NOV 12, 2015 12:00 PM PST

Keynote: Optimizing the use of laboratory testing services to improve patient diagnosis

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  • Chairman of Pathology, University of Texas Medical Branch
      Dr. Michael Laposata is the Edward and Nancy Fody Professor of Pathology and Medicine at Vanderbilt University School of Medicine. He is the pathologist-in-chief at Vanderbilt University Hospital and director of clinical laboratories. He received his M.D. and Ph.D. from Johns Hopkins University School of Medicine and completed a postdoctoral research fellowship and residency in Laboratory Medicine (Clinical Pathology) at Washington University School of Medicine in St. Louis. He took his first faculty position at the University of Pennsylvania School of Medicine in Philadelphia in 1985, where he was an Assistant Professor and director of the hospital's coagulation laboratory. In 1989, he became Director of Clinical Laboratories at the Massachusetts General Hospital and was appointed to faculty in pathology at Harvard Medical School.

      His research program, with more than 160 peer reviewed publications, has focused on fatty acids and their metabolites. His research group is focused on the study of fatty acid alterations in cystic fibrosis.

      Dr. Laposata's clinical expertise is in the field of blood coagulation, with a special expertise in the diagnosis of hypercoagulable states.

      Dr. Laposata implemented a system whereby the clinical laboratory data in coagulation and other areas of laboratory medicine are systematically interpreted with the generation of a patient specific narrative paragraph by a physician with expertise in the area. This service is essentially identical to the service provided by physicians in radiology and anatomic pathology, except that it involves clinical laboratory test results. In 2005, Dr. Laposata was recognized by the Institute of Quality in Laboratory Medicine of the Centers for Disease Control and Prevention for this innovation.

      Dr. Laposata is the recipient of 14 major teaching prizes at Harvard, the Massachusetts General Hospital, and the University of Pennsylvania School of Medicine. His recognitions include the 1989 Lindback award, a teaching prize with competition across the entire University of Pennsylvania system; the 1998 A. Clifford Barger mentorship award from Harvard Medical School; election to the Harvard Academy of Scholars in 2002, and to the Vanderbilt University School of Medicine Academy for Excellence in Teaching in 2009; and the highest award - by vote of the graduating class - for teaching in years 1 and 2 at Harvard Medical School in 1999, 2000, and 2005.
    • Project Lead for Clinical Laboratory Integration into Healthcare Collaborative CLIHC, Division of Laboratory Science and StandardsLSPPPO, Centers for Disease Control and Prevention (CDC)
        Julie received her B.S. degree in microbiology from the University of Alabama focusing on research in bacterial genetics then completed her M. S. and Ph.D. in microbiology at Auburn University where she studied immunity to bacteria and parasites. She gained experience in virology during a postdoctoral program at Emory University School of Medicine.

        Throughout her years of working in the private sector in laboratory and clinical research settings, Julie has identified, developed and completed programs addressing unmet needs in health care. Her accomplishments include patents and FDA- or USDA- licensed medical devices, vaccines, and diagnostics. She has developed both commercial and research diagnostics for detecting antigens, antibodies and cellular immunity.

        Julie's research experience includes the areas of virology, immunology, parasitology, mycology, genetics and oncology. She has worked nationally and internationally with professionals from hospitals, long term and home care institutions, academic institutions, medical device and pharmaceutical industries, State Public Health Departments, the World Health Organization, and the International Organization of Standards. She has also served as a reviewer for health care journals. These professional partnerships have resulted in journal publications, healthcare standards, and training programs.

        Julie is currently the Project Lead for the Clinical Laboratory Integration into Health Care Collaboration (CLIHC)TM from the Division of Laboratory Programs, Standards, and Services at the Centers for Disease Control and Prevention (CDC). She coordinates programs to improve laboratory quality by enhancing the capacity, infrastructure, and capabilities of laboratories worldwide.


      Diagnostic error impacts millions of US adults and children every year1,2.  Failure to order an appropriate diagnostic test and incorrect interpretation of diagnostic test results are common breakdowns in the diagnostic process3.  The Clinical Laboratory Integration into Healthcare Collaborative (CLIHC) TM, supported by the Division of Laboratory Systems at CDC, is addressing diagnostic error using several approaches.  The session will provide information on the frequency of the errors and the impact on patient outcomes.   Participants will learn about causes of diagnostic errors and strategies for reducing them.  Participants will also learn about CLIHCTM initiatives to identify gaps that exist in laboratory medicine training in medical schools and approaches being developed to promote appropriate test utilization, such as the use of test algorithms and mobile applications for test selection.    

      Learning Objectives:
      1)    Describe the frequency of diagnostic errors and the impact on patient outcomes
      2)    Discuss healthcare system failures that may contribute to diagnostic errors 
      3)    Identify at least three ways to reduce diagnostic errors 


      1. IOM. Improving Diagnosis in Health Care. Institute of Medicine, 2015.
      2. Singh, H, Meyer, A., Thomas, E,. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf, 0: 1 – 5, 2014
      3. Strategies, C. Malpractice risks in the diagnostic process. 2014

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