ADLM President Paul Jannetto, Ph.D., says the next five years will bring sweeping changes to diagnostics, but sustaining progress requires policy reform and a stronger workforce.
This summer in Chicago, thousands of laboratory medicine professionals from around the globe gathered, not merely to exchange ideas, but to signal the next frontier in how we think about, develop, and deploy diagnostic science at ADLM 2025.
Speakers, panelists, exhibitors and attendees discussed the challenges and opportunities ahead. What emerged was more than a crossroads – it was a turning point. Clinical laboratories are becoming centers of translation and intervention, deeply intertwined with data science, environmental health, and patient-centric care.
Among the emerging trends and technologies, artificial intelligence and point-of-care testing are particularly poised to redefine the future of laboratory medicine, according to Dr. Paul Jannetto, president of the Association for Diagnostics & Laboratory Medicine (ADLM, formerly AACC).
Speaking with Repertoire Magazine following the ADLM 2025 meeting, Jannetto highlighted how these technologies, coupled with growing demand for personalized medicine and rapid diagnostics, will shape the next decade of clinical laboratory practice.
AI’s expanding role in the lab
Artificial intelligence and machine learning are still emerging in laboratory medicine, but the technology is already demonstrating its value. “Laboratory experts are beginning to use AI and machine learning to determine diagnoses and identify possible outcomes to treatment more quickly, which in turn could lead to higher quality patient care,” said Dr. Jannetto, who also serves as professor of laboratory medicine and pathology, vice-chair of practice laboratory medicine, and co-director of several specialty labs at Mayo Clinic in Rochester, Minnesota.
He pointed to recent breakthroughs as proof of AI’s promise. “For example, a few years ago, researchers from the University of Michigan developed and implemented a machine learning test called ThioMon to guide treatment of inflammatory bowel disease (IBD) with azathioprine. Although azathioprine is much cheaper than other IBD medications (which can cost thousands of dollars a month), its dosage requires finetuning for each patient, making it difficult to prescribe. ThioMon solves this issue by analyzing a patient’s routine lab test results to determine if a particular dose of azathioprine works or not.”
AI is also improving infectious disease detection. “Even more recently, a blood test for Lyme disease was unveiled at ADLM 2025 that was developed with the help of AI,” Dr. Jannetto said. “The test identifies Lyme disease sooner than the current standard test and is also more accurate. Both its sensitivity and specificity are over 90%, compared to traditional Lyme testing, which detects the disease accurately only 30% of the time. With these capabilities, the new test could significantly improve patient outcomes. The researchers hope that the test, which works on standard laboratory equipment, will be commercially available by the end of 2026.”
The shift toward at-home testing
If AI represents the cutting edge of diagnostics, point-of-care testing reflects a shift in how patients access lab services. Dr. Jannetto noted that the most important change in this space has been cultural, not technological. “During the COVID-19 pandemic, the widespread use of point-of-care testing reshaped the public’s expectations for medical testing,” he explained. “Point-of-care testing offered convenience, privacy, and speed of results from home. The public and healthcare providers came to really trust results from at-home tests, using them to make critical decisions about travel, personal/social interactions, and other behaviors. This, in turn, has increased trust in at-home testing across the board, which has also increased demand for it.”
The implications for clinical labs are significant. “A big positive of this is that more at-home testing means increased patient access to testing – something that ADLM strongly supports. Expanding the use of at-home tests could also help to alleviate the burden on clinical labs in the U.S., which have been short-staffed for years,” Dr. Jannetto said. “This is likely the biggest impact that point-of-care testing could have on the traditional lab model in the near future: It could free up time for lab professionals to focus more on tests that require specialized training and equipment and that must be done in a core lab setting.”
At the same time, he cautioned against overreliance on at-home results. “Of course, increased at-home testing comes with downsides, too. Some at-home tests may not be as reliable as testing that is performed in clinical laboratories. And as with all diagnostic testing, another big challenge in interpreting an at-home test result is to not rely solely on that result to make a diagnosis. The test result counts of course, but clinical context must always be carefully considered when acting on any test result. We at ADLM do advise patients who are using at-home tests to consult with their healthcare providers and evidence-based guidance when interpreting the test results.”
Personalized medicine and rapid diagnostics
The shift toward individualized care is also driving laboratory innovation. “As the healthcare field as a whole continues to work toward making personalized medicine a reality, clinical labs have been taking a more individualized approach to diagnosis and disease management,” Dr. Jannetto said. He pointed to chronic kidney disease management as one example: “Clinical guidelines now recommend that labs use validated, lab-based equations that predict kidney-failure risk as an integral part of chronic kidney disease management. This approach enables labs to assess each patient’s individual risk of disease progression, which in turn enables clinicians to make more precise treatment decisions.”
Rapid testing, particularly in infectious disease management, is another frontier. “Phenotypic antibiotic susceptibility testing (AST) is one particular area where rapid testing is taking off,” Dr. Jannetto said. Traditional AST can take up to 48 hours – far too long for patients in septic shock. “Rapid AST could therefore play a major role in enabling patients to get timely, effective treatment for serious infections while also minimizing the potential for widespread antibiotic resistance.”
Persistent challenges: staffing and reimbursement
Despite these advances, laboratories continue to face structural challenges. “Staffing shortages remain a consistent issue for clinical laboratories and are one of the biggest operational challenges that labs face today,” Dr. Jannetto said, citing studies that show vacancy rates as high as 25% in some regions and an aging workforce nearing retirement. “These surveys show us what many laboratories are grappling with, which is that an insufficient amount of newly trained technologists are entering the field, while previous generations of laboratory medicine professionals are retiring at historic rates.”
Reimbursement pressures further complicate the picture. “Adequate Medicare reimbursements play a crucial role in helping laboratories remain financially viable,” he explained. “This is especially true for the outreach labs that serve rural and underserved communities, and that tend to operate with thin profit margins.”
The stakes are high. Under current law, more than 800 lab tests could face payment cuts of up to 15% beginning in 2026 due to flaws in Medicare’s rate-setting process. “If this happens, more than 800 laboratory tests will be subject to payment cuts of up to 15%, which could hinder patient access to routine and life-saving tests,” Dr. Jannetto warned. He expressed optimism about recent bipartisan efforts to fix the process: “Thankfully, a new piece of bipartisan legislation – the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act – was recently introduced in Congress. This legislation would ensure that the Medicare CLFS rate-setting process is based on up-to-date, comprehensive data representative of all clinical labs.”
For Dr. Jannetto, the message is clear: innovations in AI, point-of-care testing, and rapid diagnostics hold enormous promise, but sustaining progress requires policy support and a strong workforce. The future of laboratory medicine, he said, depends on balancing technological breakthroughs with practical realities.