As Q1 2022 comes to a close, the COVID-19 pandemic remains at the forefront of many clinical labs’ concerns more than two years after the first U.S. lockdowns. This ongoing battle against the virus and its variants, including the highly contagious Omicron, has brought about new challenges and lessons that have changed the way many clinical labs approach equipment purchases and supply chain issues. In working to connect labs with the technologies and supplies they need during this time, Tarlan Zaltash, Medline Vice President of Corporate Accounts, and Brett Miller, Senior Laboratory Sales Specialist, have had their fingers on the pulse of these evolving trends, with Medline recently expanding its laboratory segment to include a portfolio of 120,000 products and nearly 100 lab vendor partnerships. Labcompare recently spoke with Zaltash and Miller to discuss some of the most prominent topics in the clinical lab space for 2022, including questions and solutions that will likely remain relevant for many years to come.
1. Labs are looking for ways to repurpose molecular testing equipment once COVID-19 cases decline
The pandemic created an overwhelming demand and need for widespread COVID-19 testing, primarily using molecular diagnostic methods like RT-PCR; once this need was fully recognized, many clinical laboratories onboarded multiple new instruments to expand their capabilities or capacity and keep up with the influx of COVID-19 tests. While testing efforts are still ongoing, with variants like Omicron contributing to new spikes in demand, labs are beginning to ask the question of how they can best repurpose these new platforms once cases subside. For some labs, this could represent an opportunity to offer new tests and services that they may not have had available or even considered before.
“I think it’s a little bit unique what the pandemic’s done to this market in the laboratory. We have customers, acute care hospital customers that are smaller – 50, 25 bed hospitals – that have implemented some extremely technical instruments for COVID testing that they’re not typically used to doing, the workflows and the processes that they’ve adapted to bring in these COVID tests,” said Miller. “Some of these COVID solutions that Medline offers, they don’t typically do this type of testing in some of these smaller hospitals. So I think trends looking into 2022 and 2023, this is going to allow these hospital laboratories to bring in some of those esoteric tests that traditionally they wouldn't have looked at if there wasn’t a pandemic.”
When tackling the question of what to do with molecular testing equipment post-COVID, Miller said there are two key factors to look at that can steer labs toward an appropriate repurposing plan. The first factor is the nature of the equipment itself and what its capabilities are to accommodate new assays.
“What we would first look at is what instrumentation they currently have. Is it a true PCR instrument or is it an isothermal instrument? Is it an open platform or closed system?” Miller said. “You know, the closed cartridge-based systems, you’re limited to what tests are 510(k) cleared for that specific instrument. If it is an open platform that they have brought on for COVID testing, Medline has a breadth of solutions that we could talk with them about: infectious disease testing, respiratory testing, women’s health testing.”
The second main factor is the organization’s current send-out tests to reference labs. Managers could consider whether instruments currently being used for COVID-19 testing could ultimately bring some of that testing in-house, reducing send-out costs.
2. Automation and IT systems help labs “do more with less”
Clinical laboratories and hospitals have faced many hardships over the past two years including staff shortages, budget cuts and supply chain disruptions, leaving many to face the monumental task of managing millions of COVID-19 tests and cases with fewer resources. Not all of these problems are isolated to the pandemic – for example, The American Society for Clinical Laboratory Science notes that staff shortages have been an ongoing struggle for decades. However, the pandemic has undoubtedly added more strain on laboratory systems, with Medline working to help clients navigate supply chain challenges and connect with staffing agencies.
Other solutions many labs are now turning to are automated equipment and more advanced IT systems, which help streamline workflows, reduce hands-on work time and keep better track of inventory and large volumes of patient data. While these systems do not replace the value of having sufficient personnel and adequate resources on hand, in a difficult environment like that created by the pandemic, automation enables labs to “do more with less,” Miller said.
“Some of the big areas that customers are really liking what they hear is around automated QC and calibrations,” said Miller. “For example, I was actually with a customer this week and they shared with me that they are spending about four hours a day of hands-on maintenance on their chemistry and immunoassay platforms. And this is pretty common in daily hands-on maintenance that these techs have to do, and some of the solutions that we offer can really help bring down that hands-on maintenance.”
Cutting down on manual tasks allows staff to make the best use of their time and allows laboratories facing personnel shortages to do more with the staff that they have. IT solutions also play apart in this crucial timesaving component.
“We have a lot of IT solutions that we can bring to our customers, whether it’s data management, process management softwares, inventory management softwares, and all of these things help bring more efficiency to workflows, more efficiency to connectivity of instruments to patient results, [and] maintenance; for example, [with] our connectivity manager, all of our equipment has remote capabilities,” Miller explained. “This really helps drive uptime on instrumentation. And all of this really goes back to allowing the laboratories to do more with less or do more with what you have, by bringing some automation and some of these different IT software and capabilities to the laboratory. I think COVID has had a direct impact on staff challenges and shortages, and that’s kind of an area that we’re helping alleviate, or at least bringing to our customers as a solution some of our IT and automation capabilities.”
3. Supply chain transparency is more important than ever
Like staffing shortages, COVID-19 has magnified supply chain issues, with lack of transparency being a “huge pain point” for clinical lab directors, said Zaltash.
“The lab typically doesn’t have much visibility and control over their data. So they’re relying on their vendors to give them that information,” Zaltash explained. “... What we’ve learned really across the board is that a lot of our lab directors are unsure of their markups and distribution costs and things of that nature. They only see their price at the pump.”
Disruptions and demands brought on by the pandemic have made it more important than ever for labs to have more visibility when it comes to things like back orders and the cold chain, and to have a seat at the table in their organization’s wider supply chain strategies. Some ways that Medline has been helping its clients navigate and streamline supply chain issues include providing easy access to detailed data on their supply chain activity through its online reporting tool, and by helping organizations consolidate between their laboratory and medical-surgical portfolios.
“For instance, if the lab department is using exam gloves and the med-surg department is using exam gloves, and we’re able to consolidate that to one SKU, that supply chain is then able to procure just one SKU as opposed to working with a number of vendors. That’s really the benefit that we’re trying to bring to the table by not only just simplifying their lives, but bringing transparency behind it as well, so that their decision making is based on actual data as opposed to just guesses,” Zaltash said.
4. Gene sequencing and precision medicine are gaining momentum
While both Zaltash and Miller agreed that COVID-19 has taken up most of their clinical lab clients’ attention, emerging areas of medicine and advanced methods like gene sequencing are gaining more interest in the clinical diagnostics sphere. The growing popularity of precision medicine and preventative approaches to healthcare, as well as the increasing speeds and lowering prices of sequencing technologies, have led more labs to look into what benefits these technologies could potentially have for them and their patients.
“In general, folks are wanting to move to more prevention instead of reaction. I think gene sequencing is a good way to do that,” Miller said. “Like PCR molecular testing, 10, 15 years ago, [it was] extremely expensive. You would’ve never thought there’d be a handheld PCR device [and] for $30 you can run a true thermal cycling PCR test. Gene sequencing [also] used to be extremely expensive. It is coming down a little bit.”
Miller said so far he has seen pain management doctors using gene sequencing before prescribing medication, to understand what the medicine will do for a particular patient before the treatment begins, adding that gene sequencing is also being used for cancer diagnosis and could help improve disease detection in the future. As more research comes out about how sequencing can aid in diagnostics and treatment plans, Miller expects interest to continue to grow among lab clients.
“I do think in the next five to 10 years, that this will be something that a lot of customers and laboratories look at bringing in because of what it can do and what it does,” Miller said.
About the Experts: Brett Miller, Sr. Sales Specialist, Laboratory, has been supporting the acute care laboratory market for the last 2.5 years and has been with Medline since early 2014. Brett joined the acute care laboratory team back in 2020 to help support Medline’s fastest growing segment of healthcare, laboratory distribution. The previous 6 years Brett worked in Medline’s non-acute market supporting the alternate laboratory space. Currently, Brett oversees the acute care laboratory instrumentation business at Medline and covers the US.
Tarlan Zaltash, VP of Corporate Sales, Laboratory, has 6 years of Medline experience and joined the Corporate Sales team 2.5 years ago to help support the company’s fastest growing segment of healthcare, laboratory distribution. Tarlan previously worked as an Acute Care Representative for a large IDN system in San Diego, California and as a Sales Associate prior to that. Currently, Tarlan oversees the laboratory distribution footprint, mainly on the West Coast, and manages laboratory contracts, RFPs, usage file analyses and financial proposals.