How Pathology Businesses are Fighting Operational Issues during COVID-19

I recently spent some time catching up with Dinesh Bhatta, the Chief Operating Officer of Medlab Pathology, to discuss his thoughts around business operations during the COVID-19 crisis.

It was great to hear how Medlab Pathology are supporting their staff, and are keeping the business in good shape for the upcoming recovery period.

At the peak of the coronavirus crisis, what were the key challenges from an operations perspective faced by Medlab Pathology?

During the corona-virus peak, which we classify to be from around mid-March up until the end of April, uncertainty was a real issue. We knew that the patient visits were going to be down, although we didn’t know just how bad it was going to get. Some days we saw our volumes drop to unprecedented levels compared to the traditional levels, which was scary to see from a business perspective. We were often discussing as a leadership team the worst-case scenarios, and government support for the pathology sector was a constant concern.

Looking at how the UK and other countries such as the U.S were doing, we understood that our revenue was going to be effected in the short-to-medium term, and this uncertainty had a significant effect on our staff, who were especially concerned about their job security, which obviously we understand and empathise with.

Being a close-knit management team, we decided that we were going to support all of our staff no matter what, and we set a goal to prevent any layoffs or redundancies. Like many other businesses we had to spend time identifying ways to reduce costs, so we implemented measures such as reduced salaries and working hours. It was great to see how all our staff banded together and adopted a ‘we’re all in this together’ mentality. It affected everyone in our business, from senior management down to the lab staff, and even our scientists.

We then looked at reducing other operational costs in other areas such as collections , as that’s a big outgoing for a pathology business. With patient flow heavily reduced in our clinics, we certainly wanted to try and achieve some cost savings in that area.We tried to counter-balance reductions in revenue with reductions in costswhich is easier said than done.

Medlab Pathology is a privately owned independent pathology service provider and most of our earnings are invested back into the business by the shareholders.

Based on your time working in healthcare domains, do you believe Australia was ready for this pandemic from a clinical point of view?

I believe so. The Australian pathology sector is quite advanced compared to other countries across the globe. For the variety and volume of testing that we do, and also our ability to quickly scale our services for coronavirus, the current system has been okay.

We started performing around 50-100 test per day, but then as the pandemic fully hit, we rapidly increased this 10 fold. We appeared to be almost unknowingly well-prepared, with efficient processes already in place along with the vast network of multi-market pathology providers.

In Australia, we have diversified pathology service offerings across private and government(public hospital based) providers, who all seemed to scale up nicely. Both Private and Public Pathology providers were focused and scaled their testing capacity to provide the much needed service by the community.

Do you believe that Australian pathology labs could have done anything different to pre-empt or address challenges with patient flow? Could any countermeasures have been put in place during lockdown?

We did actually have some ideas for this during the peak period, although things did settle down by the time we could have actioned them. What would have helped would have been to create segregated outdoor testing facilities, similar to what you see in places such as the respiratory clinic or a drive through collection centre, but for routine testing, not just for coronavirus.

This could have been done by getting agreements in place with local councils to take over closed parks and recreational areas to set up collections facilities. This could have been a way to increase mass testing early on, and could have been managed by setting up a walk-through set-up for suspected COVID-19 cases, and another other area for people that suffer from other chronic diseases. If successful, this could have also been rolled out across stadiums and sporting facilities Australia-wide.

What has Medlab Pathology been doing to try and encourage patients to return back to normal levels of routine testing and to feel more comfortable attending clinics again?

From our experience, lots of medical centres were encouraging patients to go into clinics to be tested. Lots of general practitioners also had telehealth services  in place

To support tele-health consultations, we enabled our own eOrder services, implementing a contactless system where a doctor could request pathology services and send out COVID-19 alerts via SMS.

We also had COVID-19 safe practices and social distancing measures at our work places to ensure patients felt safe coming to our collection centres.

Do you believe the current approach and operating model for clinics in Australia is sustainable if we had another serious pandemic?

It all depends on how serious the next pandemic is. In the current model, the collection centres have limited space.  

I  believe availability of larger  rooms should be offered for pathology collections to ensure social distancing measures could be put in place, not just place patients in a shoe box. I would also be of value-add to have those larger pathology room attached to a treatment room or other rooms to ensure we could see patients in multiple rooms to prevent cross-contamination in an event of another pandemic. This would also create a better workflow and reduce wait times between patients.

I would also encourage the promotion of more large, independent collection centres, not just ones attached to medical centres.

Do you have any thoughts on getting patients back into routine testing?

Yes, I believe that patients should go back to getting their regular tests done again, especially now that community transmission outside of Melbourne is so low at the moment.

I would highlight that there are clean and sterile clinics available with excellent infection control measures in place, staffed by great health care professionals offering an excellent level of care and hygiene.

We will face problems during the second wave if patients don’t return to routine testing caused by the worsening of chronic health issues.

I would like to extend a big thank you to Dinesh for taking out the time to share his thoughts and insights during this challenging time, and I'm wishing Medlab Pathology and all of their staff all the best as they continue to support Australia on the front lines as one of our highly respected Pathology service providers.

‍