CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
J. Mark Tuthill, MD, division head, pathology informatics, Henry Ford Health System: I’ll start with the central IT/local IT question and then talk about labor in general. One of the interesting things I have seen over my 20-year career in informatics is that there are oftentimes places where it’s viewed that the local LIS team should be part of central IT. And that lab team is brought in and then, interestingly, it becomes utterly distracted with every other problem outside the laboratory. And so that team ends up getting put back in place in a laboratory. We’ve had good interaction with our central IT group, where we view ourselves as a peninsula of the IT team. But because we are funded by cost centers in the laboratory, our day-to-day focus is on laboratory issues.
We’re often asked by central IT to address those laboratory issues when IT is strapped for labor to carry out other large projects. An interesting recent example was that all Windows servers on Windows 2008 had to be upgraded by January 2020 to a different version of that Windows server. If IT had to take care of all of the pathology servers, they would have never made it. They were highly reliant on our laboratory-based informatics team to carry out that work. Since that team knows the applications well, they were able to do that job relatively independently without depending on project managers from central IT. It always behooves the laboratory to have that dedicated staff within its walls.
In general, the labor force for IT has probably never been a safer job. There is so much work to be done, and it is so difficult to recruit talented people. Interestingly, it’s even harder to recruit senior people because a lot of the folks who have come into these jobs have come into the industry relatively young. I have a relatively easy time bringing in junior informaticists, but I have a much harder time bringing in senior people who have had 10 to 15 years of experience because the labor market just hasn’t existed that long and people have not had that length of career available to them. So it is a challenge. And when you get to nuanced areas like business analytics, these folks don’t even exist yet. So if you want to hire someone to come in and be a data scientist or a data analyst, good luck finding that individual. It really is a safe place for someone to go into for their career.
Nick, I’d like you to speak to the same topic—centralized IT versus laboratory IT—and to talk a little about the labor force, for laboratories and for IT. I’m well aware that Verona, Wisconsin is this incredible story, as is the entirety of Epic. Still, I’d like you to talk about central IT versus IT with specific people dedicated to lab and to the labor that’s needed to make any and all of this work optimally.
Nick Trentadue, product manager, Beaker, Epic: I agree with much of what Dr. Tuthill said, and he is in both worlds, using a different LIS but having Epic as the comprehensive EHR at Henry Ford. So we have groups that run the gamut from having lab-owned resources supporting Beaker, to groups that are almost all centralized. We see a bell-shaped curve type distribution.
Most commonly, we see groups consolidating on Epic as a single platform, not only for laboratory but also for the entire patient record for the organization. Those groups and, with Epic being an integrated system, the Beaker folks who work to support the lab are brought into some of those integrated decisions and changes so that we can use the lab data, use those results, and merge them into the greater workflow of those health care organizations. They do have exposure to some of the goals of the health system as they’re using that common platform across the patient’s touchpoints throughout the organization.
In terms of the talent that’s out there, yes, there are quite a few IT people in Madison, Wisconsin. To Dr. Tuthill’s point, with IT, we see a younger labor market excited about health care IT. But I have seen a lot of laboratorians, whether they’re early or late in their career, make the move into IT. They might be new to the IT side of things, but they’re quite experienced in the laboratory and bring a wealth of knowledge about their organization over to IT. Having that operational experience is an important bridge to have. We see groups having a lot of success filling their IT team with laboratorians.
We know there are many people who started in the laboratory and who are important players in our LIS world. Sepehr and Tony, from your respective perches at Siemens and Beckman Coulter, do you find that your increasingly dedicated headcount to issues around IT, data management, and workflow management is a growing segment of the employed base?
Tony Barresi, senior marketing manager, workflow and automation business, Beckman Coulter: Yes, I would say from an investment standpoint, you’re spot-on. And Sepehr put it well earlier when he mentioned that data is king (part one). We at Beckman Coulter understand that, believe in that, and are committed to delivering our customers greater insights through clinical informatics. You’re seeing commensurate investment in technology and people related to data, data analytics, and how that can be leveraged to result in superior workflow and additional value delivery from the laboratory.
We have an entire approach that we are launching that is dedicated to workflow optimization achieved by networked combinations of our products. The underpinning of each combination is data management, data analytics, physical automation, and automation of data flow. To put a fine point on it, we are fully invested in what you’ve described, and it is reflected internally here.
Sepehr Seyedzadeh, senior director, global marketing and product management for automation and diagnostics IT, Siemens Healthineers: I echo that. As our products grow into different areas, like data analytics, we also need to grow our expertise in those areas. These people are hard to find. It’s one thing to find IT qualified people who are good with coding and security and so on. It’s a whole other ballgame to find people who are good clinical application specialists, people who can harness the power of IT for a clinical routine workflow. Even if we find very good people with IT expertise, we need to spend a lot of time educating them on the clinical aspects so they can be useful in deployment.
Wally, would you agree that this addition of the clinical insight into the IT makes some of the labor issues particularly challenging for you? Do you have that experience at NovoPath?
Wally Soufi (NovoPath): Yes, I agree with Sepehr. There is a clear distinction between somebody who is very good at IT and hardware, and, as Dr. Tuthill mentioned, upgrading servers and things like that, versus someone who is knowledgeable in the running of the LIS itself. However, with the shift to the cloud, the role of the IT specialist will eventually and naturally morph into an application or product specialist.
We have been successful in finding and training people who work well with us or for us. Clearly, there’s a lot of competition for talent. We all see and share the same experiences when it comes to recruitment.
Michelle, I’d like to ask you to comment on the labor shortage and on the same question your colleagues have—on outfitting technically expert people with clinical insights so they can make an optimal contribution.
Michelle Del Guercio (Sunquest): Staffing is a huge pain point laboratories are facing and customers are expressing. We’ve talked to a number of customers that are using creative ways to engage more people to go into the laboratory space. The same customers are also encouraging those in the lab to move into the technology and IT side because having that balance is such a nice mix and helps to support the lab and the interoperability within the organization and beyond. So having that lab talent move forward is a bonus. But most definitely the labor shortage in the laboratory space is causing concern. Things like middleware and other rules and validations, and places where you can automate and trust that automation, are helping to counter that labor staffing shortage.
Curt, please speak to us about this same question, maybe leading with the problem of labor in the laboratory because whether it’s a laboratory person with a lot of IT expertise, or a general laboratory technologist or other, a shortage has to affect the entire operation. What are you seeing in some of the Orchard sites?
Curt Johnson (Orchard): Technology, from the diagnostic vendors and from IT, does a lot to offset the labor shortage, which I’ve heard about in the laboratory marketplace for more than 20 of my 31 years in the industry.
At one point in the late 1980s or early 1990s, you needed eight to 10 people to run a microbiology department. You needed 10 to 15 people to run the EIA part of the business. You now need two automation lines with some laboratory expertise. So you need the laboratory and the laboratory expertise, but over the years, automation has helped.
There will come a point, though, where you run out of being able to solve the problem with diagnostic equipment or the LIS. Are we reaching that point? Many people think we are. All of us in the laboratory industry are looking for the best and most experienced talent. For laboratory information specialists, at Orchard, we believe in taking the laboratorian and teaching the IT point of view. We have found it more critical and more important for our customers and our ability to continue to grow to have laboratorians who can learn the IT function than to try to find IT specialists and teach them the laboratory. To us, it’s critical to have the laboratory knowledge.