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Medical laboratory

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A medical laboratory or clinical laboratory is a laboratory where tests are carried out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical Medical laboratories are an example of applied science, as opposed to research laboratories that focus on basic science, such as found in some academic institutions. Medical laboratories vary in size and complexity and so offer a variety of testing services. More comprehensive services can be found in acute-care hospitals and medical centers, where 70% of clinical decisions are based on laboratory testing. Doctors offices and clinics, as well as skilled nursing and long-term care facilities, may have laboratories that provide more basic testing services. Commercial medical laboratories operate as independent businesses and provide testing that is otherwise not provided in other settings due to low test volume or complexity.

Departments

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In hospitals and other patient-care settings, laboratory medicine is provided by the Department of Pathology and Medical Laboratory, and generally divided into two sections, each of which will be subdivided into multiple specialty areas. The two sections are: Anatomic pathology: areas included here are histopathology, cytopathology, and electron microscopy. Medical Laboratory, which typically includes the following areas: Clinical microbiology: This encompasses several different sciences, including bacteriology, virology, parasitology, immunology, and mycology. Clinical chemistry: This area typically includes automated analysis of blood specimens, including tests related to enzymology, toxicology and endocrinology. Hematology: This area includes automated and manual analysis of blood cells. It also often includes coagulation. Blood bank involves the testing of blood specimens in order to provide blood transfusion and related services. Molecular diagnostics DNA testing may be done

Medical laboratory staff

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The staff of clinical laboratories may include: Pathologist; Dcls(Doctor clinical Laboratory science) Clinical biochemist Laboratory assistant (LA) Biomedical Scientist (BMS) in the UK, Medical laboratory scientist (MT, MLS or CLS) in the US or Medical Laboratory Technologist in Canada Medical laboratory technician/clinical laboratory technician (MLT or CLT in US) Medical laboratory assistant (MLA) Phlebotomist (PBT) Histology technician

Labor shortages

The United States has a documented shortage of working laboratory professionals. For example, as of 2016update vacancy rates for Medical Laboratory Scientists ranged from 5% to 9% for various departments. The decline is primarily due to retirements, and to at-capacity educational programs that cannot expand which limits the number of new graduates. Professional organizations and some state educational systems are responding by developing ways to promote the lab professions in an effort to combat this shortage. The National Center For Workforce Analysis has estimated that by 2025 there will be a 24% increase in demand for lab professionals.

Types of laboratory

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The examples and perspective in this article deal primarily with the United Kingdom and do not represent a worldwide view of the subject . You may improve this article, discuss the issue on the talk page, or create a new article, as appropriate. ( May 2016 ) (Learn how and when to remove this template message) In most developed countries, there are two main types of lab processing the majority of medical specimens. Hospital laboratories are attached to a hospital, and perform tests on their patients. Private (or community ) laboratories receive samples from general practitioners, insurance companies, clinical research sites and other health clinics for analysis. For extremely specialised tests, samples may go to a research laboratory. Some tests involve specimens sent between different labs for uncommon tests. For example, in some cases it may be more cost effective if a particular laboratory specializes in a less common tests, receiving specimens (and payment) from other labs,

Specimen processing and work flow

In a hospital setting, sample processing will usually start with a set of samples arriving with a test request, either on a form or electronically via the laboratory information system (LIS). Inpatient specimens will already be labeled with patient and testing information provided by the LIS. Entry of test requests onto the LIS system involves typing (or scanning where barcodes are used) in the laboratory number, and entering the patient identification, as well as any tests requested. This allows laboratory analyzers, computers and staff to recognize what tests are pending, and also gives a location (such as a hospital department, doctor or other customer) for results reporting. Once the specimens are assigned a laboratory number by the LIS, a sticker is typically printed that can be placed on the tubes or specimen containers. This label has a barcode that can be scanned by automated analyzers and test requests uploaded to the analyzer from the LIS. Specimens are prepared for analysi

Laboratory informatics

The large amount of information processed in laboratories is managed by a system of software programs, computers, and terminology standards that exchange data about patients, test requests, and test results known as a Laboratory information system or LIS. The LIS is often interfaced with the hospital information system, EHR and/or Laboratory instruments. Formats for terminologies for test processing and reporting are being standardized with systems such as Logical Observation Identifiers Names and Codes (LOINC) and Nomenclature for Properties and Units terminology (NPU terminology). These systems enable hospitals and labs to order the correct test requests for each patient, keep track of individual patient and specimen histories, and help guarantee a better quality of results. Results are made available to care providers electronically or by printed hard copies for patient charts.

Result analysis, validation and interpretation

According to various regulations, such as the international ISO 15189 norm, all pathological laboratory results must be verified by a competent professional. In some countries, staffs composed of clinical scientists do the majority of this work inside the laboratory with certain abnormal results referred to the relevant pathologist. Clinical scientists have the responsibility for limited interpretation of testing results in their discipline in many countries. Interpretation of results can be assisted by some software in order to validate normal or non-modified results. In other testing areas, only professional medical staff (pathologist or clinical biologist) is involved with interpretation and consulting. Medical staff are sometimes also required in order to explain pathology results to physicians. For a simple result given by phone or to explain a technical problem, often a medical technologist or medical lab scientist can provide additional information. Medical Laboratory Departmen

Medical laboratory accreditation

Credibility of medical laboratories is paramount to the health and safety of the patients relying on the testing services provided by these labs. Credentialing agencies vary by country. The international standard in use today for the accreditation of medical laboratories is ISO 15189 - Medical laboratories - Requirements for quality and competence. In the United States, billions of dollars is spent on un accredited lab tests, such as Laboratory developed tests which do not require accreditation or FDA approval; about a billion USD a year is spent on US autoimmune LDTs alone. Accreditation is performed by the Joint Commission, College of American Pathologists, AAB (American Association of Bioanalysts), and other state and federal agencies. Legislative guidelines are provided under CLIA 88 (Clinical Laboratory Improvement Amendments) which regulates Medical Laboratory testing and personnel. The accrediting body in Australia is NATA, where all laboratories must be NATA accredited to re

Industry

The laboratory industry is a part of the broader healthcare and health technology industry. Companies exist at various levels, including clinical laboratory services, suppliers of instrumentation equipment and consumable materials, and suppliers and developers of diagnostic tests themselves (often by biotechnology companies). The top ten companies that are leading the Clinical Laboratories market are Quest Diagnostics Inc., Laboratory Corporation of America Holdings, The British United Provident Association Ltd., NHS Blood and Transplant, London Ambulance Services, Fargo Medical Laboratories, Labco Quality Diagnostics, LifeLabs Medical Laboratory Services and others. Clinical laboratory services includes large multinational corporations such LabCorp, Quest Diagnostics, and Sonic Healthcare but a significant portion of revenue, estimated at 60% in the United States, is generated by hospital labs. In 2018, the total global revenue for these companies was estimated to reach $146 billion b