Offshore Clinical Lab Tests
Remember when outsourcing did not apply to healthcare? Businesses developed the concept of contracting or otherwise arranging for some services to be performed outside the main business if it made financial sense.
Outsourcing is utilizing experts from outside the entity to perform specific tasks the entity once performed itself, if those tasks can be done more efficiently or more cost effectively. This trend has been growing since the 1980s.
Then (surprise!), this concept expanded to healthcare. For example, we all use reference labs to perform not only complex tests, but low volume, finicky or any tests they can do cheaper, better, faster.
Now, in search of cheaper labor, businesses have taken outsourcing to other countriess in a process called "offshoring." Again, the prediction is that healthcare is exempt; after all, care is delivered where the patient is physically located. Not so fast!
Teleradiology has become a very lucrative and fast-growing business. Diagnostic images (e.g., x-rays, MRI, scans) are taken where the patient is and beamed electronically to a radiologist at a remote site for reading and interpretation.
It is not uncommon for a rural hospital to take a film at 2 a.m. and have it read by a radiologist in Australia. The patient is none the wiser. Could laboratory science be co-opted in the same way?
What about WBC differentials, identification of cells in other body fluids, histology and pathology slides? What about an interpretive summary of an entire set of patient results?
While it is unrealistic to send actual specimens "offshore," it is certainly possible and very easy to transmit images and data. Where does this leave clinical laboratorians and what are we doing to prepare for this eventuality?