The Forgotten Role of Medical Technologists in Public Health

1
The Forgotten Role of Medical Technologists in
Public Health

• LT Camille Mitchell, MPH, MT (ASCP)
• LT Andrea Peay, MPH,CPH, MT(ASCP), CLS(NCA)

2
Medical Technology

• During the last 20 years the medical profession
  has placed an emphasis on preventive and public
  health.
• Medical professionals had to adjust to
  accommodate these objectives.
• Recruitment of fresh new minds to incorporate the
  new with the old.
• Training of current staff
• Changed the way medicine was viewed

3
Medical TechnologyFailure to evolve?

• Emphasis was continually placed on the clinical
  setting without linking clinical to public
  health.
• Lack of clear unity (National Credentialing
  Agency, American Society of Clinical Pathology,
  American Medical Technologist) caused problems.
• This placed the profession behind from embracing
  other avenues.

4
Clinical Laboratory ScientistWhat is that?

• Medical technologists have more than one title,
  Clinical Laboratory Scientist (CLS)
• - which has led to more confusion and
  separation.
• Although recent trends ( i.e. the future merging
  of ASCP and NCA) have encouraged the use of one
  name.

5
Medical Technology An Endangered ProfessionWhy?

• The last twenty five years has led to over 249
  schools (technologist technician) closing.
• Fewer students deciding to pursue medical
  technology.
• Current schools can only accept a small number of
  students a year.
• The majority of the current workforce is composed
  of baby boomers.
• http//www.ascp.org/MainMenu/AboutASCP/Newsroom/Ne
  wsReleases/ASCP-Wage-and-Vacancy-Report.aspx

6
Medical Technology An Endangered ProfessionWhy?

• More graduates leaving the profession
• Steadily increasing vacancy rate
• Proper medical technology training is composed of
  formal school, onsite training, and mentoring
  from experienced clinical laboratory scientists.
• Advertised jobs that do not recognize
  specialties.

7
Laboratory Staff ShortagesMedical Crisis!

• It is believed that the staff shortfall will be
  enormous by 2012.
• The number of properly trained CLS needed to
  replace exiting professionals will be in the
  100,000s.
• While the number of available trained CLS will be
  around 50,000.
• Will healthcare be able to respond to rising
  concerns like the swine flu?
• http//online.wsj.com/article/SB124217357954413095
  .html

8
Mean Number of Total Available Budgeted
Positions and Mean Vacancy Rates By Level of
Certification and Responsibility    
MT Positions

MLT Positions
    Table adapted from ASCP Wage and Vacancy
Survey of US Medical Laboratories, LABMEDICINE,
Volume 40 Number 3, March 2009, Table 6 page
138.  
9
Dual Role

• Medical technology has a dual role in clinical
  and public health settings.
• Abides by the ten essential functions of public
  health while maintaining it traditional roots.

10
Purpose

• This presentation is meant to highlight the role
  Medical Technology has contributed to the public
  health mission.
• This role needs to be recognized to change public
  perception.

11
Objectives

• 1)Identify the role of medical technology in
  public health.
• 2)Discuss at least three responsibilities of
  medical technologists.
• 3)List two disciplines of medical technology.

12
Disciplines

• There are four major disciplines in Medical
  Laboratory Technology
• Immunology
• Microbiology
• Hematology
• Chemistry
• An MTs curriculum consists of a variety of
  courses relating to these disciplines.
• http//www.ascls.org/jobs/whatiscls.asp

13
Additional Courses

• Some schools require additional courses in
• Genetics/Molecular Biology
• Statistics
• Anatomy
• Computer Science
• This well-versed training allows MTs to perform
  in a variety of conventional and unconventional
  positions.

14
Conventional Positions

• Staff Technologist
• Clinical Laboratory Specialist- stem cell and
  bone marrow labs, molecular testing.
• Section Supervisor
• Administrative Technologist
• Instructor
• Sales Representative
• Accreditation Team Member

15
Unconventional Positions

• State Public Health Laboratory Personnel
• Local, State and Federal Crime Laboratory
  Personnel
• Infection Control Coordinator
• Research Associate
• Laboratory Information Computer Analyst
• 
  (The
  University of Southern Mississippi USM, 2009)

16
The Public Health Roleof Medical Technologists

• Emergency Response and Preparedness
• Infectious Disease
• Environmental Health
• Food and Drug Safety

17
Emergency Response and Preparedness

• Clinical Laboratory Scientists working with
  chemists and biologists are important resources
  in emergency preparedness and response.

18
Emergency Response and Preparedness

• CLSs are involved in emergency response in many
  aspects. Two of these responses are with the
• Centers for Disease Control and Preventions
  Laboratory Response Network
• Mobile Laboratories

19
Laboratory Response Network

• The LRN is a national network of laboratories
  that are capable of responding to biological
  threats, chemical threats and other public health
  emergencies.
• It is composed of two divisions
• Biological and Chemical

20
Biological Divison

• Biological Division is composed of sentinel,
  reference and national laboratories.

21
Biological Division

• Sentinel Laboratory
• Provides routine laboratory testing and services.
• Can rule out suspected cases.
• Reference Laboratory
• Provides confirmatory testing of biolgical cases.
• National Laboratory
• Composed of military and research laboratories
  that identify highly infectious diseases and
  specific strains.
• (The Centers for Disease Control and Prevention
  CDC, 2009)

22
Biological Division

• The biological testing background of Clinical
  Laboratory Scientists allows them to easily
  integrate into each laboratory.

23
Chemical Division

• This division is responsible for testing samples
  for toxic chemicals and training first responders
  and local hospital personnel in collection
  techniques.
• Their background in clinical testing and sample
  collection allows CLSs to serve in this division
  as laboratory personnel and trainers.

24
Mobile Laboratory

• During an emergency the local laboratory
  infrastructure may be overwhelmed or disabled.
• Clinical laboratory scientists can respond with a
  mobile laboratory to provide basic laboratory
  tests that providers can use to treat their
  patients.
• (Travers, EM, et.al, 1994)

25
Infectious Disease Management

• An essential public health tool
• Proper handling and containment of clinical
  samples by medical technologists.
• Allows for accurate results while maintaining
  public safety during these possible events
• Bioterrorism
• emerging infections
• re-emerging infections

26
Infectious Disease Management

• The various disciplines of clinical laboratory
  science assist in controlling and preventing the
  spread of infection, such as
• Microbiology
• Hematology
• Immunology
• http//www.jhsph.edu/PublicHealthNews/articles/200
  5/Fauci.html

27
Infection Control

• Prevent the spread of microorganisms between
  staff, staff and patient, patient to patient and
  the hospital to the community.
• An efficient infection control department has a
  close relationship with the laboratory,
  particularly microbiology.

28
Infection Control

• Medical technology provides infection control
  information by
• Identifying infectious agents such as MRSA, VRE,
  Clostridium Difficle through the use of media and
  stains.
• Tracing the antibiotic history of these organisms
• http//www.infectioncontroltoday.com/articles/clin
  ical-microbiology-infection-prevention.html

29
HIV Detection

• Clinical laboratory scientists have been present
  through all phases of fighting this disease
• Serve as a liaison between the patient and the
  doctors
• Can provide more insight into viral load, CD4/CD8
  counts

30
HIV Detection

• Work with drug companies
• discover new and potentially better drugs for HIV
  patients.
• recognizing multi-drug resistant HIV strains and
  relaying this information
• providing quality assurance methods to the study
• http//grants.nih.gov/grants/guide/rfa-files/RFA-H
  D-00-006.html

31
Environmental Health

• Medical Technologists have an important function
  in environmental health.

32
Environmental Health

• Medical technologists are capable of testing
  blood, urine, tissue and other samples for
  hazardous substances.
• When used to determine the extent of biological
  and chemical exposures, this testing is known as
  biomonitoring.
• 
  
  (Association of Public Health Laboratories
  APHL, 2009)

33
Environmental Health

• Traditionally exposure to hazardous substances
  was determined in four parts
• Measuring substances in the air, soil and water.
• Observing the lifestyle and habits of those that
  may be affected.
• Pharmokinetics such as absorption,distribution
  and metabolism
• Genetics

34
Environmental Health

• Biomonitoring works to eliminate these steps by
  directly testing for chemical substances in the
  human body.
• The data obtained from this testing can be
  analyzed and used by public health officials to
  determine appropriate actions.
• 
  
  
  (CDC, 2009)

35
Food, Blood and Drug Safety

• Participate in data collection for research
  projects
• work in collaboration with nurses, doctors,
  other scientists
• ensure accurate documentation of methodology and
  results
• http//www.bls.gov/oco/ocos096.htm

36
Food, Blood and Drug Safety

• Benefit companies attempting to obtain approval
  from the Food and Drug Administration.
• Quality assurance and control

37
Food, Blood and Drug Safety

• Safe Blood Products Utilization
• Cross matching
• Antibody screening
• Antigen testing

38
Food, Blood and Drug Safety

• Identification of organisms or materials that can
  adversely affect a patients quality of life and
  well being
• Salmonella
• E coli
• Heavy metals

39
Ten Essential Functions of Public Health

• Maintain the delicate balance between protecting
  the public and respecting the rights of the
  individual.
• The everyday work done by Clinical laboratory
  scientists embodies the following functions
• http//www.apha.org/programs/standards/performance
  standardsprogram/resexxentialservices.htm

40
LINK

• By providing accurate results to the doctors so
  the patient can receive medical direction

41
Development of Policies

• Clinical Laboratory Improvement Amendments( CLIA)
  protects the patient by setting standards and
  following them.

42
Participation in Research

• Clinical laboratory scientists train and acquire
  news skills that make them more of an asset to
  the medical profession, such as Flow Cytometry.

43
Assurance

• The Provision of credible, reliable results
  creates trust towards the medical profession.

44
Evaluation

• Medical technologists continuously use quality
  control methods to evaluate their own work.

45
Informed/Educated

• About blood and HLA typing through the
  transfusion services

46
Monitoring

• Through the use of basic laboratory procedures
  such as PT/INR, BUN and Creatinine, or
  Hemoglobin and Hematocricts.

47
Diagnose and Investigate

• Clinical laboratory scientists assist other
  health professionals to control the spread of
  infectious diseases

48
Mobilize

• Other healthcare professionals in the event of an
  epidemic with their notification of unusual
  patterns.

49
Conclusion

• Medical technology is an endangered profession
  due to school closings and loss of interest in
  the profession.
• Despite this fact, medical technologists are
  still very important in many aspects of
  healthcare including the
• - diagnosis, treatment, monitoring and prevention
  of diseases.
• 
  (USM, 2009)

50
Conclusion

• Because of their education and training, medical
  technologists can
• Easily integrate into a career in public health,
  serving in emergency preparedness, environmental
  health, infection control and food and drug
  safety.

51
Conclusion

• The disciplines of medical laboratory technology
  allow clinical laboratory scientists to be an
  asset to the overall public health profession.
• While still providing needed traditional
  analytical services that assist health
  professionals in protecting the public from
  everyday illnesses.

52
References

• American Society of Clinical Laboratory Science.
  What is a clinical laboratory science
  professional? Retrieved March 20, 2009 from
  http//www.ascls.org/jobs/whatiscls.asp
• Association of Public Health Laboratories.
  Laboratory role in
• environmental health. Retrieved February 10,
  2009 from
• www.aphl.org/aphlprograms/eh/Pages/labrole.aspx
• Bureau of Labor Statistics. (2007). Clinical
  laboratory technologist and technician.
  Occupational Outlook Handbook. 2008-9 Edition.
  Retrieved March 10, 2009 from http//www.bls.gov/o
  co/ocos096.htm
• Bennett, A.,Thompson, N., Holladay, B., Boybee,
  A. Steward, C.,
• (2009). ASCP Wage and Vacancy Survey of US
  Medical
• Laboratories. LABMEDICINE, Volume 40 (3).

53
References

• Centers for Disease Control and Prevention. The
  Laboratory Response
• Network Partners in Preparedness. Retrieved
  February 11, 2009
• from httpwww.bt.cdc.gov/lrn/.
• Pyrek, K.M (2009). Clinical microbiology and
  infection prevention are essential partners.
  Infection Control Today. Retrieved April 20, 2009
  from http//www.infectioncontroltoday.com/articles
  /clinical-microbiology-infection-prevention.html
• Landro, L. (2009). Staff shortages in labs may
  put patients at risk. Wall Street
• Journal. Retrieved May 13, 2009 from
  http//online.wsj.com/article/SB124217357954413095
  .html
• Travers, EM., Wolke, J., Johnson, R., Brown, L.,
  Lijewski,R., Pinkos,A.,
• Trost,A., (1994). Changing the way lab medicine
  is practiced at the
• point of care. Medical Laboratory Observer,
  volume 26 (7).

54
References

• The University of Southern Mississippi,
  Department of Medical
• Technology. What is Medical Technology.
  Retrieved April 2, 2009,
• from http.www.usm.edu/medtech/what_is_medtech.htm
  
•