Collaborative data sharing and robust laboratory informatics solutions

Healthcare's transformation is in full swing, and laboratories are certainly feeling the winds of change. Fortunately, labs have a lot to offer to the overall improvements being made in the delivery of healthcare. Laboratory testing is healthcare's highest volume activity, with labs performing up to 10 billion tests per year. Accordingly, labs produce a tremendous amount of valuable data that, when presented in a structured format and combined with other healthcare data, can have a broad impact on improving patient care and healthcare savings. Here is a thumbnail view of some current considerations for forward-facing labs.

Data analytics provide valuable insights

As the volume and complexity of healthcare data continue to increase, it is evident that clinical data can provide a trove of valuable insights if properly captured and analyzed. In addition to internally monitoring lab productivity, laboratory analytics must expand outward and combine with data sets from other departments to have a greater impact on patient care and cost savings.

Healthcare organizations need to carefully consider what combination of software they can rely on to harness this tremendous potential. Part of this includes having a robust laboratory information system (LIS) that meets the intricate and complex needs of the laboratory, now and into the future. Laboratory data and its integration into the patient's clinical picture is a vital component of the new model, so it is important for lab leaders to ensure that they have the best IT systems in place to deliver coordinated patient care.

Consolidation and interoperability

A significant industry trend is hospital consolidation; creating larger networks with broader service reach and economies of scale that can withstand the myriad of economic and regulatory pressures that challenge the industry today. In order for the vast amount of clinical data in the laboratory to be successfully incorporated into healthcare analytics, an LIS must be integrated into the facility's IS network. The future requires advanced interoperability; getting laboratory data in the correct form and system quickly and accurately is paramount to a laboratory's success.

The patient-centered paradigm

Looking forward, laboratory management's view must extend beyond the lab's inner circle and encompass the entire patient episode with an awareness of how the timeliness, accuracy, and cost of a patient's lab work impacts his or her episode of care and final outcome. Patients need lab work all the way from delivery of diagnosis and treatment plan to follow-up and disease monitoring. This new healthcare paradigm puts the patient at the center of its focus.

At the same time, patients are expected to become more involved and diligent about their own healthcare decisions. The lab must be forward-thinking and realize how this may influence its testing menu, volumes, and testing locations. Lab leaders should also consider the role that patient self-monitoring apps play. How will this new technology play into the lab's future? Is their LIS technology advanced and versatile enough to accommodate this new paradigm of patient involvement?

POCT and data integration

As healthcare reform encourages a more proactive and patient-interactive stance, point-of-care testing (POCT) offers substantial benefits because of its ready availability and quicker turnaround time, potentially reducing ER visits and hospital admissions. As accountable care organizations and integrated delivery networks continue to develop, more testing will be performed outside of the core lab, in ambulatory settings and POC locations. It will become extremely important to coordinate this testing and ensure that all healthcare workers on the care team throughout the network have access to the data in order to make timely, optimal care decisions. It is also important that these results are captured in electronic health records for quicker diagnosis and treatment, billing, and to include data from POCT in analytics needed for risk stratification and population health statistics.

Expanding outreach

Declining inpatient visits are compelling laboratories to expand outreach services, creating connections with physician EHRs, nursing homes, clinics, and pharmacies. This creates a demand for full outreach operability that includes courier management, customer relationship management, supply and inventory tracking, and services marketing.

True costs and cost-effectiveness

With renewed focus on cost savings, laboratories can no longer afford inefficiencies or be unaware of "hidden" costs. Any IS solution requires support, upgrades, interfaces, and modifications to stay up-to-date and maximize efficiency. Beyond the initial cost of an LIS, lab directors need to consider the amount of money spent on annual support and upgrades. Laboratories cannot afford to spend $250,000 to millions of dollars for support year after year, and hundreds of thousands of dollars for each software upgrade. If the cost of upgrading a system is comparable to the cost of buying a new one, and that cost will be repeated every few years, an opportunity arises for lab leaders to recommend a system that better supports their workflow needs and meets their budgetary requirements. A lab's LIS must be a cost-effective integration system, but upgrades cannot be so cost-prohibitive that they are avoided.

Effective lab managers understand the true cost of LIS ownership. They evaluate the long-term costs and return on investment (ROI) of their LIS. As new payment models, such as bundled payments, replace fee-for-service models, we can no longer be unaware of the full costs involved in operating the systems we have in place.

The lab's expanding role

As diagnostics move toward the use of genomics and personalized medicine, laboratories will need agile informatics partners that are able to adapt as testing patterns shift and workflow enhancements occur. The future will require laboratorians and pathologists to find ways to use diagnostic testing to impact the total patient episode of care. Focus will not only be on performing accurate tests, but on finding better test methodologies and opportunities to improve the overall health of patients and the population in general. The lab will be required to expand its reach and will need the necessary IT tools to support this shift in culture.

Kim Futrell, MT(ASCP) serves as Products Marketing Manager for Orchard Software Corporation, provider of Orchard Flarvest LIS, Orchard Pathology, Orchard Copia, Orchard Trellis, and Orchard Sequoia.