ASCP: The Pathology Society of “Firsts” Part 2

In 2007, Lab Medicine published the article “The American Society for Clinical Pathology: The Pathology Society of ‘Firsts.’” Scoping the history of the first 90 years of the American Society for Clinical Pathology (ASCP), the article highlighted the extensive “firsts” the Society initiated and achieved in those decades that aided in firmly establishing ASCP as the leading pathology society in medicine. This was rooted in its prime objectives, such as promoting the practice of scientific medicine through a wider application of clinical laboratory methods to the diagnosis of disease; stimulating original research in all branches of clinical laboratory work; establishing uniform standards for the performance of laboratory exams; elevating the scientific and professional status of those specializing in pathology and laboratory science; and encouraging closer cooperation between practitioner and clinical pathologist.

In the decade since that article of “firsts” was published, ASCP has continued to initiate and meet those objectives, but has also expanded its breadth of knowledge and reach to better serve its members and patients worldwide.

In 2009, the ASCP Task Force on Transition delivered a report to ASCP that would radically change the framework of the Society to one that focuses on patient-centric advocacy. With three definitive pillars bolstering this paradigm shift, patient-centricity would become, over the next decade and beyond, the driving force behind ASCP’s initiatives, programs, and opportunities for growth. Under this new framework, resting on the strength of these pillars, the Society continues to be one of “firsts.”

Pillar 1: Patient-centricity—the driver behind our mission
One of the top priorities to come out of the ASCP Task Force on Transition was to shift the Society’s focus to be more patient centered. Specifically, its members wrote, “ASCP should be patient-centered; an advocate for the public health.” Becoming more patient-centered has allowed ASCP to better meet its members’ needs, and has enabled the Society to better collaborate and serve with other healthcare professionals and the public, and serve the public interest.

As part of this paradigm shift, ASCP recognized that in order to better serve its members—the first step in advancing toward patient-centricity—combining efforts with the National Credentialing Agency for Laboratory Personnel (NCA) was central to that mission. In 2009, out of this alignment, the ASCP Board of Certification (BOC) was formed, setting the stage for the BOC to become the first laboratory certification agency to have its credential to meet the licensing requirements of the states of New York and California. Additionally, it became the first laboratory professional credentialing agency to have its examinations available at military sites worldwide and on-base national test centers.

Over the past decade, ASCP has continued breaking new ground toward patient-centricity. ASCP continues to meet its members’ needs through the lens of patient-centric care. And because of that, the offerings to its members increasingly fall under the scope of aiding them in providing the highest-quality care possible. In 2012, for example, ASCP was the first organization to introduce a patient safety course designed specifically for pathologists. The Society developed the Institute for Science, Technology, and Policy to foster work in evidence-based practice, patient-centered outcomes, health service delivery, precision diagnostics, new technology delivery, industry relations, and scientific ambassadorship. The following year, ASCP recognized the emerging power of genomics and developed a national curriculum in cancer genomics for pathology residents via a grant from the National Institutes of Health. In 2017, the Society launched its first Patient Champions initiative, giving patients a platform to share with others how the laboratory saved their lives. Not only does this help bring the laboratory further into the public eye, it also empowers patients to advocate for themselves and their fellow patients.

Also in 2017, ASCP launched the ASCP Foundation with the mission of increasing laboratory visibility, providing scholarships, grants, and fellowships; improving global health; and supporting the ASCP General Fund. It’s a way for ASCP members to play an active role in shaping the future of the profession, supporting the education and advancement of pathologists and laboratory scientists who are not only our future, but the hope of future patients. In the first year alone, the Foundation raised more than $1.5 million—surpassing expectations and setting a bedrock on which to build success and accomplishments. These were ambitious undertakings for the Society, but it was imperative to pursue them and critical to continue to do so. Patient-centric care is both the present and the future of health care, and as leaders, ASCP members ensure leadership by example.

Pillar 2: Health services and education-based research—changing the healthcare landscape
In 2011, ASCP initiated the Center for Health Services Research as a way to enable the organization to expand clinical pathology and laboratory medicine research into broader evidence-based practice that would support pathologists’ diagnostics and advise clinical therapeutics. This ties neatly to the Society’s paradigm shift toward patient-centric care in a simple way: ASCP can provide better patient care when its members can help clinicians make better decisions.

Building bridges within the broader healthcare community enables ASCP to move the needle on health research. And that has been done with success, through Memorandums of Understanding (MOUs), such as those ASCP has with the Society for Hematopathology, the Association for Pathology Informatics, or the European Society for Pathology. These alliances help ASCP collaborate better, and allow the Society to bring better education resources to a wider audience and lay the foundation for needed research.

The bridges ASCP has built have also helped put the Society at the starting line of sea-changes within health care. In 2012, ASCP became the first pathology and laboratory medicine organization to join the American Board of Internal Medicine Foundation’s “Choosing Wisely” campaign to enhance test utilization by identifying the laboratory tests that are misused or overused, or provide little benefit, and, in some cases, cause harm to patients.

Most recently, ASCP launched the first pathology-specific, institution-based registry, the National Pathology Quality Registry (NPQR). The NPQR is a national benchmarking and quality program used to assist laboratories in assessing and improving their performance. The Centers for Medicare and Medicaid Services recognized the NPQR as a Qualified Clinical Data Registry for 2018. The NPQR has been a game-changing tool for both pathologists and their clinical colleagues, as an access point for many to improve patient care.

Pillar 3: Global health—pursuing patient-centric care around the world
Since the development of the ASCP Center for Global Health, the Society has fostered a commitment to bringing much needed laboratory infrastructure and care to people in resource-limited countries. ASCP firmly believes that global health is local health, and protecting patients everywhere is part of its duties. Though this means stepping beyond the boundaries of what the Society is asked to do, a life saved is a life saved, no matter where that life lives.

To that end, over the past decade ASCP has collaborated with governmental and industry partners to develop sustainable laboratories and necessary workforces in the places that need them most, from Sub-Saharan Africa to South America to Europe to Asia. Many of these accomplishments have come through ASCP’s activities with the President’s Emergency Plan for AIDS Relief (PEPFAR). In 2008, ASCP became the first organization to develop, in collaboration with PEPFAR, and multiple organizations and ministries of health, consensus standards on laboratory tests, instrumentation, and supplies to treat HIV/AIDS, tuberculosis, and malaria. That same year, ASCP co-authored a white paper for the US Centers for Disease Control and Prevention (CDC) on strategies to improve quality standards in resource-limited countries. This paper was accepted by the World Health Organization Regional Office for Africa and became the basis for the SLMTA (Strengthening Laboratory Management Toward Accreditation) program that has helped improve the quality of laboratory diagnosis in many countries.

In the 10 years and counting since ASCP has partnered with PEPFAR, it has facilitated more than 233 training events. ASCP has also helped countries such Cambodia, Cote d’Ivoire, Lesotho, Swaziland, Vietnam, and Nigeria develop curricula for medical technology schools. Year after year ASCP renews its cooperative agreement with the CDC, knowing it is a successful route to strengthening new and much-needed developments to stop the spread of and provide treatment for those with HIV/AIDS.

And the Society’s efforts to bring and improve patient care across the globe haven’t stopped there, but rather continue to grow. In 2015, ASCP was asked by the Obama Administration’s White House Office of Science and Technology Policy to lead a coalition of leading government and industry players, including the National Institutes of Health, the National Cancer Institute, the Centers for Disease Control and Prevention, and the Clinton Global Initiative to launch the Partners for Cancer Diagnosis and Treatment in Africa initiative. This initiative uses leapfrog technology to bring rapid cancer diagnosis and in-country care and treatment to Sub-Saharan Africa. At the outset, $26 million was pledged toward this effort, but as the project got underway, the importance of the work being done quickly expanded that commitment to $150 million. The Clinton Foundation adopted it as a commitment, and we have now pledged to work in 11 countries: Rwanda, Uganda, Tanzania, Ethiopia, Haiti, Ghana, Malawi, Liberia, Kenya, Democratic Republic of Congo, and Vietnam. ASCP is in talks with even more countries to bring in these much-needed services. Volunteers from across anatomic pathology specialties, including gynecology, soft tissue, dermatology, hematology, genitourinary, breast, gastroenterology, and endocrinology, are providing their expertise and time reading slides and providing feedback on diagnoses. The first laboratory launched in Butaro, Rwanda, in 2017 and provides resource-limited areas of the country access to rapid cancer diagnostics, as well as care and treatment. The telepathology lab houses a fully automated tissue processing system, enabling the laboratory to process upwards of 1,000 blocks per day, as well as allowing for same-day turnaround on biopsies. This is the first in what ASCP hopes will be a long and trusted partnership that will benefit so many in need of high-quality care.

The Society knows that part of its commitment to shrinking the gap between local and global health stems from sharing its members’ knowledge and expertise. As such, in 2014 ASCP held its first Middle East conference for the global laboratory community. Hosted in Abu Dhabi, United Arab Emirates, this two-day scientific conference brought live education and networking opportunities in an effort to further improve patient care across the globe. By developing the global laboratory community, ASCP stakes itself solidly in a position as leaders in health care. Since the initial meeting, the Society has partnered with Cleveland Clinic and Cleveland Clinic Abu Dhabi, continuing to provide an international platform to expand and share knowledge and insight.

Looking to its past to form the future
Over the past decade and, truly, since its founding in 1922, ASCP has experienced a phenomenal amount of growth and has pushed the boundaries of what it means to be a patient-centric healthcare organization. Its influence has extended throughout the evolution and maturation of this medical specialty, and ASCP is unique among pathology organizations in that its inclusive membership brings both pathologists and laboratory scientists together to advance practice.

It is ASCP’s dedication not only to its members, but more importantly, to the patients it serves, that drives the Society’s efforts. By keeping patients at the forefront of its mission, ASCP is building bridges within the practice of medicine. The Society provides clinician resources to help pathologists and laboratory scientists better serve those in need. ASCP is leading change in the emergence of and access to diagnostic medicine, and changing what it means to be a true collaborative partner for clinicians and patients.

And this is what will drive ASCP toward more success, more firsts, in the next ten years, and beyond.