[Histonet] Aetna and In-Office Lab Accreditation

[jdcochran <@t> aol.com]

Histonetters:

I was informed today by The Joint Commission that an oversight was made in the original letter from Aetna regarding a new requirement for in-office AP lab accreditation.  
Aetna's Medical Director states in a letter to The Joint Commission: "It can be CAP or JCAHO certification of their laboratory.  We want to encourage providers to obtain 
either one of these accreditations. We will be updating the physician letter with this change..."  To my knowledge, TJC and CAP are the only CMS-deemed authorities for 
Anatomic Pathology lab accreditation since a third accreditation organization has exited that arena.  

In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists.  In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets.  Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done.  In histopathology, the kinds of volume you want are in the thousands for each tissue type.  Many hospital labs do little skin or prostate histology anymore.  Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year.  

Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists.  In an era of high unemployment, another source of employment for our professions is "a good thing."

This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts.

John D. Cochran, MD, FCAP