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In rural Wisconsin, where the nearest hospital might be an hour away and specialist care even farther, every diagnostic decision carries extra weight. For Marshfield Clinic Health System, serving 45 communities across Wisconsin and Michigan's Upper Peninsula, this reality has driven a fundamental rethink of how to deliver high-quality HIV testing to underserved populations.
At the recent Association for Diagnostics and Laboratory Medicine (ADLM) 2025 conference, Dr. Sarah W. Bissonnette, Laboratory Director at Marshfield Clinic Health System, discussed how her organization is delivering state-of-the-art HIV diagnostics to rural communities through standardization, advanced technology, and strategic partnerships. Her presentation revealed a compelling story of how rural health systems can overcome geographic and resource challenges to deliver exceptional patient care.
The Challenge: Rural Healthcare's Perfect Storm
"Providing health care in our rural geography comes with challenges and it's imperative we think differently," explains Jeff Starck, media relations specialist for Marshfield Clinic Health System. Like many rural organizations, Marshfield faces the complex realities of rising costs, workforce shortages, and the need to maintain high-quality care across a vast geographic area spanning 11 hospitals, 65 clinic locations, and serving 350,000 unique patients.
These pressures are particularly acute in infectious disease diagnostics, where early detection and timely treatment can dramatically alter patient outcomes. In Wisconsin, an estimated 8,550 people live with HIV, with approximately 1,094 unaware of their status—awareness gaps that are often more pronounced in rural and underserved communities. Despite these challenges, Wisconsin has achieved remarkable success in HIV care. The state consistently reports lower HIV rates than neighboring states and has nearly eliminated perinatal HIV transmission—a testament to the power of early intervention and coordinated care.
Strategic Partnership Drives Community Impact
Central to Marshfield's success has been its strategic partnership with Beckman Coulter Diagnostics. This collaboration extends beyond simple vendor relationships to encompass shared innovation goals and mutual commitment to improving rural healthcare access. By working together, both organizations can address the unique challenges of rural healthcare while advancing the overall field of diagnostic medicine.
Most importantly, Marshfield's HIV testing initiative demonstrates how laboratory innovation translates into tangible community health benefits. By centralizing testing at their core lab while maintaining local specimen collection capabilities, they've created a hub-and-spoke model that addresses workforce shortages while ensuring rapid turnaround times.
This approach particularly benefits high-risk populations who might otherwise face barriers to testing. With optimized courier routes ensuring samples reach the lab quickly, even patients at the most remote clinic locations can access the same high-quality diagnostics available at major medical centers.
High-Quality HIV Assay Delivers Trusted Results and Better Outcomes
The foundation of Marshfield's success in expanding patient access to high-quality HIV testing is its adoption of Beckman Coulter’s 4th-generation HIV diagnostics. Modern HIV testing has evolved dramatically from first-generation antibody tests that required 6-12 weeks post-infection for detection.1 Today's fourth-generation HIV antigen/antibody combination tests can identify infections much earlier by detecting both HIV-1 p24 antigen and HIV-1/2 antibodies simultaneously.1
Dr. Bissonnette's team conducted rigorous validation studies of the Access HIV Ag/Ab combo assay on the DxI 9000 Access Immunoassay Analyzer, demonstrating exceptional performance that aligns with CDC guidelines. The EU clinical results speak volumes: 100% sensitivity and 99.76% specificity, with the ability to detect HIV 1.2 to 1.6 days earlier than competing platforms during the critical seroconversion period.
The Access HIV Ag/Ab combo assay requires just 60 μl of sample, delivers results in approximately 30 minutes, and eliminates the uncertainty of equivocal zones that require retesting. For a rural health system managing multiple locations with varying technical capabilities, operational advantages such as these, can translate directly into improved patient care.
Standardization as Strategy
One of the best practices adopted by Marshfield to expand patient access to high-quality HIV diagnostics has been its embrace of standardizing testing across its entire network. Previously, different locations used varying equipment, test menus, and workflows, depending on the patient populations they served. This created challenges, including different reference ranges, supply chain complications, and inconsistent training requirements.
By implementing the DxI 9000 system across locations, Marshfield achieved common reference ranges, standardized reagents, and unified training—all critical factors for ensuring consistent, high-quality results regardless of where a patient receives care.
Vision for the Future
The success at Marshfield Clinic Health System offers a powerful blueprint for rural health organizations everywhere. Through strategic partnership with Beckman Coulter—enabling technology adoption, operational standardization, and clinical improvements— even resource-constrained rural health systems can deliver high-quality diagnostic services.
In the fight against HIV, every day matters. By modernizing their approach to HIV testing, Marshfield is ensuring that geography never stands between their patients and the care they deserve. It's a testament to what's possible when clinical excellence meets innovative thinking—and a reminder that the future of rural healthcare is brighter than many believe.
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References:
1. The evolution of high-sensitivity HIV diagnostic testing. 2024. https://www.beckmancoulter.com/en/blog/diagnostics/evolution-of-high-sensitivity-hiv-testing
The clinical data referenced in the Plantier paper originates from a clinical study performed in the EU and is representative of the EU intended use population. This information should not be interpreted as reflecting the intended use across all other global regions.
2025-14890
