Medical Staff Portal
News, Alerts & Events

HQCA Integrated Lab Services Report

May 05 , 2017

This morning, the Health Quality Council of Alberta (HQCA) released a report called "A Provincial Plan for Integrated Laboratory Services in Alberta (Provincial Plan Report). This report was requested by the Minister of Health. It presents two options for labs in Alberta:

  • A separate Provincial Health Board under the Regional Health Authorities Act to manage laboratory services (recommended)
  • A Subsidiary Health Corporation under AHS as a wholly owned subsidiary

The Minister has committed to reviewing the report and bringing forward recommendations within the year. She has asked her deputy to lead a team in this work.

The Edmonton Jornal was given an advance copy of the report and has published a story today.

** Edmonton Journal story**

Report calls for one lab services agency in Alberta
By Keith Gerein 

Management of Alberta’s $700-million lab services system should be handed over to a new public agency that would be responsible for delivering all medical testing across the province, a new report recommends.

In a 158-page analysis, the Health Quality Council of Alberta says consolidating medical labs under a central organization provides the best option to address of number of issues stemming from a currently fragmented system.

A new agency could streamline what is now an unnecessarily slow and convoluted decision-making process, ensure stable investment in new testing technology and increase support for local research efforts, the report says.  

“There was strong consensus from across the province that the laboratory sector in Alberta is at a key milestone, a tipping point where change is needed,” reads the report which was obtained by Postmedia prior to its public release on Friday. “The status quo was not seen as viable.”

From simple bloodwork and X-rays to more complex biopsies and MRI scans, 75 million medical tests are currently performed each year in Alberta — a number that is only expected to grow as the province’s population grows and ages.

Overall responsibility for diagnostic tests currently rests with Alberta Health Services. However, the services are delivered by at least six different organizations, most notably AHS itself, Calgary Laboratory Services and Dynalife, a private company that handles many of the tests in Edmonton and northern Alberta.

Health Quality Council investigators found this fragmentation, combined with the fact AHS has four different vice-presidents with accountability for lab services, to be a major headache holding the system back.

The plan for an integrated, publicly run lab services model has been the province’s policy since late 2015, when Health Minister Sarah Hoffman blew up an AHS initiative to have all medical testing in Edmonton handled by a single private company.

Although critics have derided the NDP’s position as creating more centralized bureaucracy, the province has moved forward on its vow by announcing last fall that AHS would take over Dynalife’s operations starting in 2022.

The new Health Quality Council report largely serves as a reinforcement of the direction already set by Hoffman, but also offers advice on questions yet to be resolved. In particular, Hoffman noted one of the biggest issues still on the table is to decide what kind of public organization should take control of lab services.

While the Health Quality Council has recommended an entirely new agency separate from AHS, the government is also looking at expanding the model used by Calgary Laboratory Services — a wholly owned subsidiary of AHS.

“Those are the two main options the department and I will have to start grappling with,” Hoffman said in an interview. “I would like to make (the decision) as quickly as possible, but I also want to make sure we do it with the right information. I definitely expect that later this year is reasonable.”

Whatever model is chosen, the HQCA report suggests any new agency will have to contend with a number of critical issues.

• Lab services must have stable funding to upgrade equipment and technology, worth 2.5 to 3.5 per cent of annual operating revenue.

• Construction of a state-of-the-art lab facility must be expedited in Edmonton. The project is still in the early planning phase.

• Processes to fund expensive new diagnostic tests, and to review which tests should be referred out of province, must be developed.

• A program should be developed to support local research in diagnostics that can have economic benefit. Health Quality Council authors said they prefer the option of a new public agency over an AHS subsidiary, in part because economic diversification and innovation is not one of AHS’s core priorities.

By the numbers: Lab services in Alberta

 75 million: Tests performed each year in the province.

• 205,000: Average number of tests performed daily.

• 2.3 million: Unique patients served each year.

• 133: Lab facilities in Alberta.

• 5,000: Approximate number of people employed in lab services.

• $700 million: Annual budget for medical testing in Alberta.

• 70: Approximate percentage of health care decisions that rely on medical test results.

• 95: Percentage of medical testing delivered by three organizations: AHS, Dynalife and Calgary Laboratory Services.

• 76: Percentage of AHS lab equipment considered to be at the end of its life.

• 60: Percentage of Calgary Lab Services equipment considered to be the end of its life.