 molecular tests? And how much sensitivity can be safely sacrificed in favor of assay speed or the ease of collecting a particular specimen type? David Hillyard has decades of experience developing and studying molecular tests for viruses, including HIV, hepatitis B, and hepatitis C. His lab was one of the first in the U.S. to develop and validate a high-throughput assay for SARS-CoV-2. In our conversation he explains the key factors that impact the accuracy of these tests, what we know so far, and what we still have to learn.
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Jun 9, 2020
Laying the Groundwork for Data-Driven Health Care
Most healthcare professionals are frustrated by the lagging progress of health IT. In an era when Google and Facebook seem to know every detail of our lives, why can’t health IT do a better job of predicting the information needs of patients and clinicians? Or even modify their data displays based on clinical context? One reason is the nonstandardized nature of most healthcare data. Pam Banning has spent her career making health data more usable through standardized terminologies such as LOINC and SNOMED. In this conversation she describes how far we’ve come using semantic interoperability over the past 25 years, and why we still have a very long way to go.
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Jun 1, 2020
Making Sense of Thrombotic Complications in COVID-19
Thrombosis has turned out to be one of the major subplots of the COVID-19 clinical story. In this conversation, two experts in hemostasis and thrombosis explain how academic physicians and scientists have been studying the coagulation defects seen in patients with COVID-19 in order to more effectively monitor patients and prevent complications.
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May 26, 2020
How Unbiased Sequencing Technology Is Improving Infectious Disease Diagnostics, from Routine Clinical Care to New Pandemics
The SARS-CoV-2 virus was first identified and sequenced using a technique known as “unbiased sequencing.” During this conversation, Robert Schlaberg, MD, Dr Med, MPH, takes us inside this technology, helps us understand how it works, and describes how it can significantly improve infectious disease diagnosis. He also explores how scaling up this technology will catalyze a quicker diagnostic response to future pandemics.
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May 16, 2020
Improving Collaboration Between Clinical and Public Health Labs
Dr. Marc Couturier has experienced a number of pandemics during his career as a microbiologist, from West Nile virus to Zika virus to SARS-CoV-2 (COVID-19). And he knows what it’s like to work in both a commercial clinical lab and a public health lab. In this conversation, he describes how lab professionals from both these settings have been working in recent years to improve pandemic preparedness and response.
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May 6, 2020
A Peek Behind the Curtain of Data Reporting for COVID-19 and Other Public Health Events
How do clinical laboratories report data to public health agencies, and what do those agencies do with the data? In this conversation Sam Marsden describes his experiences working in both the public health and clinical diagnostic arenas. He also dives into the critical role of public health agencies in gathering, analyzing, and applying data to improve the health of communities.
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Apr 24, 2020
How an Academic Clinical Laboratory Has Become a Collaboration Hub to Accelerate COVID-19 Scientific Discovery
To manage and ultimately conquer COVID-19, the public is placing its hopes on rapid scientific discovery. What does it take to make this happen? Dr. Tracy George, executive director of clinical trials and PharmaDx at ARUP Laboratories, describes how her group is coordinating efforts across multiple outside research groups to facilitate faster and larger trials to answer important questions about COVID-19 therapy.
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Apr 16, 2020
Antibody Testing for COVID-19
Antibody testing (serology) for COVID-19 has been eagerly awaited by the medical community and more broadly by our country's political and business leaders as we chart a path forward to ease physical distancing and the strain on our economy. Drs. Slev and Rychert have validated assays and platforms here at ARUP Laboratories. In this interview, they explain what clinicians need to know about COVID-19 serology, the inherent limitations of these tests, and the research data that's still to come.
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Apr 6, 2020
Focusing on the Fundamentals Prevents Diagnostic Errors
Dr. Hardeep Singh is a general internist and authority on the various causes of diagnostic error. He argues that most diagnostic errors aren’t due to failures of complex reasoning, but rather failures of the routine processes we take for granted such as communication and followup of test results. His research focuses on improving organizational systems and processes, including those involving health information technology.
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Jan 29, 2020
Preventing Diagnostic Errors
In this second segment, Dr. Mark Graber focuses on post-analytic errors and the need for more pathologist-clinician and pathologist-patient communications. He also emphasizes the importance of inviting patients to participate in medical societies and conferences. Finally, Graber delves into the 2015 Institute of Medicine (now National Academy of Medicine) Report, “Diagnostic Error in Health Care,” and its key messages for the laboratory community.
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Dec 11, 2019
Preventing Diagnostic Errors
During Mark Graber's academic nephrology career, he became interested in bringing diagnostic error out of the healthcare shadows. Diagnostic errors occur more frequently than either surgical errors or medication errors, but they've received less attention from the patient safety community. In this initial interview, he shares personal experiences encountering diagnostic errors in clinical practice. We also discuss the central role of laboratories in addressing these problems, including where labs struggle and where the opportunities lie.
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Aug 27, 2019
The History and Future of Medical Laboratory Scientists
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.
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Jul 25, 2019
The TRUU-Lab Initiative to Improve Laboratory Test Names
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.
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Jun 21, 2019
Ethics-Centered Leadership within the Healthcare Industry
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.
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May 7, 2019
Practicing Laboratory Science in the IVD Industry
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.
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Feb 28, 2019
How Genetic Testing is Different
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.
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Dec 5, 2018
Overcoming Barriers as A Diagnostic Management Team
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.
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Dec 5, 2018
Blending academics, medicine, and the business of clinical laboratories
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.
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Dec 5, 2018
Applying Evidence-Based Medicine to the Laboratory
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.
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Oct 31, 2018
The Truth, Not the Myth, of Inventing
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.
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Aug 9, 2018
Moving clinical laboratories beyond simply performing tests
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.
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Jul 26, 2018
We traditionally associate universities with teaching and research. But what about business innovation?
Mike Astion, a pathologist and professor of laboratory medicine at the University of Washington and Seattle Children’s Hospital, shares his experiences in launching and growing three different businesses over the course of his career and describes some of the unique challenges and opportunities he faced in his academic settings. He also explains the importance of hustle and negotiation for would-be entrepreneurs.
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Jul 6, 2018
How did a Norwegian department store scion go from world class skier to academic hematopathologist to co-founder and CEO of what would become one of the largest commercial reference laboratories?
Part II: The CEO years. In this segment, Dr. Carl Kjeldsberg, professor emeritus of pathology at the University of Utah, discusses his tenure as both CEO of ARUP Laboratories and department chair of Pathology at the University of Utah. He describes how his people-first leadership philosophy was critical to growing the company.
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Jul 6, 2018
What role will pathologists play in the healthcare systems of the future, and what skills will those pathologists need?
What role will pathologists play in the healthcare systems of the future, and what skills will those pathologists need? Andrew Fletcher, a pathologist with ARUP Laboratories, describes his own varied career, including time spent as a physician assistant, medical student, surgery intern, pathologist, and health system administrator. Along the way he addresses cultural divides, inter-professional communication, and that the unique contributions that laboratories and pathologists can bring to value-based healthcare.
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Jul 6, 2018
How did a Norwegian department store scion go from world class skier to academic hematopathologist to co-founder and CEO of what would become one of the largest commercial reference laboratories?
Part I: Early career influences. In this segment, Dr. Carl Kjeldsberg, professor emeritus of pathology at the University of Utah, describes his early influences and preparation for academic entrepreneurship. He also discusses the challenges that he and his colleagues faced in order to establish ARUP Laboratories in the early 1980s.
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Improving Diagnostics in Medicine
Paul Epner’s more than four-decade career started at Abbott Diagnostics and has involved collaboration with the CDC and a tenure as president of the Clinical Laboratory Management Association (CLMA). He now serves as CEO of the Society to Improve Diagnosis in Medicine (SIDM). Throughout his career, Epner has been a powerful advocate for the role of laboratory professionals. In our special Lab Week interview, we discuss why diagnosis is a team sport, how cross-disciplinary collaboration is fundamental to the critical impact of laboratory medicine, and the overall quality of medical care.
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