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Proceedings of the 24th Arnold O. Beckman Conference |
1 University of Louisville, Department of Pathology and Laboratory Medicine, 530 S. Jackson St., C1R06, Louisville, KY 40202. Fax 502-852-1771; e-mail rjelin01{at}gwise.louisville.edu.
The Beckman Conference began in 1977 with the mission of providing a forum to educate and discuss issues of importance between clinical laboratory professionals and clinicians. This mission was embodied in the topic of the first Beckman Conference: "The Clinician and the Chemist". This year, the Twenty-Fourth Arnold O. Beckman Conference was held on February 11–12, 2001, in Newport Beach, CA. During the past 24 years, great change has occurred in laboratory medicine. Thus, the Arnold O. Beckman Conference Committee revisited the theme of the initial Beckman Conference, choosing the title of "The Clinician and Laboratorian: Dynamic Transitions". The goal was to present a spectrum of information to enable laboratorians to adapt proactively to the changing expectations of clinicians, insurers, and society.
Acknowledgement and Opening of the Arnold O. Beckman Conference
Larry J. Kricka, AACC President, opened the Conference. He stated, "We are grateful to Dr. Beckman for his generous endowment of this conference series. He said he hoped these annual conferences would help contribute to the professional growth of Clinical Chemistry and to the improvement of healthcare. We will hear from experts about preparing your laboratory for future changes, launching innovative testing protocols, delivering web-based laboratory information, implementing outcome analysis, and promoting the laboratory’s role in clinical decision-making and improvement of patient care management". As a condition of the gift from the Arnold and Mabel Beckman Foundation, AACC disseminates the conference proceedings by publishing them in Clinical Chemistry.
After President Kricka’s introductory remarks, I briefly reviewed the history of Arnold Beckman and the Conference. Additional information is available on the web (1) and in this Journal (2)(3).
2001 Conference Summary
The Conference Committee selected this year’s topic after a needs assessment, including the results of a questionnaire sent to the membership. As I indicated, a similar topic was presented at the initial Beckman Conference in 1977 and in 1985 when the topic was "The Clinical Laboratory in the New Era". This year’s conference was divided into the following five sessions: Factors Influencing the Future of Laboratory Medicine, Societal Role of the Clinical Laboratory, Information Access and Quality Medicine, Outcomes and Assessment, and Tools for the Clinical Laboratorian. In addition to the formal presentations, there was a panel discussion at the end of each day composed of the speakers.
The keynote speaker for the first session was Robert M. Kisabeth (Mayo Medical Laboratories, Rochester, MN), who spoke on "Laboratory Adaptations—Changing Expectations and Growing Opportunities". He focused on present and future opportunities for involvement by the clinical laboratory in defining appropriate patient therapy and aligning the laboratory’s analytical objectives with clinical diagnostic and therapeutic objectives. His closing thought was, "A simple truth, once difficult in the face of collective fiction to acknowledge, will become increasingly self-evident: the commitment of a clinical laboratory’s professionals to the care of the sick will continue to distinguish those medical teams consistently effective in providing care from those condemned to go through the motions".
The session on the Societal Role of the Clinical Laboratory began with a presentation from Mark E. Sobel (National Cancer Institute, NIH, Bethesda, MD) entitled, "Ethical Issues in Laboratory Testing: The Paradigm of Genetic Testing". He reviewed the ethical principles involved in genetic testing and in human tissue research, federal guidelines and recommendations for such tests and research, types of tissue samples and risks involved, and possible future changes in current guidelines for protection of patients and human research subjects. Craig A. Lehmann completed this session by discussing, "Home Testing as an Extension of Point-of-Care Testing". He discussed changes in healthcare strategies for the home healthcare market, particularly those that relate to our aging population, and concluded with a discussion on new technologies in the home healthcare arena.
The third session began with a presentation by Mathew F. Emons (Louisville, KY) on the "Integration of Patient Data for Optimal Patient Management". He indicated a shift by managed care organizations from traditional utilization management to improvement of the health of an insured population by use of sophisticated data integration to identify at-risk individuals and track outcomes. He highlighted several challenges to the integration of laboratory data into medical databases and practice management software. Next, Raymond D. Aller (MDS Laboratory Services, Brentwood, TN) spoke on "Connectivity: Moving Data from the Source to Where It Is Needed". His talk focused on the components of connectivity with emphasis on logical observation identifier names and codes (LOINC) and the synchronization of data. The last speaker in this session was Bruce A. Friedman (University of Michigan, Ann Arbor, MI), who spoke on "The Clinical Laboratory Industry as E-Business: An Integrated and Strategic Vision of the Future". He described a new model called "The Total Lab Solution", which is a new organizational approach to the delivery of laboratory services whereby a laboratory meta-network provides the total range of laboratory testing and information management services to a hospital network. The day concluded with a panel discussion of all speakers entitled, "From the Clinician and Laboratorian to the Patient: A Paradigm Shift". That evening, Beckman Coulter, Inc. hosted a trip to the Beckman Coulter Heritage Center in Fullerton, CA.
The second day, Matthew J. McQueen (McMaster University, Ontario, Canada) opened the session on Outcomes and Assessment with a presentation entitled, "Overview of Evidence-Based Medicine". He defined evidence-based laboratory medicine, the problems with the current database, and what laboratorians need to do to produce appropriate evidence for the future integrity of evidence-based medicine. David E. Bruns (University of Virginia, Charlottesville, VA) spoke on "Outcomes in Health Care". After defining outcomes, he showed how they are applied to determine the value of laboratory testing and to identify the analytical quality that is required for medical needs. Karen L. Kaul (Evanston Hospital, Evanston, IL) spoke on "Impact of Outcomes on Patient Management". She used a specific example of the molecular detection of tuberculosis to show how this new technology had improved clinical care and produced significant savings in the overall cost of the care of the patient compared with conventional assays. The last speaker of the session was Angela M. Caliendo (Emory University, Atlanta, GA), who spoke on "Successful Testing Protocols in Virology". She discussed how molecular testing and protocols have led to the improvement of patient care in early detection of disease, improving overall disease management, and directing therapy with virology testing. For each point, she used specific examples from virology testing.
Joseph H. Keffer (University of Toronto, Toronto, Canada) opened the last session with a presentation entitled, " Guidelines and Algorithms". His presentation explored the numerous interrelated issues and concepts that impact the creation, implementation, dissemination, and assessment of guidelines and related algorithms and their consequences. This included medical quality and medical error, "advocacy" guidelines, compliance, and the impact on outcomes of patients in an evidence-based medical context. All of the speakers on the second day then participated in a panel discussion on "Eminence-Based Medicine to Evidence-Based Medicine: Another Paradigm Shift". The concluding speaker of the conference was Christopher S. Frings (Chris Frings and Associates, Birmingham, AL), who spoke on "Marketing Tools for the Laboratorian to Advance the Practice". He presented suggestions for developing proactive skills for becoming a change master, making presentations, enhancing our professional image, and effective networking.
I concluded the conference with some brief comments emphasizing the dynamic transitions we are experiencing in laboratory medicine. I reminded the audience of the following quote from one of the speakers: "If you are not part of the solution, you are part of the precipitate".
Acknowledgments
As the Chair of the 2001 Conference Committee, I am especially grateful for the generous contributions of time, ability, and knowledge of my fellow committee members: Domnita Crisan, Joseph H. Keffer, Michael Kleerekoper, and David L. Witte. This was truly a team effort. Their pleasant cooperation, dedication, and in-depth knowledge of clinical laboratory medicine significantly contributed to the success of this conference. Last but not least, a special thanks to Lisa Dunay, AACC Staff, for her outstanding support of the committee and for effectively handling the logistics for the meeting and the committee.
References
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