Union doctors call Allina lab transfer a ‘disastrous, chaotic mess’

Allina Health’s shift of outpatient lab work to a for-profit company over the past week has been “a disastrous, chaotic mess,” according to a physician union leader who says delayed test results are raising safety concerns.

In July, Allina announced it would transition most outpatient lab work to New Jersey-based Quest Diagnostics, which is one of the nation’s largest lab companies. The switch occurred last Monday and has been riddled with problems, said Dr. Lisa Schweiger, a pediatrician who works at an Allina clinic attached to Cambridge Medical Center in Cambridge, Minn.

There’s been widespread confusion about how to order tests in the new system, Schweiger said, and time-consuming struggles for caregivers as they try to fix mistakes.

Some clinic and urgent care patients are being referred to other locations, including hospital emergency rooms, because there’s no other way to get labs done on a timely basis, she said. Patients are having to wait hours for routine blood draws, prompting many to go home instead and later seek lab-only appointments that are significantly delayed.

The system does not indicate when a provider has ordered lab tests incorrectly, nor does the lab contact the provider to say it was wrong, Schweiger said.

“I just worry about what effect it’s had on some of our patients,” she said. “This is dangerous stuff.”

Allina officials acknowledged the troubles Monday and said they’re working to implement fixes while upholding the health system’s standard of safe, high-quality and accessible care.

“Any complex transition of this size and scale comes with areas to be addressed, and Allina Health and Quest are putting every available resource to restoring the high level of care our patients deserve,” Allina and the lab company said in a joint statement.

“We are acknowledging and apologizing to our patients and care teams for experiencing more disruptions and delays than we anticipated or are acceptable,” the health system said. “We are seeing daily improvements and will not stop until all issues have been resolved.”

Minneapolis-based Allina is the seventh-largest nonprofit group in Minnesota and one of the state’s largest operators of hospitals and clinics, including Abbott Northwestern Hospital in Minneapolis and United Hospital in St. Paul.

As the health system this year has turned the corner on financial challenges, it’s announced deals to outsource lab work to Quest as well as bill collection and IT work to a division of Minnetonka-based UnitedHealth Group.

Last week, an Allina patient shared with the Star Tribune a message the health system is sending to patients about the lab transition.

“Please accept our apologies for the delays and disruptions you may have experienced during your visit,” Allina’s chief operating officer, Dominica Tallarico, and chief medical executive, Dr. Hsieng Su, said in the message. “Our clinics are changing lab services providers which may have caused your visit to take longer than usual.”

Schweiger, the pediatrician at the Cambridge clinic, said impacts vary across the health system, with some problems apparently hitting harder at clinics and urgent care centers that aren’t attached to hospitals. Some pediatricians at these remote centers say they can’t get tests done fast enough to see what level of care is needed for a baby with jaundice, Schweiger said, so families are being sent elsewhere for care.

Allina’s inpatient medical centers are continuing to run their own tests through the transition.

Tests to confirm if a child is sick with whooping cough used to take one to two days, Schweiger said, but now families are waiting much longer as their child potentially has a highly contagious respiratory infection. COVID tests that used to come back the same day, or the next, now are taking three to seven days — which could push a patient beyond the window for beginning treatment with the antiviral drug Paxlovid, Schweiger said.

Caregivers weren’t given adequate or even accurate training on the new system, she said, and communication problems with the lab has compounded troubles.

“It is a disastrous, chaotic mess right now,” Schweiger said.

In a statement, Allina Health and Quest said they are “committed to rebuilding trust and making things right for our patients and care team members.”

Quest announced on Sept. 16 that it had completed its acquisition of select laboratory assets from Allina; financial details of the previously-announced deal were not disclosed.

Last week, the message being sent to Allina patients said staff members were “focused on delivering exceptional care while we quickly work to resolve disruptions related to this transition.”

Schweiger said that for the 600 doctors, nurse practitioners and physician assistants who’ve only recently organized at Allina, the disruption illustrates why caregivers opted to form a union called Doctors Council in 2023. Union leaders raised alarms about the lab transition months ago, she said, but Allina officials promised a smooth transition that would be good for patients.

“This is a symptom of how medical care has become more corporate and the front-line workers like doctors and nurses, who know what’s best for their patients, are not being included in decision making,” she said.

“We work for a not-for-profit entity, which most medical systems in Minnesota are … but they’re acting more and more like for-profit entities and/or they’re partnering or selling out to for-profit entities.”