Episode 26: Generating Reliable Results at the New Spectra Laboratory with Dr. Alex Ryder and Ines Dahne-Steuber
Research has shown that more than 70 percent of a person’s health care decisions are based on laboratory results. Ines Dahne-Steuber, president of Spectra Laboratories, and Dr. Alex Ryder, medical director, join Field Notes to discuss the importance of Spectra’s new state-of-the-art laboratory in Southaven, Mississippi, and its critical impact on the care delivered to patients across the country.

Brad Puffer: Welcome, everyone to this episode of Field Notes. I'm Brad Puffer. I'm the Medical Office Communications Team at Fresenius Medical Care North America and your host for this discussion today. Here, we interview the experts, researchers, physicians, and caregivers who bring experience, compassion, and insight into the work we do every day. Research has shown that more than 70% of a person's health care decisions are based on laboratory results. Things like urinalysis and blood work for dialysis patients, that critical information can impact important health decisions made in consultation with their care teams. In August, Spectra Laboratories, a subsidiary of Fresenius Medical Care North America opened a brand new, state of the art, 200,000 square foot lab in Southhaven, Mississippi providing much needed capacity to serve more patients more efficiently. But what sets the lab apart from other facilities like it? To answer these important questions and discuss the importance of reliable laboratory testing for dialysis patients across the country, we are joined by Ines Dahne-Steuber, president of Spectra laboratories and Dr. Alex Ryder, Spectra's medical director. Ines, let's start with you. Before we get into the new lab, I was wondering if you can give us a little background on the history of spectra and how it became such an important part of Fresenius Medical Care here in North America.

Ines Dahne-Steuber: Certainly, I'd be happy to, Brad. Spectra has been dedicated to solving the kidney care community for over 30 years. We perform lab testing primarily for dialysis patients. And while 70% of health care decisions are informed by lab results, our dialysis patients really rely 100% on laboratory data to manage their health. For example, our lab tests help care teams understand how effective dialysis treatments are, if patients are on the right level of medications, and even identify nutritional needs. Since labs are such an integral part of a successful patient care in dialysis, having Spectra in the Fresenius family is important and meaningful. In addition, most dialysis treatments are reimbursed in a bundle that includes lab testing. Having a laboratory within Fresenius helps us standardize test results across all of our locations and optimize the cost of lab testing so we can be good stewards of health care spend.

Brad Puffer: Doctor Ryder, from your perspective, what is the value of having spectra within the Fresenius Medical Care family? What are the advantages for our patients, for example.

Dr. Alex Ryder: When it comes to discussing the value of the laboratory, I would say there are a number of benefits to having a reference lab that synergizes with an organization's clinical mission. But the two biggest value adds that come to mind are the expertise that we're able to offer and the relationships that we're able to build with our clinical counterparts and the patients that we all serve. As you mentioned in the opening, laboratory testing is a key component of patient care, and the patient population that we serve has unique requirements from a laboratory. The test menu that Spectra offers has been extensively curated to address the needs of patients with renal conditions. Some of this testing is quite esoteric, and all of it requires a high level of accuracy so that therapies can be tailored to fit each patient's individual needs. It's important for us as  labatorians to be experts at what we do in order to provide the most reliable and clinically actionable results possible. Being a part of the Fresenius family is incredibly important. Any time questions about laboratory test ordering or result interpretation come up, our leadership is just a call, or email, or Teams meeting away from being able to provide an answer. And what makes our position within the organization really special is that, we have the unique opportunity to serve patients both frequently and over a long duration of time. So while we may not see patients face to face, we certainly interact with them in a uniquely close way. Our expertise has a high volume renal specialty laboratory, and our close relationship with the clinical teams allows us to provide a high level of service that would be difficult to achieve if there wasn't a shared interest in serving our specific patient population.

Brad Puffer: As I mentioned in the introduction, we opened this brand new cutting edge lab in Mississippi just outside Memphis. How do you believe this new lab will help us provide the very best, most accurate information to patients and their health care providers?

Ines Dahne-Steuber: Building a brand new lab allowed us to take a step back, meet with key laboratory instrumentation vendors and scientists, and select the best in class equipment for our needs. Our chosen partner was Siemens. We also collaborated with Siemens to design a top of the line automation system that manages the samples from receipt at the lab through placing it on the right lab testing instrument to stowing the sample in a freezer and later discarding it. As a matter of fact, our high testing volumes for certain tests allow us to report results more precisely than vendor guidelines. This is very valuable for instance when caring for patients that require medications to manage anemia. We can ensure the patients receive the right dose of medication with high precision every time. We have also designed and implemented brand new laboratory IT systems, and clinic, and customer service technologies to make it easy for care teams and patients to connect with Spectra.

Brad Puffer: And Dr. Ryder, from a scientific standpoint, what makes this lab so advanced and state of the art?

Dr. Alex Ryder: Well, there was a lot of thought that went into the choice of instrumentation in the lab and the overall customization of workspace that we operate in. We utilize instrument platforms that are best in class for performance and have an automated testing process for the vast majority of the specimens that we receive in order to achieve a high level of standardization among the results we're producing. We have multiple laboratories testing sections that make use of cutting-edge technology from high throughput chemical and immunochemical analyzers to highly reliable and reproducible hematology instruments, a vast array of instruments and manual methods for identifying microbial infections and contaminants, highly specialized analyzers to detect trace elements that are important for our patient population, and incredibly precise and robust molecular instrumentation to aid in managing chronic infections. And the majority of this testing is completed on an automated line that functions to treat every specimen in the same way every time so that we're able to generate the most reliable and consistent results possible. And this is particularly important as the majority of our patients have frequent laboratory testing performed.

Brad Puffer: And Dr. Ryder, I've heard you discuss the importance of standardization. What is standardization? Why is it important? And how will this new lab provide that to our care teams and patients.

Dr. Alex Ryder: Yeah, that's a great question. Standardization within the laboratory is this overarching theme of achieving consistency by utilizing common processes. It plays a role in our day to day operations as we create standard operating procedures or SOPs that can be applied, for example, to each of the 30 plus hematology analyzers that specimens are tested on each day. It's also an integral component of our quality management system as we compare results both across instruments and over time to ensure that standardized processes are achieving the intended result of consistently accurate and precise results. Accuracy and precision are key performance indicators in the laboratory. So accuracy is our ability to achieve the correct result, and precision is our ability to achieve the same result when testing the same specimen repeatedly. So we want to maximize both of these, and standardization is able to help us achieve that. So by continuously assessing our performance, we're able to detect trends that may be pushing results in a certain direction and identify inconsistencies that may be affecting a particular instrument or a test result. By rapidly identifying these deviations, we can figure out the root cause and fix it, then we can go back to our procedures and make sure we're doing everything possible to eliminate the conditions that allow for an inconsistency to pop up. Continuously evaluating the quality of our testing is a lot easier when we have this high level of standardization. In our new laboratory, in particular, the use of a sophisticated automated line for specimens to be processed and routed to the appropriate instrument really helps us to achieve a higher level of standardization than would be possible if we were handling them with manual method.

Brad Puffer: And Ines back to you for a second, tell me a little bit about why Spectra chose Southaven, Mississippi? Why does the location matter for providing timely results?

Ines Dahne-Steuber: We serve patients from all over the US. It's always a top priority to get the samples to the laboratory as fast as possible so we can guarantee the stability of the samples and provide timely answers to our patients and their providers. We rely heavily on our partnership with FedEx to get these samples to us as quickly as possible. Memphis is centrally located and is home to our FedEx super hub. And as a matter of fact, you can see FedEx planes take off and land when you look outside the windows at the lab. We even have a vanity zip code especially created for the laboratory. This helps us provide best in class turnaround times for our tests.

Brad Puffer: Ines for you, what does the future hold for Spectra? And how does this new lab provide new opportunities?

Ines Dahne-Steuber: It's not often in one's career that one is afforded the opportunity to build a facility from the ground up that sets the standard by which others are judged. We raised the bar for the industry, and we're so proud to have accomplished this in less than two years while managing through a pandemic. If someone had told me two years ago that we would build a lab and open our doors in record time, mostly through remote collaborations, I would have said that's impossible. If someone had told me we would have to recruit a team of laboratory professionals remotely, I would have said that's impossible. But I know better now. Spectra has facilities on the East and West Coast and now in Memphis. It took cross-continental collaboration to get us where we are today. We truly are one Spectra, and I feel so honored to be part of this outstanding organization. While we had to limit our opening festivities due to the pandemic, I will say that the opening was a very moving and inspiring event that I will remember for the rest of my life. It's difficult to put into words the respect and admiration I have for everyone who helped us get us to where we are today.

Brad Puffer: It's been a pleasure speaking with you, Ines and Dr. Ryder. Thank you so much for taking the time. I think we all have a much better understanding of how this new lab will really impact our patients in positive ways. Thank you. And to our audience, you can find Field Notes on the Apple Store or Google Play or right here at fmcna.com where you can also find your annual medical report and other featured articles. We hope you'll come back and join us as we discuss more important issues in the weeks ahead. Until next time, I'm Brad Puffer, and you've been listening to Field Notes by Fresenius Medical Care. Take care everyone.