Achieving Consultative Lab Testing Services

Transcription

1 Achieving Consultative Lab Testing Services Sandy Richman, MBA, C(ASCP) Manager of ARUP Consultative Services Agenda A review of healthcare trends Impact on labs - opportunities & challenges Strategies that create greater clinical value with examples from top performing labs

2 Overarching Goals of Healthcare Reform Access Quality Cost Existing Delivery Model vs. Proposed Fragmented Care Referral Networks Fee for Service Integrated Services Accountable Care Bundled Payments

3 Paving the Path to Accountable Care Progression to the New Models Clinically Integrated; can begin contracting Information Technology Start 6-9 months 12 months months and beyond Health Care Trends Employed physicians Hospital consolidation and affiliations Services moving away from hospital setting Investment in IT/Electronic Health Records New delivery and payment models Role of the consumer/patient Continued uncertainty

4 Lab Opportunities Pre-Analytical Analytical Post-Analytical CLINICAL DIRECTION CPOE Decision Support Clinical pathways GENERATOR/ DISTRIBUTOR of clinical information ANALYTICS Analysis of aggregate clinical data Integrator of clinical data Lab Challenges IT challenges Requirement to interface to multiple EHRs Incorporating data in to Health Information Exchanges (HIEs) Competing for hospital IT resources Adjusting to new payment models Under bundled payments lab becomes a cost center Demonstrating value beyond providing a timely, accurate test result Focus on medical value and downstream cost savings

5 Change the thinking of you send us a sample and we will convert it to a number or result Data Information Knowledge Understand the pivotal role labs play in the integration of clinical and financial information Providers of knowledge not just test results Lab results drive more than 70% of clinical decisions Lab results comprise a major portion of any medical record Find a champion for the lab Align the goals of the lab with the overall strategy of the health system Show how the lab can provide value to the entire system Take your story to hospital leadership Have a clear understanding of the health system s clinical and financial objectives Stay aware of local issues that can impact your lab Stay informed on national healthcare issues Watch the competition Join health care groups outside of lab American College of Healthcare Executives (ACHE) Healthcare Financial Management Association (HFMA) Join healthcare groups on Linkedin and facebook

6 Sources of Information Become the most integrated laboratory More services are moving outside the 4 walls of the hospital Less inpatient and outpatient volume Increase in employed physicians is a built in opportunity for hospital labs Focus is moving from outreach to in-reach Fill excess capacity with outreach volume Eliminate duplicate testing control utilization lower cost of testing The hospital lab is best positioned to provide testing across the care continuum Provide one medical record for all episodes of care

7 Support of hospital senior leadership Involvement of lab leadership and staff Superior laboratory services Culture of customer service Specimen collection and logistics Electronic connectivity and EMR solutions Participation in managed care networks Marketing strategy and plan Formal sales program Client services Pricing and billing efficiencies Financial and performance indicators Utilization Management Sendouts Management Compare order patterns between similar physicians Review all sendouts over a certain amount Look for insourcing opportunities Assist in Computerized Physician Order Entry (CPOE) with clinical decision support Develop testing algorithms Set up laboratory formulary committee Use model of pharmaceuticals and therapeutics as an example

8 Engage Pathologists Analyzing aggregate clinical data for outcome and quality measures Develop care paths Involve pathologists in the direct care of patients Final Thoughts Laboratory has a limited opportunity to demonstrate its often undervalued contribution to the overall quality of healthcare Continue to look for ways to provide better care to more patients at a lower cost Tell your story now and often Ask yourself this basic question: how is it that I create value in the healthcare system? If the only answer that you can give is a lower price, then you have to scratch your head and ask, is that a survivable strategy? I m not sure it is. If the only thing you can deliver is a discount, eventually you may find that you re not delivering what the market wants to buy. -- Randy Cook Clinical Laboratory News, January 2011: Volume 37, Number 1

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