7CAREER OPTIONS FOR THE MEDICAL

TECHNOLOGIST

Cheryl G. Davis, DHA, CLS(NCA)Associate Dean for Administration

and Resource DevelopmentTuskegee University

AMT National MeetingJuly 10, 2013

Objectives Discuss the body of knowledge for

laboratory practitioners Discuss clinical skills for laboratory

practitioners Discuss career options for laboratory

personnel Advanced training and skills required

for selected career options Clinical laboratory as it relates to

meaningful use and transparency

Introduction

Medical laboratories represent an area of healthcare constantly undergoing changes due to technological advances and external pressures.

Forecasting future can be risky. Prepare for the future.

Body of Knowledge Normal and pathological physiology, biochemistry,

and basic genetics Disease processes and their etiology Differential diagnosis Pharmacokinetics Diagnostic and therapeutic procedures and their

biochemical consequences Analytical theory, quality control, and quality

assurance Ethics in laboratory medicine Diagnostic function of other pathology departments Operations of clinical environment and the

healthcare system Mechanisms for quality assurance and improvement

Skills for Clinical Liaison

Problem solving Critical appraisal Creativity, initiative, observational

and questioning skills Communication, teamwork, and

presentation skills Information technology Applied statistics Application of knowledge

CAREER OPTIONS

“The only way to predict the future, is to create it.”

Academia

Continuous supply of laboratory personnel

Curriculum development Basic and advanced training

Masters Doctorate

Administration

Hospitals Clinic/Group Practices Community-based organizations Government

Public Health

Epidemiology Infectious disease Chronic diseases Surveillance Health promotion/prevention

Research and Development

Principal investigators Collaborators New products Protocols Medical advances

Consultants

Correlate laboratory data and patients status

Proposed changes in CLIA and HIPAA to allow patients direct access to results

Home lab tests

Bioterrorism

Identification of pathogens Identification of chemical

substances Standards of practice Relationship with state and federal

agencies

Sales/Marketing/Technical

Promoting laboratory products Technical services

Meaningful Use As the healthcare landscape continues

to modernize, recent legislation was passed to encourage the adoption of Electronic Healthcare Record (EHR) technology in documenting patient care. As a result of the American Recovery and Reinvestment Act (ARRA) eligible Medicaid providers, beginning in 2011, are offered financial incentives for the implementation and meaningful use of Health Information Technology (HIT) in the management of patient populations.

Meaningful Use: Consumers

The safe and secure exchange of health information is a great benefit to health care consumers. One Health Record will not only help to improve the quality of care patients receive, it can also lead to a reduction in health care costs.

Integrity, privacy and security are essential components of One Health Record. Consumers can rest assured that their private health information will be protected under federal and state guidelines by industry leading practices and safeguards.

Transparency The trend toward greater transparency

in health care pricing continues to spread.

This trend is designed to require providers, including clinical laboratories and pathology groups to make laboratory test prices available to patients and consumers.

Transparency is expected to contain rising health care cost by creating consumer-driven competition between providers.

Continued Oregon, Utah, Tennessee, New Hampshire,

and Maine have legislation establishing statewide online database of costs for medical treatments.

Massachusetts launched MyHealthCareOptions (http://hcqcc.hcf.state.ma.us/ is an interactive, consumer-friendly web site that allows consumers and stakeholders to compare common healthcare procedures at hospitals in the state. Examples: hip replacement, angioplasty, mammogram, etc.

Advanced Practice Roles

Analyze and sign out without pathologist oversight all laboratory test requiring interpretation (i.e. bone marrow aspirates, etc.)

Define a list of test which an interpretation is approved for payment. Work with payers on test list for which interpretation is necessary and approved for payment, but does not require a medical doctor.

Continued

Perform and interpret molecular testing at the clinical, research, biotechnology, and forensic levels.

Work on team with genetic counselor, physician on all genetic testing; serve as a genetic counselor.

Replace nurses as the intake/collection/etc. personnel in all blood donor centers.

Continued

Automation engineer Biomedical engineer Information technology Pathology Assistant Physician Assistant

Advanced Technical Practice

Perform bone marrow aspirates and biopsies

Work with payers to modify/define reimbursement rules to include services/procedures performed by non-physicians

Perform cerebrospinal fluid aspirations and other non-routine specimen collections

Collect routine specimens for microbiological investigation (from throat swabs to cornea scraping)

Should the masters degree be the entry level for MLS/CLS/MT?

Leadership Quality assurance Laboratory management Education Patient advocate Consumer education

Doctorate in CLS Advanced knowledge in scientific areas that

impact on patient care and/or may not have been included in the previous CLS/MT curriculum (i.e., epidemiology, pharmacology, and pathophysiology)

Health care knowledge necessary to provide and coordinate patient care as impacted upon by laboratory testing. Development and application of clinical decision making, development and application of critical paths/test algorithms, utilization review, patient and provider safety, quality systems, and medical error prevention.

Continued Patient assessment and participation in

clinical experiences to include clinical rounds.

Collecting, managing, securing and applying information from patient records.

Interpersonal and communication skills necessary to function in direct patient care with diverse communities of patients and family members and with other health care practitioners (physicians, nurse practitioners, physician assistants, etc.) as an independent provider of health care.

Continued Capstone experience, applied research,

or translational research as required by the college. Integral components will include research design, statistics, grant writing, protection of human subjects, and research ethics.

Knowledge in development, interpretation and application of health care policy and legislation to include reimbursement policies, medical liability exposure, licensure, ethics, tort, patients privacy protection, etc.

Continued

Knowledge in health care services delivery and access through skills developed in resources management, outcomes analysis, analysis of costs relative to benefits, etc.

Integrating CLS Doctorate into the health organization

Educationally and experientially prepared to recommend support and enhance appropriate testing

Translate and transform complex laboratory data into an understandable product necessary for clinicians to be able to assess the validity of current and new assays to ensure better patient care

Assist in reducing questionable test usage, thus reducing costs

Stakeholders

Creating the Future

Proactive Advanced Training Advocate (public and legislative) Professional Organizations

Ready for the future

Opportunities Change is inevitable Visibility Use our knowledge-base Leave the lab and/or allow others in New skills sets Different thought process

LET’S CREATE OUR FUTURE!!!!!!!!!!!!!!!!!!!!

References Bossuyt. B., et.al. (2007). Clinical Chemistry. 53. No. 10, p1730-

1733 Clinical pathology labs should plan on greater transparency in

test prices and patient outcomes. Retrieved from http://www.darkdaily.com/clinical-pathology-labs-should-plan-on-greater-transparency-in-test-prices-and-patient-outcomes-813#axzz1mfcAhT9e

Montoya, I., Kimball, O. (2009). Integration of the CLS doctorate into the health care organization. Clin Lab Sci; 22(3) pp136-140.

NAACLS Doctorate in Clinical Laboratory Science Guide to Accreditation

One Health Record, www.onehealth.alabama.gov Panteghini, M. (2004). The Future of Laboratory Medicine:

Understanding the New Pressures. Clin Biochem Rev. Vol 25. November. p207-215.

Plebani, M. (2002). Charting the course of medical laboratories in a changing environment. Clinica Chimica Acta. 391, p87-100

Preparing to Implement HITECH: A Date Guide for Electronic Health Information Exchange. http://onehealthrecord.alabama.gov/Documents/1.5_Reference_Documents_and_Links/1.5.2_National/1.5.2_NGA_HIE_Report.pdf

Yu, M.(2012). Proposed Changes in CLIA and HIPAA. Advance. Posted on: January 23, 2012