ASCP News -- July 2021

Advocating Efforts Heighten Lab’s Visibility

On the advocacy front, ASCP led efforts to call for a comprehensive national COVID-19 testing strategy. The lack of a comprehensive strategy in 2020 resulted in poor coordination, disjointed testing patterns, and chronic laboratory supply shortages that slowed COVID-19 and other testing. Gary W. Procop, MD, MS, MASCP, Chair of ASCP’s Commission on Science, Technology and Policy, has led the Society’s efforts to work with the Biden Administration in support of a comprehensive national pandemic response plan. ASCP is pleased that the President and his Administration adopted many elements of the Society’s national COVID-19 strategy.

Laboratory testing has also been in the spotlight these past 12 months and ASCP has remained proactive on laboratory-developed tests (LDTs) as well. The pandemic has provided many reasons to reexamine the Food and Drug Administration’s position on the LDT front and ASCP—under the leadership of Dr. Procop and ASCP Past President William G. Finn, MD, MASCP—advocated for less regulation of low-risk tests and appropriate regulation of high-risk tests. This strategy calls for an approach that is less disruptive to pathology but still protects patients and public health.

Docuseries Shines Spotlight on Laboratory During COVID-19 Pandemic

This past year, the medical laboratory rose to the challenge of addressing the COVID-19 pandemic. In May 2021, ASCP released a four-part docuseries that examines the issues that arose in the medical laboratory during the pandemic, and how and why the lab persevered and how we can play a leadership role in the prevention of future pandemics.

ASCP CEO Blair Holladay, PhD, MASCP, SCT(ASCP)^CM, traveled to six major medical centers and laboratories to speak with leaders and staff about lessons learned, healthcare disparities, policy issues and preparedness for the future.

Early on, the pandemic highlighted how the public—and medical community—took the lab for granted. At the beginning of the COVID-19 outbreak, medical laboratories struggled mightily, and they still do in some regards. The docuseries highlights four themes:

• How pathologists and medical laboratory professionals coped with burnout while working round the clock to fight the novel coronavirus
• How existing healthcare disparities were brought to the forefront during the pandemic
• The leadership role that the laboratory played in advocating for patients’ needs
• How laboratories and health systems can apply the lessons learned dealing with the COVID-19 pandemic, including addressing staffing and supply shortages, to prepare for future pandemics.

The sites included NorthShore University HealthSystem, the Cleveland Clinic, the University of Washington, Seattle, the UCLA Health System, Quest Diagnostics and the University of Nebraska Medical Center. You can find the docuseries at www.ascp.org/scientists-who-saved.

Addressing Healthcare Disparities

Providing quality care for all patients requires an understanding of the diseases that disproportionately impact minorities. The newly-created Society of Black Pathologists (SBP), a new nonprofit organization based in Chicago, IL, aims to encourage more Black and under-represented minorities to enter the pathology profession and enhance leadership development in an effort to provide more equitable care. Part of SBP’s mission also includes conducting research that carefully examines healthcare issues that pose greater risks to people of color.

“Expanding the pipeline so that more Black and Brown professionals enter the pathology and laboratory medicine workforce is critical to addressing health inequities,” said Carla L. Ellis, MD, FASCP, President of the SBP and Associate Professor of Pathology at Northwestern University’s Feinberg School of Medicine. “SBP is committed to connecting with students from under-represented populations and supporting their training through scholarship aid and providing mentorship and leadership opportunities that will allow them to make a significant impact on patient care.”

To achieve this mission, SBP has established a partnership with the American Society for Clinical Pathology (ASCP) in which ASCP will manage certain activities of SBP to promote mutual interests in education and diversity and inclusion.

“ASCP has managed other medical societies for more than a decade, and it has a well-established commitment to mitigating disparities in health care in Black and other under-represented populations,” Dr. Ellis said. “In addition to working to expanding the pipeline of Black and other individuals of color to into the pathology workforce, our partnership will work to increase equity and retention through mentorship and leadership development in our efforts to strengthen a culture of antiracism and inclusion in pathology. It will also promote evidence-based research on racial and ethnic health disparities and social determinants of health.”

"ASCP is honored to partner with the SBP,” said ASCP CEO Blair Holladay, PhD, MASCP, SCT(ASCP)^CM. “The creation of an organization such as the SBP is long overdue. The impact of the COVID-19 pandemic has pushed the critical role of the medical laboratory team and pathology to the forefront. It is an opportunity for us to not only continue to recognize the individuals who play a significant part of delivering patient care, but to encourage individuals from under-represented communities to explore careers in this profession so that our profession truly reflects the communities that they serve.”

In the upcoming year, ASCP will assist the SBP with planning its inaugural education event. The SBP will also provide members to serve as faculty for ASCP’s Annual Meeting this fall.

Join us for ASCP 2021 in Boston Oct. 27-29

Mark your calendar for Oct. 27-29, and join us at the ASCP 2021 Annual Meeting in Boston, MA, to hear renowned experts address the critical issues affecting health care today and beyond. This year’s Annual Meeting will be a hybrid, offering some sessions in person as well as numerous sessions virtually.

A highlight of this year’s Annual Meeting will be enhanced career services offerings, provided by ASCP’s Human Resources experts. This will include a session on how to develop effective strategies to build your career profile, round tables, mentoring sessions, and workshops on resume-building, negotiations, LinkedIn and online job searches, mock interviews and much more.

This year, ASCP is also proud to host the 2021 World Cancer Leaders’ Summit in Boston, prior to the ASCP Annual Meeting. This prestigious, invitation-only event—organized by the Union for International Cancer Control (UICC)—brings together key decision makers from around the world to facilitate debates about emerging issues related to cancer control.

ASCP Expands Number of COVID-19 Tests to Question Before Using

ASCP has selected two more targeted, evidence-based recommendations for COVID-19 testing to add to its existing roster, bringing the total number of COVID-19 tests to review to four. The ASCP Effective Test Utilization Committee and the ASCP Commission on Science, Technology and Policy developed the recommendations.

“Our understanding of COVID-19 and the appropriate tests has evolved so quickly that we needed to make sure the medical community understands what tests are most appropriate for each patient,” said Lee H. Hilborne, MD, MPH, FASCP, DLM(ASCP)^CM, a past ASCP President and chair of the ASCP Effective Test Utilization Committee.

As stewards for laboratory medicine, ASCP is mindful of the need to use the best tests available while conserving scarce testing resources. The two newest recommendations related to COVID-19 tests state:

• When antigen tests are used to evaluate an asymptomatic population, positive results should be confirmed using a RT-PCR method.
• Do not order a respiratory viral panel (ie, SARS-CoV-2 and other pathogens) for COVID-19 screening to evaluate asymptomatic patients following possible exposure or for return to work/school. Instead, order just the appropriate SARS-CoV-2 ( COVID-19) PCR or antigen test.

In recent months, ASCP has also advised against using serology testing to evaluate patients with upper or lower respiratory tract symptoms of acute COVID-19 infections, and to instead use nucleic acid amplification or antigen testing. Another recommendation for clinicians, when treating symptomatic patients with a negative antigen test, is to confirm with a more sensitive test (i.e., PCR) if clinically indicated. ASCP’s recommendation notes that antigen tests are less sensitive than nucleic acid amplification tests. Hence, if a patient appears to have COVID-19, but the antigen test is negative, then a follow-up COVID PCR test is strongly recommended. Read more about these recommendations on page 6.

USPSTF Recognizes ASCP Vitamin D Recommendations

The U.S. Preventive Services Task Force (USPSTF) cited ASCP in its recent recommendation on vitamin D screening, noting there is “insufficient evidence to recommend screening the general population for vitamin D deficiency.” In outlining its determination, USPSTF cited ASCP for its recommendation against population-based screening for vitamin D deficiency.

ASCP’s Vitamin D recommendation stems from its partnership with the ABIM Foundation’s Choosing Wisely (CW) initiative to advance a national dialogue around avoiding unnecessary medical tests and treatments.

Innovative Education on NSCLC Biomarker Testing Available for the AP Team

Waiting for biomarker testing results or having inadequate samples can delay treatment for patients with advanced non-small cell lung cancer (NSCLC). Time and accuracy are of the essence for these patients. ASCP and Genentech are partnering to develop cutting-edge education and resources to facilitate best practices for anatomic pathology (AP) teams to improve NSCLC patients’ experiences. The aim of this initiative is to ensure that AP laboratory managers and their teams have the latest knowledge to ensure continuous quality improvement in biomarker testing.

The initiative’s “Best Practices in NSCLC Biomarker Testing” Videoconference Series will provide AP laboratory managers and their teams with knowledge related to best practices in NSCLC biomarker testing, examples of success stories and guidance on real-life challenges they may face. This interactive videoconference series leverages the Project ECHO approach, in which experts will present on various topics related to NSCLC biomarker testing. In addition, participants will share their success stories and relevant real-world scientific and implementation challenges from their institutions, and seek feedback from participants and ASCP experts through discussion.

Through this partnership, ASCP will also create an Online Resource Hub to provide supporting resources, and will offer a summit focused on NSCLC biomarker testing. Other activities will include the creation of a Facebook group to foster networking and discussion. The summit, videoconference series, online resource hub and Facebook group will be designed to promote best practices in pre-analytic, analytic and post-analytic biomarker testing for patients with NSCLC.

“The initiative pioneered by ASCP and Genentech will provide engaging opportunities for AP teams to create a community with solution-minded colleagues across unique laboratory settings. Through collaborative interactions, the goal of elevating patient outcomes will be realized through real-life quality improvement successes in the space of NSCLC biomarker workflows,” said Amy Spiczka, MS, SCT, HTL, MB(ASCP)^CM, ASCP Senior Director, Quality and Patient Safety. For more information, visit www.ascp.org/content/learning/lung-cancer.

Groundbreaking Study Proposes Strategies to Stem Workforce Shortage

The clinical laboratory workforce that underpins the U.S. healthcare system is under siege. As the providers of critical information to patient and medical providers to diagnose, treat, and manage disease, the number of laboratory professionals in the workforce is dwindling as baby boomers retire and accredited programs close. The COVID-19 pandemic has exacerbated this crisis.

To reverse this trend, ASCP and the University of Washington Center for Health Workforce Studies together conducted a study, Clinical Laboratory Workforce: Understanding the Challenges to Meeting Current and Future Needs. Supported by a generous grant from the Siemens Healthineers Fund of the Siemens Foundation, the study proposes innovative strategies, such as introducing careers in the medical laboratory to students as young as elementary school, while also working to build a more diverse and inclusive laboratory workforce. Read more about this study on page 8 in this issue of Critical Values.