Providing educational and consultative services to help labs succeed

April 24, 2017
James Liggins CEO,COLA Resources, Inc.


I have been in my present position as CEO of CRI for over two years. I transitioned into this role from the position of Chief Marketing Officer at COLA. I have been in the healthcare arena for more than 25 years, starting in a direct-care environment and assuming greater responsibilities through the years. Prior to COLA, I worked for 10 years at Magellan Behavioral Health.
I received a BA degree from Tuskegee University, which has been an amazing foundation to support our work in laboratory medicine. I will complete my MBA from the University of Maryland in the summer of 2017.
I am a member of Leadership Howard County (Maryland) and I serve as a Trustee on the board of the Maryland 10th Cavalry Association. My family and I participate in events that support youth mentoring, Howard County Police Foundation, Rebuilding Howard County, and the Howard County Hospital Association, among others.

How would you characterize the mission of COLA Resources, Inc. (CRI), in a few words, for people who may not be aware of it? The mission of CRI is to “provide educational and consultative services aimed at improving laboratory medicine and patient care.” Between the changing healthcare environment, the depth of regulatory demands placed upon laboratories, and the demand for continuing education, CRI recognizes the value and impact that continuing education has on driving quality laboratory medicine. CRI is positioned to focus on the educational needs of this ever-changing environment.

What is the history of CRI? When and why did it separate from COLA itself? The decision to develop CRI as a separate educational and consultative services entity was based on the confidence that our services, which had been specifically for COLA-only laboratories, would provide value for all laboratories. CRI has a wealth of knowledge and experience that we want to make available to the entire laboratory profession. With more than 20 years of experience developing educational products and with expert knowledge of the field of laboratory medicine including regulatory, operational and quality requirements, we are confident that CRI is a superb resource for quality achievement.

We decided in 2012 to separate CRI as a COLA subsidiary, with the goals of providing an educational platform to assist laboratory and other healthcare professionals, and to assist these professionals in establishing Continuous Quality standards through consultative services.

What types of educational resources does CRI provide for the laboratory? For the lab director? For brand new labs that are yet to be surveyed? Through CRI’s LabUniversity distance learning program, healthcare professionals can access a wide array of education resources through a single, convenient online learning management system. In addition to an extensive series of online educational courses, the educational platform addresses important industry issues, enables physicians to meet CME education requirements to qualify as a laboratory director of a moderate complexity laboratory, and assists laboratory professionals in earning P.A.C.E. credits to meet state licensure requirements. CRI also provides an extensive series of webinars, training and review videos, and educational manuals and guides, plus live presentations at our annual Symposium.

For brand-new labs, we offer a Quality Improvement Program led by our CRI Educational Surveyors. These surveyors are tasked with on-site visits to these new (start-up) laboratories that have chosen COLA as their accreditation organization. They visit the laboratory for a full day and review all essential aspects of a quality laboratory operation (on-site pre-assessments). These visits occur prior to an official COLA survey, and are designed to review, assess, and advise those laboratories, many of which do not have experienced personnel. This service is provided at no cost to these labs. After almost two years of this service to COLA labs, studies have indicated a significant reduction in first-time survey citations. Our plans are to expand this pre-assessment initiative to any laboratory. We think labs will consider the cost to be an investment in quality.

What do you see as significant trends in the clinical lab industry? How is CRI staying “ahead of the curve”? The laboratory industry is subject to the same technological, regulatory, demographic, cultural, and political forces as all other components of the healthcare industry. CRI, through its webinars, videos, written blogs, and continuously updated product information on regulatory requirements, is aggressively keeping our fellow professionals current with all these changes. The most significant trends can be characterized under the following categories:

Technical:  Trends include point-of-care testing; mobile (including wearable) technology; digital storage and transmission of data (including electronic health records); molecular diagnostics and genomic testing, enabling the development of personalized medicine; and computerized, virtual office visits between patients and their physicians.

Demographic: Aging baby boomers require more frequent medical services, including management of chronic diseases. Millennials, who are much less likely to have designated personal physicians, and are quite comfortable with as-needed medical visits, are also more likely to utilize and promote the newest technological innovations. They feel more at ease accessing walk-in and retail clinics staffed by non-physician professionals such as nurse practitioners.

Cultural: The opioid epidemic has had a significant effect on laboratory technology—for example, enormous growth of Mass Spectroscopy laboratories and the resources needed to regulate them. Also, the growth of retail medicine and mobile technology has led to the decentralization of how medical care is provided.

Political: An additional 20 million people are now covered through the Affordable Care Act (ACA), resulting in an overloaded healthcare delivery system and exacerbating the physician shortage, as well as shortages in allied healthcare professionals, including laboratorians. Future changes to the ACA will affect insurance coverage and access to medical care. I also would include in this category PAMA (Protecting Access to Medicare Act) and how its payment/reimbursement requirements will affect the future survival of smaller hospital, reference, and physician office laboratories, and all the activities of professional organizations around this issue.

How is CRI helping labs to improve quality patient care, for example, when it comes to frequently cited citations? CRI is working on several fronts to assist laboratories to achieve the highest quality of patient care possible, and improve compliance with quality standards:

Our Annual Symposium always includes several presentations discussing the most frequently cited citations, either directly, or through discussions of laboratory quality and regulatory

CRI sponsors a series of video presentations by Dr. John Daly, Medical Director for COLA, titled “Solutions for Common Citations,” in which very specific information is provided in convenient five minute bites addressing the most commonly cited criteria.

CRI also sponsors a monthly Quality Advisor blog, published in Lab Testing Many of these discuss the most frequently cited criteria, and how to address these issues.

The CRI Technical Writer has written for several professional publications, discussing how to address such issues as Quality Control, Quality Assessment, Competency Assessment, and Personnel qualifications, all of which have been the basis for the most frequently cited

How is CRI helping to foster interest in laboratory medicine through its new website? We have a very informative website that is easily navigated to provide a complete picture of who we are, and the products and services offered. These include links to all of our educational products (through our LabUniversity website), not only by content but by venue (online, video, live presentations, Symposium), and with instructions as to cost, accessibility, educational credit provided, and schedules (when appropriate). In addition, our site includes all Quality Advisor blogs that cover topics of interest to quality-minded laboratory professionals. We also have a separate section with detailed information about initiating and maintaining an IQCP program.

CRI recently was recently awarded a $1.5 million grant from the CDC to improve waived testing performance and outcomes at Certificate of Waiver (CW) sites nationwide. What is the scope of this project and what do you plan to accomplish? The purpose of this project is to provide the resources and support to encourage and enable CW laboratories to achieve higher quality standards of practice nationwide. CRI will use the funding to expand the reach of existing quality assurance and quality improvement products, and to develop new educational products that provide information on regulatory requirements, good lab practices, training, education, and quality improvement tools. CRI will deliver a waived testing assessment tool that identifies areas of strengths and weakness and provides feedback and additional resources from CRI and other laboratory professionals to improve waived testing practices.

Participation from waived testing sites in programs to improve quality continues to be a challenge due to the lack of governmental regulatory requirements. To improve participation, education must be provided in a manner that it is easy to access, meaningful, and relevant. To provide assistance to CW sites, CRI provides a web-based learning management system (LMS) to support customers in selecting products while tracking their advancement through the designated criteria. The LMS manages student activities, providing reports to management on the results, scores, and demographics of the students enrolled. The grant would fund the expansion of the LMS and the educational products it warehouses to support the waived testing project, and serve as a resource to track participation and highlight areas of weakness and opportunities for improvement.

Years of experience in crafting educational materials for waived testing sites, experienced staff, proven tools, and educational product development and delivery expertise are all key attributes that CRI brings to the project. These attributes are designed to support the increased adoption and implementation of quality practices, increase the participation in QA/QI activities, decrease inappropriate performance, and improve the use of Waived Testing results to improve healthcare decisions.

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