The regionalization of laboratory services at the University of Utah Medical Center. Associated Regional and University Pathologists Inc (ARUP).

We feel that now, four years out, we have achieved the interim goals that we set for ourselves. There are some key aspects that we would do differently if we were now starting over, and we have provided that information to those seeking to begin similar off-site ventures who have sought our advice. There is an interesting constellation of factors that must be present for such an operation to succeed, and the individual components of that constellation will differ by institution and location. The rationale and circumstance will vary profoundly, and what is "right" in one setting may be entirely "wrong" in another. I feel compelled to caution the reader about the myriad of determinants and ingredients that must be considered. Study the precedents and seek knowledgeable advice from financial, legal, insurance, human resource (personnel), and laboratory management professionals. Regional laboratories can succeed. Hospitals may well benefit from a strategy of marketing services to physician staff members and the incremental financial and service benefits from added testing volume can be significant. However, the more expansive the business design, the more complicated the management requirements and demands and, potentially, the higher the risks, costs, pressures, and down-side factors. We feel very strongly about our focus of supporting the pathology and medical technology professions. Our value-added services are geared not only to providing technology, management, and financial services support for our clients, but also to not competing with them for local clientele. We have a program of teaching them how to market to that clientele and of providing the support materials to assist them in so doing. We have progressed from being a hospital laboratory to being a hospital laboratory referral laboratory, and now have also become a referral laboratory for other reference laboratories. As a full-service reference laboratory we send out very few tests, and are continually incorporating new tests and technologies. We have referral testing accounts currently in 42 states and we want to be the very best at what we do, namely, esoteric reference testing. Our credo is that quality at ARUP is making best continually better.