What does the future hold for laboratory medicine? A new perspective piece in Clinica Chimica Acta features four insightful laboratorians—Larry J. Kricka, Tracey G. Polsky, Jason Y. Park, and Paolo Fortina—giving their take on what lies ahead.
The authors first look at past predictions of how labs of the future would look and then make their own prognostications. For example, concern about staffing shortages are likely to continue in laboratories, the authors write, and declining lab reimbursement will force labs to take more cost-cutting measures, “which may include a major role for test triage by laboratory professionals,” the article states. “But over ordering of tests and inappropriate test requests will be difficult to control and enforce in the absence of penalties for offenders.”
Also, due to increased access to international medical care, some experts have proposed outsourcing laboratory services to countries with equally sophisticated laboratories but with lower costs. “In addition to outsourcing and globalization of laboratory testing, there has been an increased migration of testing to the point-of-care. This transition may decrease reliance on hospital laboratories and reduce test volumes in hospital or regional laboratories,” according to the authors.
Giving consumers access to a greater number of home tests may also further decrease how often they visit laboratories in person. “Although it’s possible that empowering consumers via deregulation of direct-to-consumer testing may increase overall test volumes, predicting the consumer response to a large menu of newly accessible diagnostic tests remains difficult at this time,” observe Kricka et al.
Many other factors weigh into what the future could look like for laboratory medicine, including how computers, memory capacity, wearable devices, networking portability, and the Internet affect costs. Neither lab-on-a-chip devices nor nanotechnology have had quite the punch they were predicted in the past to have, but the authors suggest that prospects for both look promising in the long term.
Meanwhile, there appears to be an unstoppable wave in favor of point-of-care testing (POCT), integration of POCT into patient management strategies and care pathways, as well as home-based testing.
An area that perhaps does not have as bright a future is pharmacogenomics. “Poor adoption, even in the context of clinical benefit, suggests that unless there are external pressures, this type of testing will not increase,” they explained. “However, the implementation of personal credit card-sized pharmacogenomic profile cards illustrates one way in which pharmacogenomics could evolve in the future.”
While the authors conclude that their own predictions might not be any more accurate than past predictions in the field that ultimately did not pan out, they emphasize that looking into the future still is an important part of the forward planning process.