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We believe the switch to a digital pathology (DP) workflow is imminent and it is essential to understand the economic implications of conversion. Many aspects of the adoption of DP will be disruptive and have a direct financial impact, both in short term costs, such as investment in equipment and personnel, and long term revenue potential, such as improved productivity and novel tests. The focus of this whitepaper is to educate pathologists, laboratorians and other stakeholders about the business and monetary considerations of converting to a digital pathology workflow. The components of a DP business plan will be thoroughly summarized, and guidance will be provided on how to build a case for adoption and implementation as well as a roadmap for transitioning from an analog to a digital pathology workflow in various laboratory settings. It is important to clarify that this publication is not intended to list prices although some financials will be mentioned as examples. The authors encourage readers who are evaluating conversion to a DP workflow to use this paper as a foundational guide for conducting a thorough and complete assessment while incorporating in current market pricing. Contributors to this paper analyzed peer-reviewed literature and data collected from various institutions, some of which are mentioned. Digital pathology will change the way we practice through facilitating patient access to expert pathology services and enabling image analysis tools and assays to aid in diagnosis, prognosis, risk stratification and therapeutic selection. Together, they will result in the delivery of valuable information from which to make better decisions and improve the health of patients. [ABSTRACT FROM AUTHOR]

We believe the switch to a digital pathology (DP) workflow is imminent and it is essential to understand the economic implications of conversion. Many aspects of the adoption of DP will be disruptive and have a direct financial impact, both in short term costs, such as investment in equipment and personnel, and long term revenue potential, such as improved productivity and novel tests. The focus of this whitepaper is to educate pathologists, laboratorians and other stakeholders about the business and monetary considerations of converting to a digital pathology workflow. The components of a DP business plan will be thoroughly summarized, and guidance will be provided on how to build a case for adoption and implementation as well as a roadmap for transitioning from an analog to a digital pathology workflow in various laboratory settings. It is important to clarify that this publication is not intended to list prices although some financials will be mentioned as examples. The authors encourage readers who are evaluating conversion to a DP workflow to use this paper as a foundational guide for conducting a thorough and complete assessment while incorporating in current market pricing. Contributors to this paper analyzed peer-reviewed literature and data collected from various institutions, some of which are mentioned. Digital pathology will change the way we practice through facilitating patient access to expert pathology services and enabling image analysis tools and assays to aid in diagnosis, prognosis, risk stratification and therapeutic selection. Together, they will result in the delivery of valuable information from which to make better decisions and improve the health of patients. [ABSTRACT FROM AUTHOR]

Mitochondrial DNA (mtDNA) damage is closely associated with typical diseases of aging, such as Alzheimer's or Parkinson's disease, and other health conditions, such as infertility. This damage manifests in reduced mitochondrial copy number and deletion mutations in mtDNA. Consequently, the analysis of mitochondrial damage by determining the parameters copy number and deletion ratio using quantitative real-time PCR (qPCR) is of interest for clinical diagnostics. To bring the findings from research into laboratory practice, a suitable and reliable process is needed, which must be thoroughly validated. This process includes the software used for the analysis, which must meet extensive regulatory and process requirements. Existing software does not adequately implement the requirements of laboratories and, in particular, does not provide direct support for the calculation of the aforementioned mtDNA parameters. The paper discusses the development of a new software-based analysis workflow that is designed specifically for laboratories to help with the calculation of mtDNA parameters. The software was developed using the User-Centered Design method and is based on the recently introduced prototype, "PlateFlow". Initial user tests provide positive feedback. In the future, this workflow could form the basis for validations of mitochondrial tests in medical laboratories. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare centers (PHC) ensure that patients receive comprehensive care from promotion and prevention to treatment, rehabilitation, and palliative care in a familiar environment. It is designed to provide first-contact, continuous, comprehensive, and coordinated patient care that will help achieve equity in the specialty healthcare system. The healthcare in Saudi Arabia is undergoing transformation to Accountable Care Organizations (ACO) model. In order for the Kingdom of Saudi Arabia (KSA) to achieve its transformational goals in healthcare, the improvement of PHCs' quality and utilization is crucial. An integral part of this service is the laboratory services. Methods: This paper presents a pilot model for the laboratory services of PHC's in urban cities. The method was based on the FOCUS-PDCA quality improvement method focusing on the pre-analytical phase of the laboratory testing as well as the Saudi Central Board for Accreditation of Healthcare Institutes (CBAHI) gap analysis and readiness within the ten piloted primary healthcare centers. Results: The Gap analysis, revealed in-consistency in the practice, lead to lower the quality of the service, which was seen in the low performance of the chosen key performance indicators (KPI's) (high rejection rates, lower turn-around times (TAT) for test results) and also in the competency of the staff. Following executing the interventions, and by using some of the ACO Laboratory strategies; the KPI rates were improved, and our results exceeded the targets that we have set to reach during the first year. Also introducing the electronic connectivity improved the TAT KPI and made many of the processes leaner. Conclusions: Our results revealed that the centralization of PHC's laboratory service to an accredited reference laboratory and implementing the national accreditation standards improved the testing process and lowered the cost, for the mass majority of the routine laboratory testing. Moreover, the model shed the light on how crucial the pre-analytical phase for laboratory quality improvement process, its effect on cost reduction, and the importance of staff competency and utilization. [ABSTRACT FROM AUTHOR]

Ethics guide in difficult situations to make the distinction between right and wrong. Professional ethics ought to be given priority in laboratory medicine. Laboratory results deeply impact the decisions of the physician and the well-being of the patient. Hence, the ethical dilemmas in the laboratory have to be addressed to achieve better care for the patient. Ethics encompasses all the three phases - pre analytical, analytical and post analytical of the total testing cycle. Practical implementation of ethical codes is always a challenge. In this paper we aim to decode the various ethical considerations that need to be addressed during the total testing cycle while working in a resource constrained settings and the ethical conundrums during a public health crisis. [ABSTRACT FROM AUTHOR]

In today's environment, many laboratories are challenged to maintain or increase their quality while simultaneously lowering their overall costs. The objective of this research is to use the Cost of Quality (COQ) model to estimate the Cost of Quality-related activities at Clinical Laboratory located in Morocco. Using data collected during six month, we allocated the direct costs associated with quality-related activities in the laboratory across COQ's cost categories: prevention, appraisal, internal failures, and external failures. We found that approximately 83% of total cost of quality was spent on costs of "good quality" (prevention and appraisal), while 17% was spent on costs of "poor quality" (internal and external failures). The high percentage of cost of quality spent on prevention and appraisal activities is consistent with efforts to ensure high quality laboratory results. The paper introduces the COQ model and illustrates how it can be applied to a clinical laboratory setting. We begin with an overview of the COQ concept and its four main cost categories, followed by an illustration of how the model can be applied. We then discuss some of advantages of this methodology. [ABSTRACT FROM AUTHOR]

Background: Strong laboratory capacity is essential for detecting and responding to emerging and re-emerging global health threats. We conducted a quantitative laboratory assessment during 2014-2015 in two resource-limited provinces in southern China, Guangxi and Guizhou in order to guide strategies for strengthening core capacities as required by the International Health Regulations (IHR 2005).Methods: We selected 28 public health and clinical laboratories from the provincial, prefecture and county levels through a quasi-random sampling approach. The 11-module World Health Organization (WHO) laboratory assessment tool was adapted to the local context in China. At each laboratory, modules were scored 0-100% through a combination of paper surveys, in-person interviews, and visual inspections. We defined module scores as strong (> = 85%), good (70-84%), weak (50-69%), and very weak (< 50%). We estimated overall capacity and compared module scores across the provincial, prefecture, and county levels.Results: Overall, laboratories in both provinces received strong or good scores for 10 of the 11 modules. These findings were primarily driven by strong and good scores from the two provincial level laboratories; prefecture and county laboratories were strong or good for only 8 and 6 modules, respectively. County laboratories received weak scores in 4 modules. The module, 'Public Health Functions' (e.g., surveillance and reporting practices) lagged far behind all other modules (mean score = 46%) across all three administrative levels. Findings across the two provinces were similar.Conclusions: Laboratories in Guangxi and Guizhou are generally performing well in laboratory capacity as required by IHR. However, we recommend targeted interventions particularly for county-level laboratories, where we identified a number of gaps. Given the importance of surveillance and reporting, addressing gaps in public health functions is likely to have the greatest positive impact for IHR requirements. The quantitative WHO laboratory assessment tool was useful in identifying both comparative strengths and weaknesses. However, prior to future assessments, the tool may need to be aligned with the new WHO IHR monitoring and evaluation framework. [ABSTRACT FROM AUTHOR]