Despite the trend toward reporting negative impacts, a few PHLs in our informal poll reported positive impacts from other health market changes. According to our informal poll of PHL directors, among the positive impacts identified by PHL directors were increased collaboration between the PHL and other private laboratory entities, and a decreased burden of state PHL CLIA '88 responsibilities.
Once again, the interviews and case studies confirm the poll results. As a result of market changes, Washington's PHL has been able to forge a close working relationship with the University of Washington's Department of Laboratory Medicine on laboratory issues. Also, Kansas reported that because of hospital laboratory consolidation, the portion of CLIA '88-regulated laboratories that the state PHL must survey and monitor has decreased by 15%.