Last month, the Martha’s Vineyard Hospital began in-house testing for Lyme disease. The fact that the hospital was able to acquire at no charge a sophisticated machine used to test blood samples for the indicators of infection was due in large part to the sophisticated background of the new lab manager, until recently a night shift technician.
Ursula Lena Prisco took on her expanded responsibilities in October. In the past eight months she has focused on expanding the lab’s capabilities and procedures. That has included more rapid turnaround of test results and a new contractual arrangement with the Mayo Clinic to provide testing beyond the scope of the hospital lab.
Ms. Prisco, 52, and the mother of a 20-year-old son and 23-year-old-daughter, did not move to Martha’s Vineyard in November 2007 intending to further a successful research and management career. But she was waiting in the wings, literally, when the job became available.
Timothy Walsh, Martha’s Vineyard Hospital chief executive officer, told The Times that last fall Lynn Mercier, lab manager, told him that she wanted to scale back her work responsibilities. “That was the bad news,” Mr. Walsh said. “The good news was that she and Ursula proposed that they switch responsibilities.”
Mr. Walsh said the transition has been seamless. In a recent conversation in her office adjacent to the testing area, Ms. Prisco agreed.
“Lynn and I are actually two sides of the same coin,” she said. “I am the bigger implementation type: let’s think about doing this and let’s try to do that. Lynn is what I would call the super-tech. She is not only very quick, she is also very good and that is what she loves. But it is hard to be in this seat and do that.”
Ms. Prisco added, “I am the outside-of-the-box thinker and she helps me implement the vision. What better combination. She’s in a role she wants to be in and I’m in a role I want to be in so it works well. It’s a great partnership.”
Back to basics
Ms. Prisco’s move to the Vineyard followed a familiar path. She and her partner, Arlene Star Prisco, who planned to retire, were looking for a new home. They visited the Island, a place Ursula Prisco had visited often as a youngster, and decided to stay.
At the time, the couple was living in Fairfield County, Connecticut. Both women worked in the pharmaceutical industry in New York City.
After moving to the Vineyard in November 2007, Ms. Prisco, vice president at Paraxel, continued to work. She telecommuted and traveled back and forth between the Vineyard and New York or New Jersey.
“That got pretty old,” she said.
She applied for a number of different jobs. “What kept coming back is you are way over-qualified,” she said.
One day she saw an ad in the newspaper. Martha’s Vineyard Hospital was looking for an evening technologist.
Before she earned a masters degree and doctorate in pharmacology and entered a professional career in neuro-science research, Ms. Prisco began her medical career as a medical technician. Confident she could resurrect those skills, she applied for the job.
The hospital hired her immediately, and she began working on evenings and weekends. “It was good to kind of regroup and not be the boss because in my former position I supervised close to 60 people,” she said.
She was happy to assist lab manager Lynn Mercier with responsibilities outside the realm of a lab tech. “I enjoyed it and it was almost second nature to me,” she said.
Last summer, Ms. Mercier approached Ms. Prisco and told her she wanted to step down as manager but the only way she could do that was if Ms. Prisco took the job. “I almost fell off my chair,” Ms. Prisco said.
“We needed to switch roles and that’s what happened,” she said.
From the outside
In her new role, Ms. Prisco said, “I looked for those tests that could enhance patient care, first and foremost — what kind of information do physicians need — and then I looked at volume, how many are we actually doing per year and how fast are we getting those results.”
That philosophy drove the decision in March to switch from the Qwest reference laboratory to the Mayo Clinic in Andover for tests that did not fit into the routine of the hospital lab. “If you are drawn for something one day, the Mayo has the results available for us most times the next morning,” Ms. Prisco said.
The added advantage of contracting with the Mayo is that the hospital now has electronic access to the laboratory data bases and strong support. Because the hospital’s parent organization, Partners Healthcare, also contracts with Mayo, it will eventually lead to full electronic medical records access.
Last year, the hospital did over 4,000 tests for Lyme. Less than 35 were new positives — that is, people who had not previously been infected — and the results indicated Lyme disease, she said.
Ms. Prisco said she knew back in September she wanted to address Lyme testing. Sending the tests off Island to Imugen in Norwood was time-consuming and expensive, mostly because of the high level of testing provided.
She reasoned that a triage approach, starting with the first level of tests and ruling out the obvious negatives, would be more practical. If more sophisticated analysis was required it would still be available.
Ms. Prisco decided to bring Lyme testing in-house. “I had already identified the instrument I wanted to use, also knowing, and this comes from being in pharmacology, that there are ways to bargain with a lot of these companies,” she said.
She acquired a new instrument, a Biomerieux MiniVIDAS analyzer, which can detect the antibodies that help to confirm a Lyme infection in 60 minutes. She said it is extremely sophisticated but also easy to use.
Although in-house testing started last month, she has continued to send tests to Imugen to validate her results.
Ms. Prisco said there is almost a “hysteria” about Lyme disease. The test helps to confirm a diagnosis but is not absolute, she said.
For example, the test could detect anti-bodies a person’s body generated during a previous infection, or the test would not detect infection should a person take antibiotics in reaction to a tick bite prior to developing any symptoms.
Ms. Prisco looks at Martha’s Vineyard Hospital from the vantage point of an outside professional with experience in a variety of settings. When she and her partner were considering where to set down roots, access to quality health care figured large in the equation. She said that helping to provide that care is rewarding.
In 2011, the lab did 301,580 total tests. “That’s quite a bit,” Ms. Prisco said. “It’s pretty busy for a little lab.”
Given the size of the hospital, 24 beds, and the population, Ms. Prisco said, “It is remarkable that we have a laboratory this well equipped that does this much.”