Development trend of medical laboratory

Development trend of medical laboratory 20 17

With the progress of science and technology and the improvement of people's medical care level, the medical system will be constantly changed and gradually improved. Its development trend will be polarization: on the one hand, it will reduce costs, improve efficiency and effectiveness, popularize new technologies and equipment, and at the same time strengthen medical treatment, teaching and medical research, and cultivate talents, which will further develop to a moderate scale; On the other hand, with the aging of the population, in order to facilitate the masses, reduce the burden, strengthen health care guidance and the prevention and treatment of frequently-occurring diseases and chronic diseases, it is necessary to divert some elderly and chronic patients to community medical care. The premise of patient triage is the corresponding improvement of community medical level, which can meet the basic medical needs, and it also depends on thoughtful service, comfortable environment, convenient medical treatment and reasonable price to attract patients. With the reform of medical system and medical security system, the discipline of clinical laboratory is bound to change accordingly. The following is my understanding of the development trend of medical laboratory. Welcome to reading.

? 1. With the further improvement of laboratory automation system and laboratory information system, most routine operations will be replaced by machines.

? From the receipt of samples to data analysis, it will transition to the assembly line to realize the automation of the whole laboratory. Special inspection will be transferred to the central laboratory or reference laboratory. The traditional model and structure of clinical laboratory need to be adjusted or reorganized. In addition to special microbial detection in aseptic, isolation or biosafety laboratories, routine clinical detection will enter the assembly line to improve efficiency and reduce costs. Closed operation will be replaced by open operation and will move towards internal unity and external cooperation. The laboratory implements standardized management, the test results enter the information network, the medical information resources are shared, and the medical expenses of patients are reduced. Decentralized, inefficient and wasteful situation will be replaced by centralized, efficient and economical mode, and extensive management will change to intensive management.

? Two, the implementation of all-weather service, with the least medical resources to obtain the maximum medical and health benefits, in order to reduce the economic burden of patients and the country.

? High-end medical equipment is enjoyed by the whole society and has become a global development trend. Due to the large-scale development of small-scale testing instruments, simple and rapid bedside testing (POCT) will go to community health care and enter families, and it will be valued and popularized to facilitate bedside, consulting room, micro-laboratory testing or patient self-monitoring.

? Only the inter-hospital cooperation mode of sharing resources, technology, information and benefits can help patients, reduce the waste of medical resources, improve the overall medical level of the whole society and narrow the gap between advanced and backward development. Experience has proved that only by solving the reasonable distribution of benefits and giving appropriate support to community and township hospitals and clinics can other problems be solved? * * * Enjoy? , give full play to the efficiency of high-end equipment, carry out comprehensive cooperation between hospitals, and guide patients to reasonable diversion. Otherwise, any medical consortium or cooperative group cannot be consolidated for a long time. This is an economic principle that cannot be ignored under the condition of commodity economy, and it is also a health policy issue that the government should not ignore in order to ensure that everyone enjoys basic medical and health services.

? Third, the development of computer network will be more convenient for clinic and patients, and more conducive to the use and exchange of information; The development of biochip, the decryption of gene map and the study of protein omics will definitely change the face of clinical examination.

? Modern medical laboratories will gradually be equipped with a large number of advanced, precise and precise analytical instruments, and classical serological and microbiological methods will be replaced by more sensitive, accurate, simple and rapid methods and instrument analysis. Enzyme chemical analysis, enzyme immunochemistry technology, fluorescence polarization technology, chemiluminescence technology, time-resolved immunofluorescence technology and electrochemical technology will be further developed and popularized. Cell morphology and cytopathology will be further combined with physicochemical methods such as histochemistry and immunochemistry to reach the level of ultrastructure and molecular examination. The development of medical bioengineering and molecular biology technology, the perfection of nucleic acid molecular hybridization, PCR and DNA sequencing technology, the analysis and development of gene map and protein omics, and the development of new technologies such as DNA chip and protein fingerprint will further clarify the etiology and pathogenesis of many diseases at the molecular level. Patients only need to provide a small number of specimens to obtain more examination information, and can reveal the etiology, pathogenesis, pathology, pathophysiology and even complete disease images including genetics. Some bedside examinations and monitoring and the development of non-invasive sensors will reduce many iatrogenic pains of patients.

? Fourthly, monitoring emerging infectious diseases will be an important task for microbiologists.

? Genetic stability and variability are universal laws in biology. Facts have proved that some infectious diseases have been eliminated, and new infectious diseases will appear again; Due to gene mutation, non-pathogenic bacteria may become pathogenic bacteria, and non-toxic species may become toxic species; Due to the abuse of antibiotics, conditional pathogens may flood. Due to some uncontrolled human activities, such as deforestation, disorderly land reclamation, large-scale construction of reservoirs and so on. The ecological barrier is destroyed, wild animals are forced to compete with human beings for habitat, and human beings kill or get in close contact with wild animals. Natural focus diseases or some pathogens of wild animal hosts spread and transfer to human beings, which will eventually threaten human health and life. For example, Lyme disease infected by Borrelia burgdorferi, AIDS infected by human immunodeficiency virus (HIV), epidemic hemorrhagic fever infected by Hantavirus, EHI, Ebola hemorrhagic fever infected by Ebola virus, West Nile fever infected by West Nile virus, hemorrhagic colitis infected by hemorrhagic Escherichia coli serotype O 157: H7, Legionella pneumophila and severe acute respiratory syndrome associated with human coronavirus. The inspection and monitoring of all this will become a key content or an important aspect of preventive medicine, disease control and laboratory medicine.

? Material movement is eternal, and people's understanding is infinite. The progress of basic medicine and the increase of examination methods will inevitably further promote the development of clinical medicine. However, no matter how technology develops and instruments progress, computers cannot completely replace people's creative spirit, nor can electronic instruments completely replace people's experience. The basic skills of examiners under the microscope and clinicians in asking, seeing, touching, knocking and listening still need to be strengthened, and cannot be weakened, let alone discarded. The progress of laboratory medicine and the development of medical images provide more means for understanding diseases; However, machines were invented only to improve efficiency and effectiveness. Medical thinking and decision-making based on evidence-based medicine, standardized management and quality assurance of laboratories, rational selection, scientific combination and application of diagnosis and treatment means, and avoidance of abuse of medical means and excessive consumption of medical resources all depend on the knowledge, morality and wisdom of instrument users and managers. The continuous improvement of quality, efficiency and benefit depends on human scientific knowledge, creative spirit, conscious behavior and management. To bridge the communication between laboratory and clinic requires knowledge and experience in laboratory medicine and clinical medicine, as well as people with high sympathy for patients, extremely responsible spirit and good professional ethics. Clinicians and laboratory doctors face patients with great individual differences and ever-changing conditions. Only * * * is responsible, cooperates closely, insists on taking patients as the foundation and patients' interests as the starting point, can it be more conducive to the diagnosis and treatment of diseases and more in line with the purposes and principles of medicine. Paying attention to and solving these problems is not only the responsibility of clinical laboratory workers, but also an important topic for health managers and medical educators.

? 2 1 century will be an era of rapid development of science and technology, especially biological science. With the constant revelation of the mysteries of life, more and more newer technologies will be applied to clinical medicine and laboratory medicine. If hospital laboratories provided tens of thousands of tests for doctors and patients in the 20th century, it is possible to provide more updated tests in 2 1 century, which will effectively help human beings to fight diseases. However, just as the development of medicine has a positive effect and brings hope for human health and longevity, there will also be some negative effects and a series of social problems. In fact, since the end of the 20th century, the development of medicine has brought a heavy economic burden to the society. American association for clinical chemistry (AACC) predicts that there may be six changes under this policy.

? (1) Hospital laboratories are dense: some experimental projects that are not very nervous and not often done are concentrated in some large laboratories, which may further form networks and groups.

? (2) Vigorously reduce personnel: The most expensive medical cost in developed countries is personnel cost.

? (3) External pressure: Both the government and patients will exert greater pressure to ask the medical profession to provide more effective and cheap services.

? (4) Reduce unnecessary inspections: filter the current projects and delete some unnecessary, repetitive or worthless projects. For example, the CPT code in the United States has included some clinically useful items in time, and medical insurance often uses this as the basis for payment. In addition, new projects and technologies are strictly reviewed by the FDA. Although some new projects and technologies are unreliable or of little clinical value, they are not allowed to go on the market, or only allow scientific research, and cannot charge patients.

? (5) Fully automated laboratory: This is the most effective way to reduce labor and improve efficiency. The staff of this kind of laboratory requires comprehensive inspection technology operation, instrument repair and maintenance ability, as well as new technicians with certain management and computer skills.

? (6) Further strengthen the standardization work: more standard documents will be formulated, and technical operation specifications will enable the clinical laboratory to make more consistent test results.

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