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/NewsReleases/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 Shortages=Medical 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

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. Get more students to enroll, Better wages Cease school closings View experience in the correct way: as a bonus to the medical profession and not a hindrance to career progression Get more students to enroll, Better wages Cease school closings View experience in the correct way: as a bonus to the medical profession and not a hindrance to career progression

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. Some medical technology programs even require additional courses such as genetics, statistics, anatomy and computer science. Some medical technology programs even require additional courses such as genetics, statistics, anatomy and computer science.

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. Clinical Laboratory Scientists working along with chemists and biologists are important resources in emergency preparedness and response.Clinical Laboratory Scientists working along 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 Prevention’s 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/2005/Fauci.html Microbiology has particular public health significance, with its use of media and stain to detect mycobacterium, fungi, yeast, bacteria and viruses. The quality work done every day by medical technologists can alert public health professionals of a potential health crisis, like new tuberculosis infection. A Public Health crisis can affect individuals or the population as a whole. For example, a Hematologists is capable of recognizing malarial elements on a blood smear, while a Parasitologists could observe Cryptospordium in a stool sample leading to the discovery of a contaminated water source. Microbiology has particular public health significance, with its use of media and stain to detect mycobacterium, fungi, yeast, bacteria and viruses. The quality work done every day by medical technologists can alert public health professionals of a potential health crisis, like new tuberculosis infection. A Public Health crisis can affect individuals or the population as a whole. For example, a Hematologists is capable of recognizing malarial elements on a blood smear, while a Parasitologists could observe Cryptospordium in a stool sample leading to the discovery of a contaminated water source.

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. The clinical laboratory is the first entity to recognize drug resistant organisms, new infections and the beginning of a possible epidemic. The clinical laboratory is the first entity to recognize drug resistant organisms, new infections and the beginning of a possible epidemic.

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/clinical-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-HD-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 patient’s 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/performancestandardsprogram/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/oco/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 http:www.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