A podcast that explores the future of laboratory medicine
Join Dr. Brian Jackson as he interviews some of the top minds in diagnostic laboratory medicine. Listeners are privy to personal anecdotes and creative insights into important challenges facing laboratories and clinicians.
Dr. Brian Jackson
Associate professor of pathology at the University of Utah and a medical director at ARUP Laboratories.
An Interview with Dr. Kathryn Gibson: Protecting ARUP’s Workforce Members and Their Families During the Pandemic
COVID-19 presented ARUP’s Family Health Clinic with two major challenges: First, find ways to safely continue delivering the full range of primary care medical and wellness services. And second, set up a comprehensive infection control and contact tracing program for ARUP’s approximately 2,500 on-site workforce members. In this discussion, Dr. Kathryn Gibson, medical director for the clinic, describes how she collaborated with staff from the clinic, Wellness Center, Safety department, and others to succeed on both fronts.
An Interview with Dr. Peter Weir: Primary Care the Way It Was Meant to Be at the ARUP Family Health Clinic
Primary care in the United States is in crisis. Fee-for-service payment models cause clinics to maximize the volume of visits, leaving doctors feeling like hamsters running on a wheel, and patients feeling rushed and ignored. Medical and preventive health needs are shortchanged, resulting in poor health outcomes and enormous downstream costs. A decade ago, Dr. Peter Weir decided to solve this problem for ARUP’s employees and their dependents. He took ARUP’s employee health clinic and transformed it into a full-service medical home, untethered from fee-for-service reimbursement. Not only is the clinic enormously popular with ARUP’s workforce and their families, but it also reduces ARUP’s overall healthcare costs.
An Interview with ARUP's Supply Chain Management Team: How the COVID-19 Pandemic Has Upended Laboratory Purchasing
Supply shortages, from collection kits to reagents to personal protective equipment, have been a major bottleneck for COVID-19 testing. Join the ARUP supply chain management team and me as we take you behind the scenes of clinical laboratory supply sourcing. Michael Bevan and his team describe how purchasing processes and vendor-supplier relationships have dramatically changed in the era of COVID-19, and tell you why those processes and relationships may never be the same again.
An Interview with Dr. David Grenache: Lab-Developed vs FDA-Regulated Tests — Separating Fact from Fiction
A lot of misinformation has been propagated about the FDA’s role in regulating laboratory tests. Some have advocated for FDA regulation of all lab-developed tests as “medical devices,” which could be a death knell for many of these tests and put a stranglehold on the laboratory's ability to respond to certain patient care needs. In this conversation with Dr. David Grenache, chief scientific officer for TriCore Reference Laboratories, he discusses why laboratory-developed tests play an important clinical role, how they’re currently regulated, and how to best modernize those regulations.
An Interview with Dr. Julio Delgado: Personal Insights on Leading a Laboratory During a Pandemic
Crises such as COVID-19 have a way of compressing a lifetime of leadership preparation into a single intense performance. Dr. Julio Delgado has worked as a primary care physician, immunology researcher, laboratory director, and chief medical officer of ARUP Laboratories. In this discussion he explains how his philosophy of leadership, which is based on valuing and connecting with individuals, has been tested in the context of the COVID-19 pandemic.
An Interview with Dr. Tracy Frech: Patient- and Science-Centered Support for Patients with Autoimmune Disease during the COVID-19 Pandemic
Image used with permission
Patients with autoimmune disease have faced some distinct challenges during the COVID-19 pandemic. These challenges include tough decisions about whether to stop their immunosuppressant therapy and difficulties refilling their regular prescriptions for hydroxychloroquine. Dr. Tracy Frech, director of the Systemic Sclerosis clinic at the University of Utah, describes how she's supporting her patients during this difficult time. She also describes her research collaboration with clinical laboratorians and other academic colleagues to find answers to key questions that are important for this patient population.
An Interview with Dr. David Hillyard: Delving into the Sensitivity of SARS-CoV-2 Diagnostic Testing
How much do we really know about the sensitivity of COVID-19 molecular tests? And how much sensitivity can be safely sacrificed in favor of assay speed or the ease of collecting a particular specimen type? David Hillyard has decades of experience developing and studying molecular tests for viruses, including HIV, hepatitis B, and hepatitis C. His lab was one of the first in the U.S. to develop and validate a high-throughput assay for SARS-CoV-2. In our conversation he explains the key factors that impact the accuracy of these tests, what we know so far, and what we still have to learn.
An Interview with Pam Banning: Laying the Groundwork for Data-Driven Health Care
Most healthcare professionals are frustrated by the lagging progress of health IT. In an era when Google and Facebook seem to know every detail of our lives, why can’t health IT do a better job of predicting the information needs of patients and clinicians? Or even modify their data displays based on clinical context? One reason is the nonstandardized nature of most healthcare data. Pam Banning has spent her career making health data more usable through standardized terminologies such as LOINC and SNOMED. In this conversation she describes how far we’ve come using semantic interoperability over the past 25 years, and why we still have a very long way to go.
An Interview with Drs. Kristi Smock and Karen Moser: Making Sense of Thrombotic Complications in COVID-19
Thrombosis has turned out to be one of the major subplots of the COVID-19 clinical story. In this conversation, two experts in hemostasis and thrombosis explain how academic physicians and scientists have been studying the coagulation defects seen in critically ill patients with COVID-19 in order to more effectively monitor patients and prevent complications.
An Interview with Dr. Robert Schlaberg: How Unbiased Sequencing Technology Is Improving Infectious Disease Diagnostics, from Routine Clinical Care to New Pandemics
The SARS-CoV-2 virus was first identified and sequenced using a technique known as “unbiased sequencing.” During this conversation, Robert Schlaberg, MD, Dr Med, MPH, takes us inside this technology, helps us understand how it works, and describes how it can significantly improve infectious disease diagnosis. He also explores how scaling up this technology will catalyze a quicker diagnostic response to future pandemics.
An Interview with Dr. Marc Couturier: Improving Collaboration Between Clinical and Public Health Labs
Dr. Marc Couturier has experienced a number of pandemics during his career as a microbiologist, from West Nile virus to Zika virus to SARS-CoV-2 (COVID-19). And he knows what it’s like to work in both a commercial clinical lab and a public health lab. In this conversation, he describes how lab professionals from both these settings have been working in recent years to improve pandemic preparedness and response.
An Interview with Sam Marsden: A Peek Behind the Curtain of Data Reporting for COVID-19 and Other Public Health Events
How do clinical laboratories report data to public health agencies, and what do those agencies do with the data? In this conversation Sam Marsden describes his experiences working in both the public health and clinical diagnostic arenas. He also dives into the critical role of public health agencies in gathering, analyzing, and applying data to improve the health of communities.
An Interview with Dr. Tracy George: How an Academic Clinical Laboratory Has Become a Collaboration Hub to Accelerate COVID-19 Scientific Discovery.
To manage and ultimately conquer COVID-19, the public is placing its hopes on rapid scientific discovery. What does it take to make this happen? Dr. Tracy George, executive director of clinical trials and PharmaDx at ARUP Laboratories, describes how her group is coordinating efforts across multiple outside research groups to facilitate faster and larger trials to answer important questions about COVID-19 therapy.
An Interview with Drs. Patricia Slev and Jenna Rychert: Antibody Testing for COVID-19
Antibody testing (serology) for COVID-19 has been eagerly awaited by the medical community and more broadly by our country's political and business leaders as we chart a path forward to ease physical distancing and the strain on our economy. Drs. Slev and Rychert have validated assays and platforms here at ARUP Laboratories. In this interview, they explain what clinicians need to know about COVID-19 serology, the inherent limitations of these tests, and the research data that's still to come.
An Interview with Dr. Hardeep Singh: Focusing on the Fundamentals Prevents Diagnostic Errors
Dr. Hardeep Singh is a general internist and authority on the various causes of diagnostic error. He argues that most diagnostic errors aren’t due to failures of complex reasoning, but rather failures of the routine processes we take for granted such as communication and followup of test results. His research focuses on improving organizational systems and processes, including those involving health information technology.
An Interview with Dr. Mark Graber (Part II): Preventing Diagnostic Errors
In this second segment, Dr. Mark Graber focuses on post-analytic errors and the need for more pathologist-clinician and pathologist-patient communications. He also emphasizes the importance of inviting patients to participate in medical societies and conferences. Finally, Graber delves into the 2015 Institute of Medicine (now National Academy of Medicine) Report, “Diagnostic Error in Health Care,” and its key messages for the laboratory community.
An Interview with Dr. Mark Graber (Part I): Preventing Diagnostic Errors
During Mark Graber’s academic nephrology career, he became interested in bringing diagnostic error out of the healthcare shadows. Diagnostic errors occur more frequently than either surgical errors or medication errors, but they’ve received less attention from the patient safety community. In this initial interview, he shares personal experiences encountering diagnostic errors in clinical practice. We also discuss the central role of laboratories in addressing these problems, including where labs struggle and where the opportunities lie.
An Interview with Elissa Passiment: The History and Future of Medical Laboratory Scientists
When Elissa Passiment studied medical laboratory science decades ago, she believed physicians would appreciate her advice on testing strategies. This didn’t always turn out to be true. Yet, she never backed down from her conviction that lab professionals should play a much larger clinical role than simply performing tests. In our interview, this former executive VP of the American Society of Clinical Laboratory Science discusses the history of clinical labs and medical lab scientists, and why she is optimistic about the profession’s future.
An Interview with Dr. Ila Singh: The TRUU-Lab Initiative to Improve Laboratory Test Names
Dr. Ila Singh, director of clinical laboratories at Texas Children’s Hospital, recently launched a collaboration with a broad set of clinical, IT and pathology stakeholders to improve the clarity of laboratory test names. She discusses why it is so challenging to create clear and helpful test names for physicians, given all of the informational goals and IT constraints. She also explains the importance of professional and geographic inclusivity for this project.
An Interview with Dr. Ronald Weiss: Ethics-Centered Leadership within the Healthcare Industry
Ron Weiss, MD, MS, MBA, served as president and COO of ARUP Laboratories in the early 2000s. He was one of the principle authors of ARUP’s “Five Pillars” statement of ethical principles. He pulls from his experiences growing up with a family business to explain how ARUP’s early success required both business acumen and patient-centered values. Weiss also discusses why he’s optimistic about the future of U.S. healthcare.
An Interview with Dr. Ana Stankovic: Practicing Laboratory Science in the IVD Industry
Ana Stankovic recently retired as senior VP of Worldwide Medical Affairs at BD, one of the best-known in vitro diagnostic companies. Prior to her employment at BD, she worked as a basic science researcher, blood banker, reference lab clinical pathologist, and public health officer. In this interview, Dr. Stankovic describes what science looks like from the inside of the IVD industry, specifically how the selection process and character of projects differ from those of academic labs while scientific norms and patient-centered goals remain the same.
An Interview with Dr. Elaine Lyon: How Genetic Testing is Different
Few people understand clinical genetic testing—from biology to technology to ethics to regulatory issues—better than Dr. Elaine Lyon. Over her long academic and clinical career, she has made many important contributions to the development, use, and interpretation of genetic tests. In this conversation, Dr. Lyon discusses what makes genetic testing different from other areas of laboratory medicine, and what she sees as the greatest challenges in the regulatory, ethical, and clinical landscapes. Originally published February 28, 2019.
An Interview with Dr. Mike Laposata: Overcoming Barriers as A Diagnostic Management Team
In the 1990s, Dr. Mike Laposata created the world's first Diagnostic Management Team (DMT) at Massachusetts General Hospital, in order to better care for patients with coagulation disorders. In this interview, he discusses the distressing and all too common issue of diagnostic errors, and how a collaborative, team-based approach can make a vital difference. Laposata also addresses the systemic barriers to team-based diagnosis such as the lack of insurance reimbursement, and suggests ways to surmount these barriers and scale up DMTs.
An Interview with Dr. Rita Horvath: Applying Evidence-Based Medicine to the Laboratory
The Evidence-Based Medicine (EBM) Movement gained traction in the mid-1990s, spurring a paradigm shift in how we view the relationship between science and clinical care. While EBM was percolating, clinical pathologist Rita Horvath was beginning her medical career at the University of Oxford—a hotbed for EBM thinking. Since then, she has become a thought leader in how to apply EBM principles to laboratory medicine.
An Interview with Dr. Harry Hill: Blending Academics, Medicine, and the Business of Clinical Laboratories
Curiosity, grit, and persistence over the course of many decades allowed Dr. Harry Hill to master many roles: pediatrician, immunodeficiency expert, laboratory director, NIH-funded researcher, business leader, and mountain climber. In this interview, he discusses the critical role of diagnostic test development in caring for patients with immunodeficiency syndromes. Dr. Hill also talks about the challenges and successes of blending an academic model within a commercial laboratory operation in co-founding ARUP, and then later developing the ARUP Institute for Clinical & Experimental Pathology®.
An Interview with Dr. Carl Wittwer: The Truth, Not the Myth, of Inventing
Dr. Carl Wittwer, inventor of the LightCyclerTM, is a well-recognized name in clinical laboratory diagnostics. In this interview, he describes what drove him to push the limits of PCR beyond the biotechnology industry of its time. His own invention story reflects what Thomas Edison once said about this process: It’s 1 percent inspiration, 99 percent perspiration. Dr. Wittwer shares his vision of how environment, people, and organizational policies all contribute to fostering entrepreneurial innovation.
Originally published November 1, 2018.
An Interview with Khosrow Shotorbani: Moving Clinical Laboratories Beyond Simply Performing Tests
Long-time lab industry executive Khosrow Shotorbani asserts that laboratories should be actively engaged in population-health management. He says impacting health outcomes is what matters (e.g., shorter hospital stays, reduced emergency room visits, fewer complications) and not just the efficient delivery of test results. To promote these ideas, under the title of “Lab 2.0,” Shotorbani teamed up with some of the most forward-thinking laboratory leaders in the largest health systems.
An Interview with Dr. Michael Astion: Serial Academic Entrepreneur
We traditionally associate universities with teaching and research. But what about business innovation? Mike Astion, a pathologist and professor of laboratory medicine at the University of Washington and Seattle Children’s Hospital, shares his experiences in launching and growing three different businesses over the course of his career and describes some of the unique challenges and opportunities he faced in his academic settings. He also explains the importance of hustle and negotiation for would-be entrepreneurs.
An Interview with Dr. Carl Kjeldsberg (Part II): Scaling ARUP into a Mature Company
Part II: The CEO years. In this segment, Dr. Carl Kjeldsberg, professor emeritus of pathology at the University of Utah, discusses his tenure as both CEO of ARUP Laboratories and department chair of Pathology at the University of Utah.
An Interview with Dr. Carl Kjeldsberg (Part I): Founding and the Early Shaping of ARUP
Part I: Early career influences. How did a Norwegian department store scion go from world class skier to academic hematopathologist to co-founder and CEO of what would become one of the largest commercial reference laboratories?
An Interview with Dr. Andrew Fletcher: His Career Path and Expanding the Role of Pathologists
What role will pathologists play in the healthcare systems of the future, and what skills will those pathologists need? Andrew Fletcher, a pathologist with ARUP Laboratories, describes his own varied career. And addresses cultural divides, inter-professional communication, and that the unique contributions that laboratories and pathologists can bring to value-based healthcare.