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