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New tests, new wrinkles in HIV algorithm

September 2017—Three years—including a total eclipse of the sun—have sped by since the Centers for Disease Control and Prevention and the Association of Public Health Laboratories recommended a new HIV diagnostic testing algorithm for laboratories. In 2014, the algorithm was seen as bringing HIV test ordering up to speed with the advances in HIV test technology and increasing the accuracy and reliability of HIV screening and diagnosis. Have laboratories made the adjustment, and is the CDC/APHL algorithm proving workable and worthwhile?

Turning points in transgender medicine

September 2017—The intricacies of transgender medicine are many. They are unique; they are universal. A la Walt Whitman, they contain multitudes: identities, challenges, questions, even fears. But the first step toward comprehending them can be simple. Tim Cavanaugh, MD, started with a cup of coffee. Dr. Cavanaugh, of Fenway Health, Boston, began delving into the topic about a decade ago, when an assistant administrator at his previous job, at a small community health center in Rhode Island, told the center’s leaders that the transgender population was medically underserved.

Advanced parameters offer faster, surer guidance to cancer care

September 2017—After a career spent studying malignancies in the bone marrow and monitoring the effects of chemotherapy on the bone marrow and neoplastic cells contained therein, Cheryl Hirsch-Ginsberg, MD, stepped out from the bone marrow realm and into the faster-paced world of high-volume hematology.

Market based? A view of PAMA process, pricing

September 2017—Under the Protecting Access to Medicare Act of 2014, Medicare rates for laboratory tests will be recalculated to reflect “market-based pricing” as reported by “applicable laboratories.” But are labs going to get a market-based price, or is the Centers for Medicare and Medicaid Services “gaming the system to ensure there will be a cut to the fee schedule”?

New requirement, updates in transfusion checklist

September 2017—Like an old friend with a new facelift, or a high-mileage car with a thorough tune-up, the 2017 edition of the CAP transfusion medicine checklist has undergone a significant number of small changes—none of which is startling in itself, but all of which combine to produce a fresh and streamlined effect. More than 90 of the checklist’s requirements have been revised, many in the name of alignment with FDA requirements.

Antibiotic stewardship gets a boost in FDA’s OK

September 2017—Those who have seen the strength of antibiotic stewardship hope the FDA’s clearance this year of an assay for antibiotic management will drive further and move faster the efforts being made to curb unnecessary use.

Bringing data analytics to bear on diabetes care

September 2017—Can data move the dial on diabetes? That’s the thinking behind Roche Diabetes Care’s new partnership with Accenture, and it’s how some labs and health care systems are already driving diabetes care to a whole new level.

For NIPT laboratories, a new proficiency test in 2018

September 2017—The CAP Surveys program is offering for 2018 a novel external proficiency test for laboratories that perform screening of cell-free (cf) DNA in maternal plasma for common aneuploidies.

For Quality Registry, details and demos at CAP17

September 2017—The CAP is set to launch next month the Pathologists Quality Registry for pathologists to begin using in 2018 to collect data under Medicare’s Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) track.

Making it personal: transgender medicine

August 2017—Talk about personalized medicine. While the national discussion about transgender women and men often pivots on civil rights legislation (exhibit A: so-called bathroom bills), the medical community has quietly begun to ask questions about how to provide care for transgender patients. In the process, assumptions are being turned sideways. And as laboratory professionals are realizing, the impact can affect everything from start (patient identification, test ordering) to finish (test results, billing), seemingly one patient at a time.

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