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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Offshore Clinical Lab Tests

Published December 18, 2007 10:41 AM by Glen McDaniel

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?


It is not "unrealistic" to send actual specimens 'offshore'.  The drive to the lowest cost testing service provider will eventually result in licensed labs beings established in Mexico and in Asia to do routine testing.  It is only a matter of time.  Reference laboratories have been using scheduled domestic air carriers for years.  Several additional hours for China delivery or a much shorter flight to Mexico is no major hurdle.  

Eric, Instrumentation - Project Leader January 20, 2008 11:36 AM
Marlborough MA

Kudos on your decision to pursue an MBA, Brian. As we enter the age of informatics and tele-operations, we must think more globally. The very nature of what we do as clinical laboratorians means we will have to stay on the cutting edge of technology to serve patients best and (like it or not) to stay competitive. If we ever doubted it in the past we all now know that healthcare is a service, a calling and a business.  One part of that equation is certainly learning how to understand the marketplace and how to best take advantage of the global economy.

Glen January 15, 2008 2:37 PM

This is a very interesting topic.  I do agree that outsourcing has become more common in the medical field especially for medical staffing agencies.  I also believe that due to the advancement in technology medical professionals will be able to access their portion of patient information through integrated systems at various locations throughout the world.  A term use to define this type of action would be virtual communication. Virtual communication has made it possible for companies to communicate faster especially among those that expand internationally.  To answer your question, I do believe that laboratory science can and will be co-opted in the same way.  I think as laboratorians we need vision. If we don't know where we are going how will we advance to the level of technology. Once the vision is determined then we must have a plan of action. I have a bachelors in medical technology/allied health but I recently returned to school to get a MBA. I 've only been in the program for a short time but the knowledge that I've obtained so far has been quite amazing. Some of my course topics have included outsouring, virtual communication, and integrated systems.  How do we prepare ourselves? We educate ourselves. Hopefully, this will also have an impact on the pay as well:)  


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