Today we are talking about PCR testing in-house, but first, go back and read Part 1 of our series if you have not already.

The pros of testing all samples in-house:

• You get all the revenue from running the test
• With the right volume and practices in place, it can be cheaper than using a reference lab
• You have full control over the processes in place and turnaround time
• You may already have some of the necessary equipment from running COVID-19    tests

Let’s look at these advantages more in-depth. If you were to send out your samples to be tested at a reference lab, you would be charged a fee from the reference lab, meaning you won’t collect all the revenue for yourself. In theory (but not always) you would make more money by not having to share the revenue, especially if you receive high volume and maintain efficient processes.

“Laboratory testing has the potential to be one of the most revenue-generating components of a healthcare system,” the Healthcare Financial Management Association (HFMA) confirms.

Additionally, many people take comfort in being able to control the entire process and not having to rely on a partner or third-party reference lab. I agree there can be comfort in having full control, but that doesn’t mean there aren’t going to be problems that arise — the likes of which could impact how you operate.

The cons of testing all samples in-house:

• Reagents and primers can be costly if you must purchase them from vendors
• New Quan studios equipment for validation is expensive
• Inconsistent volume can affect efficiency costs related to overhead and other expenses. The staffing and/or purchased materials, consumables, and supplies used to optimize value are all things affected by volume.
• Panels must be validated
• You are held responsible for turnaround times

While the costs of reagents and primers have come down some over the years, they still cost more than they would if they were produced internally. This is one area where a reference lab may be able to give you a better price by sharing their internal savings. If you already have some of the equipment from COVID-19, you’re ahead of the game — but purchasing necessary equipment such as Quan Studios for validation comes at a steep price, plus the cost of routine maintenance.

As previously stated, you could make more money in theory by testing in-house. I said “in theory” because there are some critical factors that disrupt that line of thinking, most notably inconsistent volume.  When volume dips, you still have your fixed overhead expenses and also need to have staff available in case volume rises back up. But if volume dips too low, covering overhead expenses becomes a struggle. To keep up with turnaround times during low-volume periods, you might not be able to fully fill your plates — thereby leaving more money on the table.

If volume increases rapidly from your norms, it can delay turnaround times if you don’t have the necessary staff, equipment, and processes in place. But by using a reference lab, the inconsistent volume doesn’t hurt you in any of those areas because the reference lab takes on all that responsibility.

Perhaps that’s why “utilization of reference laboratory services is strongest among those facilities outsourcing 10%-30% of total testing workloads,” according to Medical Lab Management. “Whether providing relief for high-volume testing or offering esoteric instrumentation and expertise, reference labs remain a vital resource for medical diagnostic testing.”

The cons can appear daunting, but there are a number of ways they can be overcome if you still want to go in-house. Lighthouse Lab Services, for example, is a strong leader in the start-up lab front in assisting with the transition to molecular diagnostics. They can help with CLIA certification, reagents, equipment, and validation of panels. BioFire is another service that can be used for reagents and equipment.

That being said, it’s important to be aware of costs, possible contracts, and other restrictions with those types of services, like being tied to their reagents, equipment, and processes without the option to use other vendors.

What can NCF Diagnostics & DNA Technologies do for you?

Here at NCF Diagnostics & DNA Technologies, we have experienced many of these issues firsthand since our inception in 2011. A lot of our expertise can be accredited to our founder, Dr. Jeyaprakash, who believed molecular diagnostic PCR testing was far superior to culture testing and should be used more regularly — several years before the onset of the pandemic.

Thus, we specialize in running curated, fully-validated, large, and customizable panels in every infection category for one low price. This is a great way for practices/labs to meet their patients’ and providers’ needs while they are in the process of curating their own panels, learning about their volume, or just exploring the industry. We give you an option to provide accurate and fast molecular diagnostic PCR testing without having to worry about the problems of doing it yourself.

Ready to learn more? Contact NCF Diagnostics & DNA Technologies today by calling (352) 375-5553 or emailing info@ncfdna.com.