Section of Laboratory Medicine

Mission Statement

The University of Pittsburgh Department of Pathology Section of Laboratory Medicine is committed to being an international leader in all aspects of Laboratory Medicine (Clinical Pathology): patient care, academic productivity, and trainee development. To accomplish and maintain these missions, the Section must provide both career development and necessary facilities to faculty.

Research Activities

The research endeavors of the faculty of this Section are varied from basic cell biology through systems biology to patient-directed translational investigations; these combined efforts form a large part of the academic mission of the Department of Pathology. The research endeavors of the Section continue to evolve though they remain quite substantial. The past year has been productive with many faculty obtaining stable grant funding and expanding their published works. This is especially gratifying considering the national state of support for research. The Section welcomes the investigative (as well as clinical and collegial) contributions of Drs. Nahed Ismail, Grant Bullock and Steve Dobrowolski, even as we say goodbye to Dr. Jay Raval. Dr. Ismail filled a spot in Microbiology, leading the clinical endeavors at Magee Hospital, while transferring her work on rickettsia and now branching into global aspects of the microbiome. Dr. Bullock, who will help support clinical work in Hematopathology, was recruited in collaboration with the Vascular Medicine Institute, where he will pursue his research into iron handling and anemia. Dr. Dobrowolski, who joined Clinical Chemistry to direct the biochemical genetics laboratory at Childrens Hospital, is continuing his funded work on inborn errors of metabolism and mitochondrial defects. They have joined an established cadre of investigators with the result that the 7th floor research space is now filled and with "spill over" into the VMI and CHP.

Teaching / Training Activities

The amalgamation of the various Divisions has improved the Laboratory Medicine training of residents, resulting in increased continuity and comprehensiveness of training among the disciplines that comprise the Section. The residency program has been revamped to take advantage of the unique situation at University of Pittsburgh Medical School and UPMC. The network of academic and community hospitals provide an exceedingly broad range of clinical materials and patient care interactions; a new mandate on junior lab director rotations utilizes the VA and community hospitals to provide a realistic experience in small hospital settings.

The fellowship programs in many of the constituent Divisions (Hematopathology, Molecular Diagnostics, and Transfusion Medicine, in particular) and affiliated Departmental Divisions (Transplant Pathology) are being integrated more deeply into the pan-Laboratory Medicine approach. This is a real boon, as the traditional lines of clinical support are blurring with advances in scientific understanding and technology. In response to our overall strategic plan last spring, we will be focusing more on fellowships. In addition Dr. Octavia Peck Palmer and the Clinical Chemistry faculty have launched a fellowship program that has two strong trainees who are splitting their time between clinical training and research in a two year fellowship. We hope to establish a Microbiology Fellowship in the near future.

With the ongoing strengthening of the basic investigative research component in the Section, graduate and post-doctoral education has emerged as a major focus. There are about ten graduate students from various Departments and Institutions undertaking their thesis work in the laboratories of faculty of the Section. Two of these students have graduated in the past year. In addition to the graduate students, a large number of post- doctoral fellows are training within these laboratories. For this latter group, members of the Section have become deeply involved in the Departmental endeavor to improve post-doctoral training and provide important tools for career progression during this difficult transitional stage.

Lastly, despite the national trends, extramural research grants represent a growing source of support particularly with the addition of the new faculty, all of whom have transferred funding. Salary recompense from these funded programs have allowed the Section to maintain faculty members in numbers and specialties that go beyond that supportable solely by our clinical mission.

Clinical Activities

The Section of Laboratory Medicine encompasses the Divisions of Clinical Chemistry, Hematopathology, Immunopathology, Clinical Microbiology, Molecular Diagnostics, and Transfusion Medicine. This structure enhances the interdisciplinary approaches that improve the academic, teaching, and service missions of these Divisions. Dr. Wells serves as a Vice-Chair and Section Director. Individual Divisions and Directors present complementary specialized approaches to patient care and education, which in total represent the whole of Laboratory Medicine - a clinical approach to patient care directed from an outcomes-and-data-based diagnostic testing modality.

The level of activity in the clinical sector continues to increase significantly. This has resulted in the addition of new faculty members in Clinical Chemistry, Hematopathology and Microbiology. We are currently recruiting for the positions in Molecular Diagnostics, and possibly Transfusion Medicine.

A major effort is to provide direction and integration across the 17 hospital laboratories that comprise UPMC. This has improved medical delivery and ease of moving patients and physicians across the system, as well as saving the laboratories significant resources which have redeployed in new endeavors. We are central to not only integrating clinical data from the Hamot Hospital but also in the development and now opening of UPMC East.

This next year will see major changes in the administrative and technical leadership of the clinical laboratories. In conjunction with the hospital, the VP and Manager for laboratory services will change. Ms. Stacey Armstrong who has been Executive Director of the Laboratories is now assuming a VP position, but will still oversea the clinical laboratories. A search for the Executive Director position will be launched in the fall, but the laboratories are under capable hands with interim leadership being pulled from a strong core of Administrative Directors.

The upcoming year promises to be eventful as we finish off the Clinical Laboratories Building (CLB) into which most all of CP will move from the current South Tower (old CHP) and scattered locations in Scaife and PUH. This move will enable us to take on new programs in proteomics, molecular medicine, and stem cell therapies to name a few. We will move into this space next summer and consolidate testing from PUH and Magee along with strengthening COE that serve all of UPMC.

Laboratory Ventures

UPMC and Quest Diagnostics, Inc. have established a laboratory joint venture known as the Quest Diagnostics Joint Venture. The Joint Venture laboratory is located in Greentree and serves the geographic region within 150 miles of Pittsburgh - excluding existing Quest Diagnostics, Inc. Joint Ventures in Erie. A key component of the Joint Venture is the medical and doctoral scientist leadership provided by the Department of Pathology. The faculty support the Joint Venture and are responsible for the quality of care and quality of service provided by the Joint Venture Laboratory.

The initial focus of the Joint Venture is on Clinical Pathology "Outreach" testing. Physician offices and long term care facilities have already begun to transfer their tests from UPMC hospital laboratories to the Joint Venture Laboratory. UPMC hospital laboratories also use the Joint Venture Laboratory as their Reference Laboratory. The Joint Venture aims to: 1) improve the quality, consistency and reliability of laboratory testing across multiple clinical settings of patient care, 2) enhance information technology connectivity to permit electronic order entry and results reporting, future integration of diagnostic test reports, and data archiving capability, and 3) improve laboratory efficiency and service through consolidation of infrastructure support such as patient service centers, courier services, and client service to achieve significant system-wide cost reductions while providing an opportunity to enhance the quality of care and quality of service to physicians and patients.

This past year, Pathology in conjunction with the UPMC International and Commercial Services Division is establishing a laboratory in collaboration with a new oncology-focused specialty hospital in Hyderabad, India. This is the first venture for UPMC in the subcontinent, and represents an opportunity for training and development in global health for our faculty and trainees. This laboratory is opening this fall as a core of chemistry, hematology/coagulation, flow cytometry, microbiology, surgical pathology/cytology and immunohistochemisty. Shortly thereafter, we will bring on molecular diagnostics in microbiology and anatomic pathology, tissue typing, and other high end services.

Goals and Objectives

The goals for the upcoming year are to maintain our high level of excellence and productivity in all aspects of academic Laboratory Medicine. We aim to increase our research base not only through the new recruitments but also in the current investigative laboratories. One reason for this optimism is the increasingly collaborative nature of our section members thus leveraging their expertise. Also, as the growth in clinical faculty has finally caught up with the increased work load, the academic productivity of this group of faculty has increased. In addition, there are intriguing new efforts involving both investigative and clinical academic faculty in systems biology.

We aim to better educate our clinical trainees with a re-engineered residency training program with more clearly defined curricula and evaluations and teaching modalities. As the investigative laboratories have blossomed, our graduate and post-graduate training efforts should grow as we attract more and better quality graduate students and post-doctoral fellows. This will be evaluated by number of trainee publications, presentations, and awards/recognitions.

Clinical enhancements are also targeted along with maintaining a high level of individual case excellence. We are initiating new diagnostic modalities in automated testing, special chemistry and tissue typing. We are in the midst of re-organizing the clinical laboratory structure at PUH and SHY so as to strengthen our specimen quality and make the entire diagnostic loop from physician order to resulting more efficient and useful.