Lab-based solutions for infectious and immunologic diseases

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Managing complexity with efficiency

Infectious and immunologic disease are major causes of morbidity and mortality, challenging healthcare providers in achieving optimal clinical outcomes, operational efficiencies, reimbursement, and patient satisfaction.

  • Costly Conditions
  • Costly Solutions

Conditions such as HIV, tuberculosis, psoriatic arthritis, and lupus are expensive and difficult to manage if they progress undiagnosed.

Costly Conditions

Improving patient care in infectious and immunologic disease management can require investment in costly technology and scarce, highly compensated clinical specialists.

Costly Solutions
  1. Razavi H, Elkhoury AC, Elbasha E, et al. Chronic hepatitis C virus (HCV) disease burden and cost in the United States. Hepatology. 2013;57(6):2164-70.
  2. Aeras. The global impact. www.aeras.org/pages/beyond-a-health-crisis.
  3. Lucado J, Paez K, Andrews R, Steiner S. Adult hospital stays with infections due to medical care, 2007. Statistical Brief #94. Healthcare Cost and Utilization Project (HCUP). 
 February 2011. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb94.jsp.
  4. Sørensen J, Hetland ML, on behalf of all departments of rheumatology in Denmark. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing 
 spondylitis: results from the Danish nationwide DANBIO registry. Ann Rheum Dis. 2015;74:e12.
  5. Sawah S, Daly RP, Foster S, et al. Understanding delay in diagnosis, access to care, and satisfaction with care in lupus: findings from a cross-sectional online survey in the 
 United States. Presented at the European League Against Rheumatism (EULAR) 2015 Annual Conference. June 2015. Rome, Italy.
  6. Salary.com. Microbiologist IV salaries. www1.salary.com/Microbiologist-IV-Salary.html. Accessed September 4, 2018.
  7. Salary.com. Physician—infectious disease salaries. www1.salary.com/Physician-Infectious-Disease-Salary.html. Accessed July 17, 2018.
  8. O’Dell JR. The happiest specialty: rheumatology is #1. The Rheumatologist. 10 Jul 2012. www.the-rheumatologist.org/article/the-happiest-specialty-rheumatology-is-1/. Accessed July 17, 2018.
  9. Salary.com. Physician—pathology salaries. www1.salary.com/Physician-Pathology-Salaries.html. Accessed July 17, 2018.

Quest tests, tools, technologies, and expertise help health systems manage infectious and immunologic disease—for better health outcomes.

1,200 molecular, serology, and microbiology tests covering the continuum of care, from screening and pathogen identification, to therapy selection and monitoring. 

Broad health plan coverage, patient engagement tools, convenient access to testing centers, 
and advocacy for early detection contribute to improved HCAHPS scores and help patients stay compliant for better health.

Consultation with rheumatologists and other medical experts is augmented by clinical algorithms, interpretation guides, and regional labs offering specialized 
testing such as microbiology testing and employee tuberculosis screening.

Quest offers 1,200 tests covering the full continuum of care, from screening to therapy selection, monitoring to cure. With an array of innovative infectious and immunologic disease solutions, we help health systems improve patient outcomes and reduce costs. 

A few areas of focus include:

  • Antimicrobial Stewardship

    With antibiotic overuse and misuse, virulent microbes develop resistance to antimicrobials over time, threatening the efficacy of important disease-fighting treatments. Quest offers a solid antimicrobial stewardship approach for health systems.

    The challenge:

    More than half of hospitalized patients receive antibiotics,2 but up to 50% of these prescriptions are inappropriate.1.2

    • Antibiotics are responsible for almost 1 out of 5 emergency department visits for adverse drug events.

    • Patients getting broad-spectrum antibiotics are up to 3 times more likely to get another infection from an even more resistant bacteria.

    • ~2 million Americans develop antibiotic-resistant infections annually and ~23,000 people die of those infections.3

    Quest approach:

    Quest offers a solid antimicrobial stewardship approach for health systems:

    Access to fast, innovative testing methods

    • Complete microbiology testing menu
    • Molecular testing to prevent overprescribing antibiotics
    • Drug susceptibility testing to ensure the right agent is prescribed

    Standardized processes for improved quality

    • Fast turnaround times from regional labs for quick clinical decisions
    • Guideline-based test panels, eg, for STIs
    • Clinical algorithms and pathways to ensure right test/time/patient

    Expert consultation, management, and 24/7 support

    • Help compile hospital antibiograms
    • Infectious disease and microbiology specialists available for consultation
    • Ability to supervise or manage the clinical microbiology lab

    This approach helps to ensure every patient gets:

    • An antibiotic only when one is needed

    • The right drug

    • At the right dose

    • At the right time and for the right duration4

    How antimicrobial stewardship helps your health system—and the world

    Antibiotic stewardship programs can improve patient outcomes and reduce costs of care.

    1. Fridkin SK, Baggs J, Fagan R, et al. Vital Signs: improving antibiotic use among hospitalized patients. MMWR. 2014;63.
    2. Dellit TH, Owens RC, McGowan JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44:159-177.
    3. Centers for Disease Control and Prevention (CDC). Antibiotic/antimicrobial resistance. August 28, 2017. https://www.cdc.gov/drugresistance/index.html. Accessed August 7, 2018.
    4. Srinivasan A, Centers for Disease Control and Prevention (CDC). Antibiotic stewardship: why we must, how we can. Cleve Clin J Med. 2017 Sep;84(9):673-679.
    Read more …
  • Chronic Viral Infection

    Despite progress made in the treatment of chronic viral infections, there is still much room for improvement. Quest can help health systems improve testing for hepatitis C (HCV), HIV, and other viruses as a gateway to treatment.

    The challenge:

    There is room for improvement when it comes to diagnosing and treating chronic viral conditions such as HCV and HIV infections.

    HCV Infection

    Roughly half of people with chronic HCV do not know that they are infected1,2 yet, left untreated, the virus can cause serious health problems, including liver damage, which is expensive to treat.

    HIV Infection

    More than half of Americans still have not been tested for HIV3 despite an ongoing HIV epidemic.4

    Quest approach:

    Testing can lead to earlier detection and treatment, which can improve patient outcomes.

    HCV Infection

    Early detection and treatment of HCV is estimated to prevent >320,000 HCV-related deaths from 2010 to 2060.5

    HIV Infection

    Highly effective treatments make it possible to live a long, healthy life with HIV.

    A progress report on chronic viral infections: we can do better than halfway

    More than half of Americans still have not been tested for HIV, and roughly half of people with chronic HCV do not know that they are infected. See how testing can be the gateway to treatment and care.

    1. Centers for Disease Control and Prevention (CDC). A guide to comprehensive hepatitis C patient counseling and testing. https://www.cdc.gov/hepatitis/resources/professionals/pdfs/counselingandtestingpc.pdf.
    2. Centers for Disease Control and Prevention (CDC). Hepatitis C kills more Americans than any other infectious disease. News release, May 4, 2016. https://www.cdc.gov/media/releases/2016/p0504-hepc-mortality.html.
    3. Centers for Disease Control and Prevention (CDC). HIV testing in the United States. CDC fact sheet. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-testing-us-508.pdf. August 2016.
    4. Centers for Disease Control and Prevention (CDC). HIV basic statistics. July 23, 2018. https://www.cdc.gov/hiv/basics/statistics.html.
    5. Rein DB, Wittenborn JS, Smith BD, Liffmann DK, Ward JW. The cost-effectiveness, health benefits, and financial costs of new antiviral treatments for hepatitis C virus. Clin Infect Dis. 2015;61:157-68.
    Read more …
  • Latent Tuberculosis Infection

    Latent tuberculosis infection (LTBI) can disrupt the health system environment. Quest offers a portfolio of interferon-gamma release assays (IGRA) blood tests that help to accurately uncover LTBI so health systems can take steps to keep staff and patients safe.

    The challenge:

    LTBI is when TB bacteria lives in the body, but without symptoms. While not infectious or contagious, LTBI can progress to TB disease. In fact, more than 80% of TB diagnoses in the US are associated with LTBI.1

    Healthcare workers are at 2 times greater risk of LTBI than the general population.2 Infection is costly for health systems and individuals.

    • Lost work hours

      A sick employee may lose 3-4 months of work time3

    • Quality of care challenges

      Staffing shortages and replacement of workers present new challenges

    • Reduced productivity

      Globally, TB results in a decline of worker productivity at a cost of $12 billion USD each year3

    Quest approach:

    Detecting LTBI before it becomes active is an important step to help control the spread of the disease.

    Current CDC guidelines support TB screening for healthcare workers. Clinical studies identify TB blood testing as the most effective strategy when screening healthcare workers for LTBI.4,5 Specifically, testing with IGRA is preferred for many patients compared to the century-old Mantoux tuberculin skin test (TST) because:

    • Test results are unaffected by the bacille Calmette-Guérin (BCG) vaccine
    • Only 1 patient visit required6
    • Flexible collection options: 4-tube or 1-tube
    • Results can be available in 24 hours6
    • Option for electronic results (reported straight to EMR)
    • Cost savings

    Quest offers a portfolio of IGRA blood tests that help to accurately uncover LTBI.

    • Quest Diagnostics is the first commercial reference lab to offer a choice of TB blood tests:

      • QuantiFERON-TB Gold Plus (QFT-Plus)
      • T-SPOT®.TB.
    • Both blood tests have low false-positive rates,* so you can help prevent TB exposure to other staff members.

      *in BCG-vaccinated patients

    • A trusted team of MDs and PhDs for help with test selection and results interpretation.

    A better way to test for tuberculosis (TB)

    Learn the advantages of TB blood testing from Quest Diagnostics.

    1. Centers for Disease Control and Prevention. Testing for TB infection. https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm. Updated April 14, 2016.
    2. Uden L, Barber E, Ford N, Cooke GS. Risk of tuberculosis infection and disease for health care workers: an updated meta-analysis. Open Forum Infect Dis. 2017;4(3):ofx137
    3. World Health Organization. Guidelines for workplace TB control activities: the contribution of workplace TB control activities to TB control in the community. http://www.stoptb.org/assets/documents resources/publications/technical/workplace_guidelines.pdf.
    4. Sosa, Lynn E., and Gibril J. Njie. “Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019 | MMWR.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2019, www.cdc.gov/mmwr/volumes/68/wr/mm6819a3.htm?s_cid=mm6819a3_x.
    5. Nienhaus A, Schablon A, Costa JT, Diel R. Systematic review of cost and cost-effectiveness of different TB-screening strategies. BMC Health Serv Res. 2011;11:247.
    6. Centers for Disease Control and Prevention. Latent tuberculosis infection: a guide for primary health care providers. Last reviewed October 20, 2014. https://www.cdc.gov/tb/publications/ltbi/diagnosis.htm#twoStepTSTTesting.
    Read more …
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Learn how Quest Diagnostics infectious disease and immunologic testing can benefit health systems and patients

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