From pandemic disruptions to the rise of molecular point-of-care testing, the laboratory market is undergoing rapid transformation. Today’s labs are becoming the backbone of a more distributed, technology-driven diagnostic ecosystem. For distributors, suppliers, and providers alike, these shifts bring both opportunities and challenges, from supply chain volatility and workforce shortages to new frontiers in wearable and home-based testing.
To explore these dynamics, Repertoire Magazine interviewed several members of the NDC Clinical Lab Advisory Council, including Jim Macholz of Atlantic Medical Solutions; Kevin Barefoot of MTMC; Rick Wilburn of Wilburn Medical USA; and John Cook, Douglas Harper, and Brad Thompson of NDC. Together, they discussed the formation of the NDC Clinical Lab Advisory Council, ongoing supply chain hurdles, the impact of emerging technologies and how the lab’s role in patient care is evolving.
Roundtable panelists
- Jim Macholz, President and CEO of Atlantic Medical Solutions in Charlotte, leads a distributor specializing in the non-acute space. His team focuses heavily on lab and point-of-care testing with a dedicated field sales force.
- Kevin Barefoot, Director of Point of Care and Primary Care at MTMC. MTMC serves as a leading outsourced sales partner, representing a wide range of products from exam tables and gloves to point-of-care testing solutions.
- Rick Wilburn, Founder of Wilburn Medical Supply, a trusted distributor of healthcare supplies and equipment.
- John Cook, Vice President of Sales, Healthcare at NDC. Cook designs and executes innovative sales strategies, develops emerging leaders, and drives strategic growth initiatives.
- Doug Harper, Capital Equipment Program Director at NDC.
- Brad Thompson, Vice President of Supplier Management at NDC, is responsible for managing clinical lab supplier relationships and identifying new supplier prospects to expand NDC’s portfolio.
Repertoire Magazine: What prompted the formation of the NDC Clinical Lab Advisory Council, and what were some of the initial goals you wanted to achieve?
Thompson: During the COVID-19 pandemic, our focus shifted heavily toward clinical lab products specific to the COVID market. While we were selling a lot in that space, we lost focus on other areas of the business. About two years ago, Jack Stevens, our president and CEO, approached me about refocusing on the broader clinical lab category. From there, John Cook, Doug Harper and I put together a go-forward strategy that included the formation of the Clinical Lab Advisory Council. It has paid huge dividends – helping us bring on new suppliers and reestablish focus across the category.
Harper: The council was designed to be a collaborative, non-competitive forum where lab-focused suppliers and distribution partners could openly share insights on industry challenges, emerging products, and successes. It’s been a great way to learn from each other. Just this morning, I spoke with Kevin about an emerging product he’s excited about – it’s those kinds of conversations that make the council so valuable. We now have 18 members: seven distributors with NDC, seven supplier partners, and four members of the NDC team. We meet quarterly in a virtual format and also gather in person once a year during our NDC Power of Partnership Exhibition, which is our national meeting.
Repertoire Magazine: How would you describe the lab marketplace today?
Macholz: Bumpy. Supply chain issues continue to create barriers in point-of-care testing. Even now – well past the height of COVID – we’re seeing vendors already back-ordering COVID tests. It’s surprising, even shocking, considering we’re just at the beginning of the season. If you look at Australia, they had an early flu season, and it was a tough one. Now we’re seeing early signs here that could point to the same, with vendors already struggling to meet demand.
Cook: Another factor is suppliers transitioning products that were introduced under Emergency Use Authorization (EUA) to full FDA 510(k) clearance. That shift is creating logistical challenges. They’re trying to work through existing EUA inventory while bringing 510(k)-cleared products to market – but production isn’t always keeping pace. As a result, suppliers sometimes have to fall back on EUA products, creating uncertainty about availability. Over time, as more suppliers complete that transition, the situation should stabilize. But for now, it adds to the bumpiness you mentioned.
Macholz: We also saw some “pretenders” enter the market during COVID – manufacturers that weren’t really specialists in point-of-care testing. Many of them have now exited, which has pushed more volume and pressure onto the true point-of-care specialists. That added strain on credible manufacturers contributes to the uneven supply situation we’re experiencing.
Thompson: That’s a great point. Another challenge is expiration dating. As a master distributor, we have to carefully manage inventory. Demand can spike suddenly, then drop off just as quickly. If products have only six to eight months of shelf life, we can’t roll them into the next season. That creates risk for both distributors and manufacturers when it comes to maintaining adequate inventory without ending up with expired product.
Repertoire Magazine: What are some emerging trends or technologies you are watching?
Barefoot: One of the biggest issues we need to pay attention to is antimicrobial resistance (AMR). Too often, antibiotics are prescribed without proper diagnostic stewardship. That misuse fuels resistance, which could lead to as many as 10 million deaths annually by 2050 – surpassing cancer worldwide. Molecular point-of-care testing, especially rapid molecular isothermal technology for respiratory illnesses, is a key step forward. It allows for more accurate results, ensuring patients receive antivirals or antibiotics only when appropriate. Over time, broader adoption of these technologies will play a critical role in slowing AMR.
Thompson: Along those lines, we’re watching a new point-of-care molecular platform for sexually transmitted infections, expected in late 2026. It will be CLIA-waived and able to test for chlamydia, trichomonas, gonorrhea, and syphilis, including resistance markers for gonorrhea. That could be a game changer in helping providers choose the right antibiotic treatment.
Cook: Another area to watch is wearables. There’s a startup in Melbourne developing a skin patch that could replace traditional blood draws, allowing lab testing through the skin. They recently secured $75 million in funding. More broadly, wearable biomarker technology is gaining momentum, with potential to identify and monitor conditions without requiring a doctor’s office visit.
Barefoot: That kind of technology could remove barriers for patients who delay lab work, something as simple as fasting for a blood test can discourage follow-through. Combining advances in wearables, molecular testing, and platforms that address AMR and STIs shows the direction we’re heading: faster, more accurate, and more accessible diagnostics.
Repertoire Magazine: Are you seeing a growing demand for point-of-care testing in the physician office space? And if so, how is it changing the way labs operate?
Macholz: Yes, demand remains strong. Physicians want faster results so they can move patients through quickly but still ensure accurate diagnoses. We’ve seen some fatigue with at-home testing – patients are more likely to go back to their doctors for respiratory illnesses like flu and COVID. There’s simply more confidence in provider-administered tests than in swabs done at home.
Wilburn: The growing demand for rapid point-of-care testing (RPOCT) is reshaping how labs operate by shifting more diagnostic decision-making closer to the patient. Instead of being the sole gatekeepers of testing, central labs are adapting to a decentralized model where urgent, rule-in/rule-out results are generated at the point of care. This allows labs to focus their resources on more complex, high-throughput testing while supporting providers with quality oversight, connectivity, and test stewardship.
Labs are moving toward operational efficiency through molecular standardization. Health systems and clinics can now unify testing across labs and point of care, creating scalability, quality assurance, and system-wide harmonization. Labs are evolving into the central coordinators of a distributed diagnostic ecosystem, a key message for reps engaging health system leaders.
Barefoot: For respiratory illnesses such as Flu, Covid, Strep A, RSV, testing is definitely shifting into physician offices, especially pediatrics, where rapid molecular platforms are being adopted far more than a few years ago. For example with Strep A testing, a provider can now get a 2-minute positive result using a Waived rapid molecular analyzer. But for blood work, we’re seeing fewer phlebotomists in practices, so those samples are still going out to centralized labs.
Macholz: That’s right. And it varies state by state, largely because of insurance. Reimbursement policies heavily influence whether practices use molecular or rapid testing. In states where molecular isn’t well reimbursed, you see more reliance on rapid point-of-care tests.
Barefoot: Absolutely, POC testing is always increasing; however insurances could make it tough at the start for some smaller practices, especially private practices may not be negotiating molecular reimbursement rates and adding this higher fee to their negotiated private payer contract and managed care plans. Therefore, customers may stick with rapids. The problem is that insurers aren’t incentivizing molecular testing like they may incentivize A1C testing, etc. – even though it could save costs long-term by improving treatment accuracy and reducing antimicrobial resistance. If molecular was tied to quality measures, like diabetes or cholesterol management, you’d see broader adoption.
Macholz: And patient behavior plays a role too. Parents, for example, often prefer the doctor’s office because they don’t want to swab their kids – or worry they’re not doing it correctly. That accuracy and confidence is a big driver of why we’re seeing patients pivot back to physician offices.
Barefoot: Right. Compliance is much higher when a provider collects the sample. Patients trust the results more – and that’s critical in shaping testing trends.
Repertoire Magazine: Are there trends in preventive medicine or personalized care that you believe will redefine the lab’s role in the next five years?
Wilburn: Overall, that RPOCT is undeniably expanding, driven by strong market demand, expanding technology, and shifting healthcare models – moving testing from labs to clinics, pharmacies, homes, and beyond. The market is robust and evolving.
The next frontier is molecular diagnostics in the home. Extending lab-quality testing beyond the lab and clinic enables earlier detection, faster treatment, and more effective preventive care. For health systems and clinics, it empowers a continuum of molecular care across lab, point of care, and home without sacrificing quality.
Cook: I believe with the rise of insurance, more corporations are pushing for preventive health programs in their organizations. This will lead to more preventative tests and visits for the lab market. This could also in turn have labs shift from reactive diagnostics (identifying disease after symptoms appear) to predictive analytics that inform preventive strategies and personalized treatment plans. I also believe that the lab-on-a-patch market will see tremendous growth and innovation in the next five years, resulting in labs changing the way they operate and POLs as well.