Quest Diagnostics 2012 Annual Report Download - page 8

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Diagnostic Information Services
Background - clinical testing.
Clinical testing is an essential element in the delivery of healthcare services. Physicians use clinical testing to assist in
the detection, diagnosis, evaluation, monitoring and treatment of diseases and other medical conditions. Clinical testing is
generally categorized as clinical laboratory testing and anatomic pathology services.
Clinical laboratory testing generally is performed on whole blood, serum, plasma and other body fluids, such as urine,
and specimens such as microbiology samples. Clinical laboratory tests which can be performed by most clinical laboratories
are considered routine. Routine testing measures various important bodily health parameters such as the functions of the
kidney, heart, liver, thyroid and other organs. Commonly ordered tests include blood chemistries, urinalysis, allergy tests and
complete blood cell counts.
Esoteric tests are clinical laboratory tests typically that are not routine. Esoteric tests include procedures in the areas
of molecular diagnostics, protein chemistry, cellular immunology and advanced microbiology. These tests may require
professional “hands-on” attention from highly-skilled technical personnel, generally require more sophisticated technology,
equipment or materials and may be performed less frequently than routine tests. Consequently, esoteric tests generally are
reimbursed at higher levels than routine tests. It is not practical, from a cost-effectiveness or infrastructure perspective, for most
hospitals, commercial laboratories or physician office laboratories to develop and perform a broad menu of esoteric tests, or to
perform low-volume esoteric testing in-house. Such tests generally are outsourced to an esoteric clinical testing laboratory,
which specializes in performing these complex tests. Commonly ordered esoteric tests include viral and bacterial detection
tests, drug therapy monitoring tests, genetic tests, autoimmune panels and complex cancer evaluations. Gene-based and
esoteric tests increasingly are ordered by physicians to assist them in the diagnostic process, to establish a prognosis and to
choose or monitor a therapeutic regimen.
Anatomic pathology services are performed on tissues, such as biopsies, and other samples, such as human cells.
Anatomic pathology involves the diagnosis of cancer and other diseases and medical conditions through examination of tissue
and cell samples taken from patients.
Our services.
We are the world's largest provider of diagnostic information services. We provide information and insights based on
clinical testing, and related services. The clinical testing that we perform includes routine testing, esoteric or gene-based
testing and anatomic pathology testing. We are the leading provider of routine, esoteric and gene-based and anatomic
pathology testing in the world, and offer customers the broadest access to the most extensive test menu. We also are a leader
in providing testing for the detection of employee use of drugs of abuse, offering a full range of solutions, including urine, hair,
blood and oral fluid tests. Our Quest Diagnostics Drug Testing Index,TM which is an annual report of our aggregate drug testing
results, is cited by employers, the federal government and the media to help identify and quantify drug abuse among the
nation's workforce. We also provide wellness testing and analytic services, such as our Blueprint for Wellness® program, to
employers to enable them and their employees to take an active role in improving their health and containing costs.
We believe that offering services based on a full range of tests strengthens our market offering, market position and
reputation. Our experienced medical staff has a passion for providing the highest quality service to patients. Our in-house
experts, including medical directors, scientific directors, genetic counselors and board certified geneticists, provide medical and
scientific consultation regarding our tests and test results, and help physicians and others best utilize these tests to improve
patient outcomes and enhance patient satisfaction. Our approach fosters personalized patient care.
As part of our 2011 acquisition of Celera Corporation ("Celera"), we gained access to a pipeline of biomarkers to
drive growth in gene-based and esoteric testing services. Our esoteric laboratories provide reference testing services to
physicians, large academic medical centers, hospitals and other commercial laboratories. Our esoteric testing laboratories
perform hundreds of complex tests that are not routinely performed by our regional laboratories, including but not limited to
the following fields:
• endocrinology and metabolism (the study of glands, their hormone secretions and their effects on body growth
and metabolism);
• genetics (the study of chromosomes, genes and their protein products and effects);
• hematology (the study of blood and bone marrow cells) and coagulation (the process of blood clotting);
• neurology (the study of the nervous system, its structure and its diseases);