IMPACT OF TECHNOLOGICAL DEVELOPMENTS AND ORGANIZATIONAL STRATEGIES ONCLINICAL LABORATORY COST REDUCTION

Health care reform efforts, largely under the aegis of managed health care initiatives, have prompted clinical laboratories to increase effi ciency and reduce both expenditures and test turnaround times. The ado ption of newer technologies is viewed as a mechanism of achieving the latter objectives, but direct and indirect costs and outcomes are ofte n difficult to project. Issues explored in this article include the im pact on a large university hospital-based clinical microbiology labora tory following the application of various technological approaches to organism recognition and susceptibility testing and the consolidation of certain testing services. Included are applications of an automated blood culture system; radiometric detection, identification, and susc eptibility testing of mycobacteria; and the use of molecular probes to identify various microorganisms. Assessment was made through retrospe ctive review of direct costs, estimates of average test report turnaro und times, work flow changes, and real or perceived outcomes. Both the application of technology per se and consolidation of an independent virology service into the general microbiology laboratory enabled impr ovement in test report times and led to direct or indirect cost reduct ion. Managerial strategies to bring about organization changes through out all clinical laboratories in response to a major hospital-wide cos t reduction program are also presented together with financial outcome s achieved.