The laboratory’s role in patient care has been evolving and morphing for decades, but never more so than in the last three to five years. With changes in regulation, reimbursement, test focus, and patient access to information, and especially with the rise in general of patient-centric care, the lab has become the central cog in a very strategic wheel of healthcare. This is a significant departure from the perception of the past that the lab’s role was simply to provide a test result.
If you imagine the lab as the central component of the patient care team, with spokes pointing to the other members—clinicians, therapists, pharmacists, specialists, surgeons, etc.—all of the patient-specific information is now available to be viewed, shared, and discussed electronically both to diagnose and treat each individual as exactly that: an individual. Each patient, with his or her specific disease or disorder, can now be treated based upon specific genetic and environment factors (along with risk factors) to enable the best outcome. And, it is primarily the technology that a laboratory uses—as a platform for combining, sharing, and automating the communication of all patient data, history, demographics, test results, recommended medications, and physician- and even patient-specific reporting capabilities—that is driving the movement toward patient-centric care and the new healthcare paradigm at whose center is the lab.
Pathologists and other lab leaders should be “lobbying” for themselves—and patients—by showing the value they bring as a member of a patient care team. One way that they can demonstrate their value is by working effectively with the vendors of laboratory information systems (LIS) that can enhance the lab’s centrality to the new care paradigm.
Vendors as mentors
Lab leaders today are increasingly looking to LIS vendors for a mentor- or coach-style relationship, and forward-thinking vendors are offering that service. With all of the recent changes in testing regulations and reimbursements, as well as test types merging and evolving—such as crossover molecular, PGx, etc.—labs need to be able to focus on the medical side of their business. Their technology providers should be giving them clear direction on how to best leverage their IT investment. Vendors should provide coaching throughout setup, implementation, automation, and integration with all aspects of the lab’s IT infrastructure, and beyond. Vendors should be partnering and developing technology integrations with one another to provide all aspects of patient information data flow that are relevant for a physician to make an accurate diagnosis and develop a customized treatment plan. After all, no one should understand the technology and technical capabilities better than the vendors, as it relates to how to best gain efficiencies and utilize technology to support laboratory objectives. And they need to be able to act on that understanding by giving labs valuable direction.
Lab data as gold
Another key aspect to consider is that data are each laboratory’s gold. The LIS is the central repository of all of the data coming into, and going out of, the lab. There are many types of data that the LIS has access to—not just the obvious ones of patient data, demographics, test results, and diagnosis—and all are extremely valuable not only in the testing the lab is doing, but also in the big data picture. All of this discrete data are information that can be processed, analyzed, and used to provide personalized medicine—in many forms, but primarily in the form of treatment plans that are linked to the most favorable outcomes.
In addition, there is also extremely valuable data that give labs insights into their business operations, data that most labs might not think of when they consider the value of an LIS. These data include information such as test turnaround times; accessioning times per case; repeat runs of certain tests or specific instruments; cases corrected by accessioner/pathologist/technologist; instances when an external customer has been sending in fewer (or more) tests; specific types of tests; how long or how many attempts it takes to get a payor to pay a claim—the list is a long one. These are all pieces of information that can show trends a lab can act upon to improve its business. They can point the way toward an easy retraining of specific employees that would have an immediate impact on the bottom line or a way for a lab to “save” or recover a specific customer who is falling off on ordering tests because of an unrecognized issue that can be easily resolved.
Knowledge as value
These data provide insight for each lab to understand where its strengths and weaknesses lie as a business. They provide a significant opportunity for the lab to incorporate new processes and make changes to existing ones or updates in training, interfaces, and automation to become more profitable, have better turnaround times, and focus on areas that have higher and faster reimbursements and customer retention, all the while enhancing personalized medicine.
In this era of increasing consolidation and test expansion, each laboratory needs to find ways to move forward toward patient-centric care and to operate efficiently and effectively as a business. Healthcare is not a commodity, but the services and the service providers in the healthcare industry are certainly being forced in that direction. Patients are more involved and smarter, and more able to shop their physicians, and they have information readily available on where the “best” providers are (both in terms of price and outcomes). In short, to their credit, they are becoming savvy information gatherers, and technology as well as regulations are providing them with the information. The lab also needs to utilize technology in an expanded role to become a savvy, and sought after, provider of a vital service.
Lisa-Jean Clifford serves as CEO of Massachusetts-based Psyche Systems Corporation. She has more than a fifteen years’ experience in the healthcare high-tech field.
