As outpatient visits continue to increase, it has become more and more common for hospital systems to consider (or reconsider) a lab outreach business, and to open additional ambulatory care centers in order to better serve their patients and bolster financially sustainable volumes. Today, more than 70 percent of care is delivered outside the hospital, contributing to approximately half of hospital revenues. Ambulatory care centers require tremendous coordination with numerous ancillary departments within the hospital. Some of the industry’s best care centers partner with their hospital laboratories to provide services at these centers to ensure the highest levels of quality in testing, quick turnaround times (TATs), and patient and physician satisfaction.
Laboratory teams must work with phlebotomy, information technology (IT), clinical laboratory professionals, and client services teams to open and maintain satellite laboratories for their ambulatory care centers, as well as additional patient service centers. Because patients can visit many ambulatory locations, standardization of the laboratory instrumentation is crucial in providing excellence in quality and safe care. It is imperative that the laboratory information system (LIS) directly integrate the laboratory instrumentation and follow similar workflows for physicians, patients, and laboratory staff. One must also rely on consistent processes, so that the laboratory staff is able to work at different locations to further maximize staffing arrangements due to standardized workflows and procedures at each location.
By utilizing well-defined processes, standard instrumentation, and one LIS, typically more than 75 percent of testing is able to stay local to the respective laboratory where the patient visited the physician and had the specimens collected. In addition to drastically reduced TATs, patient care centers typically see decreased transportation issues and a reduction in lost specimens when transferring samples to laboratory locations. Test results are automatically interfaced and available in the electronic medical record (EMR) and are sent directly to the physicians in minutes, as opposed to hours or days. This expedited TAT empowers physicians to make nearly immediate clinical decisions—often while patients are still present in the office—reducing the need for additional callbacks to patients and follow-up visits. Patient and physician satisfaction levels are increased.
When transport of specimens, supplies, and results to and from physician offices is needed, a comprehensive customer relationship management (CRM) system coupled with a Dispatch and Mobile Courier application is imperative. Many dispatch and courier “systems” today are very manual and paper-ridden. By implementing a CRM and Dispatch + Mobile Courier application, laboratories are now able to help close the loop between pickup and drop-off of specimens, as well as gain analytics in their operations.
Staff training should be streamlined with the use of the same EMR and LIS across laboratories, patient service centers, and ambulatory care centers. By utilizing “performing labs” in an LIS, a laboratory is able to utilize consistent order codes for its physicians, phlebotomy staff, and technologist staff, which eliminates the need for additional education for employees. The result is a reduction in errors and the ability for managers to move staff across locations much more efficiently. Like many healthcare organizations, labs nowadays are asked to do more with less. Standardization and consistency within computer systems are the cornerstones for thriving on limited resources.
A 2014 Marwood Survey reports that 85 percent of CFOs want more lab volume to come in-house, rather than let independent laboratories take the business. More than 70 percent of hospital CFOs view the lab as strategically important, and 50 percent of them expect to buy or partner with independent laboratories.1 With excess capacity, laboratories are being tasked to do exactly what many other market leaders are doing. Diagnostic communities are no longer a thing of the future, but a reality of the present.
- Dunn L. The Acute-Care Continuum: The Future of Hospital-Based Care. Becker’s Hospital Review. http://www.beckershospitalreview.com/white-papers/the-acute-care-continuum-the-future-of-hospital-based-care.html. Published June 20, 2013. Marwood Research, 2014.
Jamel Giuma serves as Director, Integration and Outreach Solutions, for Sunquest Information Systems.