1. www.csmls.org Canadian Society for Medical Laboratory Science (CSMLS) Future of the Professions: Who has the Crystal Ball? Christine Nielsen BHA, MLT, CAE Bessie Carydis M MSc, BHA, ART

2. www.csmls.org/www.scslm.org Evolving needs in healthcare Co-dependent nature of lab (subservience) Setting the standards Unfinished journey of regulation for MLA Meeting future patient’s needs – impact of Boomers Crystal ball Drivers of Change

3. www.csmls.org/www.scslm.org Regulation of MLT (PEI, BC and territories excluded) Delegation of Controlled Act - phlebotomy Employer Demand – lazy HR departments Evolving Technology – lab on a chip? POCT Aging Demographics HHR IPC Global migration Starved for clinical placements Devolution of duties Dynamic Health Care-Evolving Landscape

4. www.csmls.org/www.scslm.org Are we actually in a health human resource crisis? Will the boomers ever retire? Will MLAs dominate the market place? Foreign Qualification recognition – we identify the gaps, WHO helps the clients fill them? Role of higher education HHR

5. www.csmls.org/www.scslm.org CMA approves all CSMLS Competency Profiles for accreditation MLT - since 1941 MLA - since 2007 Ensure integrity of ALL MLA programs – private and public Certification exam offered to graduates of CMA accredited MLT and MLA programs, or equivalent through PLA Certification accepted as entrance to practice for MLT/MLA in all provinces except Quebec CSMLS Competency Profiles serve as scope of practice for MLT and MLA in Canada Canadian Medical Association Accreditation

6. www.csmls.org/www.scslm.org Creation of National Competency Profiles Periodic competency profile review- consultative process Standardization of MLT/MLA Profession Eligibility Criteria for CSMLS Exam - Additional Eligibility Pathway - PLA Competency Profile / blueprint for testing Creation and delivery of national certification exam – often enough? National Certification

7. www.csmls.org/www.scslm.org Every 5 years or when major change to domain Taskforce composed of subject matter experts Consultative process – educators, members, non-members, practitioners, regulators, employers etc Market demand - future competencies, emerging technologies Major themes identified (feedback via survey) Draft new competency profile Consultative validation process with all stakeholders If insufficient support – redrafted, validation cycle repeats Process takes 12-18 months to complete Competency Profile Review

8. www.csmls.org/www.scslm.org Competency Profile Process

9. www.csmls.org/www.scslm.org PEI and BC are pursuing regulation of MLT MLA not regulated in any province Alberta, Ontario, Newfoundland, Saskatchewan, Manitoba all requested MLA regulation but denied BC/PEI are pursuing MLT and MLA umbrella regulation No MLAs in Quebec Unfinished Journey of Regulation

10. www.csmls.org/www.scslm.org Rapid changes in technology (slow uptake in Canada) Focus on molecular genetics, diagnostics and targeted therapies What is funded depends on province – individual willing to pay? In Pursuit of the “Magic Bullet”

11. www.csmls.org/www.scslm.org HPV molecular testing vaccines have made great strides in cervical cancer Pap smear screening on a decline – change of screening matrix, change in screening algorithm – less cytotechs needed 2014 – Competency Profile review outcome was to expand the scope of practice to include histology, performing molecular techniques, pathology assistant duties and screening of histology slides Sweeping Changes in Diagnostic Cytology

12. www.csmls.org/www.scslm.org MLTs MAY evolve into biomedical specialists – more in line with the rest of the world 1.Core Lab Technologist (hematology, transfusion medicine & microbiology) 2.Pathology Technologist (histology, cytology & pathology assistant) 3.Clinical Genetics technologist (cytogenetic & molecular genetics ) MLA perform (not interpret) most lab tasks – automation Crystal Ball - Within 20 years

13. www.csmls.org/www.scslm.org Dark Daily – May 12 – Significant Numbers of Primary Care Doctors Are Uncertain About the Correct Clinical Laboratory Tests to Order Will the NEW technologist become more involved in schedule of test, referral patterns, advising on appropriateness? Will anyone LISTEN? Designer genes, diagnostics and therapies MLTs all involved in genetics?? Full automation with larger numbers of MLAs What is the impact of global migration? Crystal Ball - Within 50 years

14. www.csmls.org/www.scslm.org Molecular diagnostics – targeted therapies Point of Care testing – at patient bedside and homes – QA crucial Changing roles – outside of the lab and in the communities Champions of Patient-centred Care

15. www.csmls.org/www.scslm.org Christine Nielsen, CEO christinen@csmls.org Bessie Carydis, Director – Certification and PLA bessiec@csmls.org www.csmls.org