bioMérieux Canada is spearheading an effort to persuade stakeholders that innovation adds value to the healthcare system.
The FilmArray® diagnostics system, an unimposing unit about the size of a desktop printer, is at the centre of a paradigm shift in how patients presenting to the Emergency Room (ER) are assessed. While physicians currently use educated guesswork or order one lab test after another to help make their diagnoses, the FilmArray® system can test for 20 or more pathogens from a single specimen in about an hour.
Replacing guesswork with clinical certainty
This innovation, called a syndromic approach to diagnostic testing, complements the way physicians work through the process of making a diagnosis. “Having the ability to obtain test results and to quickly make a diagnosis has benefits for both patients and physicians,” says François Turgeon, Senior Clinical Marketing Manager at bioMérieux Canada.
Studies seek to bolster evidence
The company is currently supporting studies to test the hypothesis that a syndromic approach to laboratory testing will add sufficient value to justify its cost. In a clinical study at Montreal’s CHU Sainte-Justine pediatric hospital, children presenting to the ER with respiratory symptoms (about 280 patients so far) provide a specimen for testing using FilmArray®. The diagnosis—and the right course of action—are determined right on the spot, versus the conventional approach that would keep the child in observation for the time it takes to go through a battery of tests (up to three or four days).
Will users see the value?
“This innovation is more expensive, so we hope to show that it saves hospital resources and improves patient care,” says François. “We also want to know if physicians and laboratory personnel appreciate having the means to quickly obtain reliable results. Do they see an increase in patient satisfaction? Do technicians find the equipment easier to use?”
The goal of this research is to help persuade stakeholders that innovation can make a significant contribution to improvements in the healthcare system, from multiple perspectives:
- Less waiting and uncertainty, better outcomes and greater satisfaction for patients
- Fewer delays and more precise decision-making for physicians
- Greater efficiency and simplicity for laboratory technicians
- More rational use of scarce hospital resources, for administrators
A second study, involving adults with respiratory symptoms at Vancouver General Hospital, will have a more limited objective: to determine if reducing the time to diagnosis yields a cost advantage to the system due to spending less time on the ward, avoiding unnecessary tests, and so on.
Rapid diagnosis of GI complications
A third study, at Maisonneuve-Rosemont hospital in Montreal, uses the syndromic approach to diagnose gastrointestinal (GI) symptoms. Study participants, about 100 so far, are bone marrow transplant recipients whose immune systems have been wiped out by anti-rejection drugs, so they are vulnerable to developing GI issues.
When these patients develop symptoms, the challenge is to determine whether they are having an adverse reaction to their medications or to the transplanted marrow, or if they caught a virus or picked up a bacterial infection. Physicians have been using FilmArray® to help them make a diagnosis.
Early results from this study indicate that about 25% of patients had a change in their management as a direct result of testing; the next step will be to review patient files to assess the clinical impact and cost savings attributable to these changes.
“So far, every clinical oncologist we have spoken to wants to keep using FilmArray®. The final analysis will tell us if it makes economic sense.”
– François Turgeon, bioMérieux Canada
Encouraging signs of collaboration
Healthcare in Canada is fragmented because funding is provided by the federal government, but budgets are set by each province—and some provincial regimes are more progressive than others. François likes what is happening in Alberta. “They gathered suppliers together in 2015 and announced that they had identified areas, such as critical care and cancer, where they saw room for improvement. They challenged companies to propose innovative solutions.”
According to François, this is a more enlightened approach than exists in other provinces, where companies can propose a new technology but usually have no idea where problems exist that their technology could address. By comparison, Alberta’s approach is more collaborative. “It would be great to have this kind of approach in Quebec, because we could help our partners in healthcare find innovative solutions.”
François says this type of initiative could also move the conversation forward in more provinces, once bioMérieux recruits local advocates who understand the value of the syndromic approach. “If we get the results we hope for, it will confirm that bioMérieux is at the forefront of infectious disease diagnosis, specifically with respect to taking a syndromic approach.”