by Dennis Ernst • April 05, 2018
It's not often I get a behind-the-scenes tour of a laboratory that processes more than 165,000 laboratory specimens per day. In fact, I would say never... until last month. By special invitation from Dr. Dorothy Adcock, LabCorp's Chief Medical Officer, I received a VIP tour of the company's main laboratory in Burlington, North Carolina, the largest laboratory in their system and one of the largest clinical testing laboratories in the world. It was massive, mind-boggling, and a marvel of automation and robotics. But that's not what impressed me the most.
As an organization, LabCorp processes over 500,000 specimens per day at its nationwide network of primary, specialty and STAT laboratories. It's fleet of 3000 couriers log 435,000 miles/day, making 75,000 stops to pick up samples at 1800+ locations. Besides the U.S. Postal Service, I don't know too many companies that have to move so many pieces so far so fast. The USPS may process more pieces of mail, but they merely deliver one way. LabCorp not only receives samples from around North America, but then tests them and sends back the results to the appropriate provider, usually within 24 hours of collection. But that's not what impressed me the most, either.
On the front end, LabCorp has perfected the preanalytic process as much as automation and software allows without robots replacing its staff of 13,000 phlebotomists who currently draw 2.5 million samples per month. Robotics may have made substantial inroads into the laboratory industry, but neither you nor I will see robots performing venipunctures in a clinical setting in our generations. The key to LabCorp's preanalytical standardization is a dynamic software application they refer to as "Touch," which is deployed at nearly 2000 of LabCorp's Patient Service Centers (PSCs) and over 5000 office-based phlebotomy locations.
From the moment a patient scans his/her ID, Touch takes over, directing every action and activity like the conductor of a symphony. If that conductor has a name, it's Kevin DeAngelo, VP of Corporate Operations and logistics guru. With the help of his team, DeAngelo designed, developed, tweaked and maintains Touch to coordinate the steps of every draw and standardize every patient's experience. Touch prompts the phlebotomist to scan the patient's ID and labels, ask the patient to confirm his/her ID, what tubes to draw, how many times to invert them and when, scan the labeled tubes, what rack to place them in and more. No stone was unturned to standardize the collection process and make it intuitive for all users. Although the phlebotomist still has to select the best vein, choose the most appropriate device combination, manage post-venipuncture care, etc., all according to the standards, Touch eliminates many error points. For all the streamlining it brings into the preanalytic process, Touch is still not what impressed me the most.
I don't know about you, but my impression of big-box labs has always been that of massive operations that turn massive numbers of blood samples into massive quantities of data, the scale of which could not possibly avoid disproportionately compromised quality. I now know that not to be true, at least at LabCorp.
It's not the automation I saw at their largest lab, nor the size of their North American operation, nor the Touch software that changed my impression. It's the people making it all work.
I've been in board rooms before with top-level executives. When it comes to passion, I'm not easily fooled. It has a certain countenance, a feel, a tenor that can be neither suppressed nor feigned. Those I met in Burlington were some of the organization's biggest movers and shakers. Though their responsibilities are substantial and ever-pressing, we talked about sample quality well into the night. They sweat it, and their concern seems engineered into their logistics, operations, and software.
For the record, this is an unsolicited testimonial from which I neither require nor expect any gain. You've known me long enough to know I don't work that way. From where I sit, I see a lot of dysfunctionality, which I keep to myself. But when a person, company, or organization impresses me, I'm compelled to bring it to your attention. Not as an endorsement, but so that you might have hope. There is a lot to be concerned with about the laboratory professions and industry, i.e., the diminishing of our expertise, oppressive government regulations, the dearth of qualified applicants, and more. I'm here to attest to you that, in many regards, the glass is not half empty, but half-full and rising.
Dennis J. Ernst MT(ASCP), NCPT(NCCT)
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