title: A Model of Shared Mycobacteriology Testing Services: Lessons Learned.
abstract: OBJECTIVE
  The need for public health laboratories (PHLs) to prioritize resources has led to increased interest in sharing diagnostic services. To address this concept for tuberculosis (TB) testing, the New York State Department of Health Wadsworth Center and the Rhode Island State Health Laboratories assessed the feasibility of shared services for the detection and characterization of Mycobacterium tuberculosis complex (MTBC).
  
  
  METHODS
  We assessed multiple aspects of shared services including shipping, testing, reporting, and cost. Rhode Island State Health Laboratories shipped MTBC-positive specimens and isolates to Wadsworth Center. Average turnaround times were calculated and cost analysis was performed.
  
  
  RESULTS
  Testing turnaround times were similar at both PHLs; however, the availability of conventional drug susceptibility testing (DST) results for Rhode Island primary specimens and isolates were extended by approximately four days of shipping time. An extended molecular testing panel was performed on every specimen submitted from Rhode Island State Health Laboratories to Wadsworth Center, and the total cost per specimen at Wadsworth Center was $177.12 less than at Rhode Island State Health Laboratories, plus shipping. Following a mid-study review, Wadsworth Center provided testing turnaround times for detection (same day), species determination of MTBC (same day), and molecular DST (2.5 days).
  
  
  CONCLUSIONS
  The collaboration between Wadsworth Center and Rhode Island State Health Laboratories to assess shared services of TB testing highlighted a successful model that may serve as a guideline for other PHLs. The provision of additional rapid testing at a lower cost demonstrated in this study could potentially improve patient management and result in significant cost and resource savings if used in similar models across the country.
authors.affiliation: New York State Department of Health, Wadsworth Center, Albany, NY.
authors.forename: Kara
authors.initials: K
authors.lastname: Mitchell
authors.affiliation: New York State Department of Health, Wadsworth Center, Albany, NY.
authors.forename: Tanya
authors.initials: T
authors.lastname: Halse
authors.affiliation: New York State Department of Health, Wadsworth Center, Albany, NY.
authors.forename: Donna
authors.initials: D
authors.lastname: Kohlerschmidt
authors.affiliation: Rhode Island State Health Laboratories, Providence, RI.
authors.forename: Toby
authors.initials: T
authors.lastname: Bennett
authors.affiliation: Rhode Island State Health Laboratories, Providence, RI.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Vanner
authors.affiliation: Rhode Island State Health Laboratories, Providence, RI.
authors.forename: Ewa
authors.initials: E
authors.lastname: King
authors.affiliation: New York State Department of Health, Wadsworth Center, Albany, NY.
authors.forename: Kimberlee
authors.initials: K
authors.lastname: Musser
authors.affiliation: New York State Department of Health, Wadsworth Center, Albany, NY.
authors.forename: Vincent
authors.initials: V
authors.lastname: Escuyer
mesh_terms: D001431:Bacteriological Techniques; D003365:Costs and Cost Analysis; D004526:Efficiency; D005240:Feasibility Studies; D006755:Hospital Shared Services / Q000191:economics*; D007753:Laboratories / Q000191:economics*; D008827:Microbiological Phenomena; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009172:Mycology; D009518:New York; D012237:Rhode Island; D013997:Time Factors