Following a hospital merger or acquisition, integration between multiple entities with disparate Electronic Health Records, unique hospital registration systems, varied Laboratory Information Systems, multiple instrument interfaces and different physician Electronic Medical Record vendor connections is costly, time consuming and often chaotic.
The impact on laboratory efficiency and revenue should not be overlooked. Untapped laboratory value can be accessed by examining how existing assets are used, adopting a new mind-set and implementing some strategic operational changes.
As the dust settles, the labs that are part of a redefined or newly created health organization find themselves in a new landscape.
• Maybe a single institution clinical lab must integrate workflow with multiple off-site partners after a merger.
• Perhaps a lab has become part of a test-sharing network or a member of a larger performing lab network.
• An esoteric lab may acquire additional referring lab clients.
• Or perhaps a lab might join a high-volume regional or national reference network due to an alliance or acquisition.
Many of these new health organizations are now beginning to consider the need to acquire additional performing labs. Thus, the laboratory network again will need to quickly and smoothly coordinate orders and results with a new laboratory partner.
All these scenarios share a common need: multiple laboratories within a health system or labs belonging to a test-sharing network need to integrate and create a virtual, single experience as a unified, public-facing entity. But that doesn’t mean necessarily replacing or eliminating existing information systems, which could prove to be a lengthy and expensive process.
Among the many organizational changes that need to occur following a merger, laboratory needs must be included in the calculations. For example, a dedicated focus on lab inreach and outreach growth, along with work-flow cost-saving efficiencies can deliver previously unrecognized profits to a newly created network, alliance or health system. Additional profits may be generated by expanding / sharing lab test menus across the health system enterpriseleading to the performance of more tests in-house and the reduction of reference lab or send-out costs. But before gains can be measured, there are obstacles to overcome.
Obstacles to success
The newly created multi-laboratory network may face hurdles for access to resources. IT support may be scarce if priorities skew toward the need to transition to a single enterprise system. Alternatively, a possible move to, or addition of, a new LIS will trigger expense, a lengthy timeline for implementation, possible synchronization of multiple laboratory test catalogsand, again, a need for IT resources.
Additional challenges may include a lack of patient-centric identification. Each entity in the multi-lab environment may have a unique hospital registration system yielding multiple patient identifiers. Overlapping geographic areas may scatter patients across the system, increasing the risk for duplicate patient records within the health network.
Duplication of laboratory testing throughout the new entity or network may prevail, along with confusion about proper routing or needed resources for managing send-outs for test orders.
The efficient coordination of diagnostic and laboratory services needs to be viewed as a core building block in achieving success for a new organization’s goals (efficiency, lowered costs and better patient care).
Managing multiple laboratory networksan integration checklist
The ideal path to creation of a sleekly-integrated lab network involves the thoughtful selection of solutions “friendly” toward existing IT infrastructure, eliminating the need for replacement of current enterprise systems for example.
Manage orders, routing and workflow
A dedicated platform solution can seamlessly address electronic order management across a network of unrelated systems and deliver straightforward functionality for test sharing, test routing and joint test catalog management. Expect to find the benefits of lab-lab collaboration take shape with standardized pre- and post-analytic workflow processes for all labs. Efficient management of specialized orders such as reflex tests, special orders or add-on tests delivers additional value. A flexible system should enable and enforce standardized workflow processes for all labs and users, while still allowing for unique workflow rules for individual labs.
As a baselineclean, efficient electronic orders with smart test routing and rules will improve turnaround time, decrease costs and help elevate physician satisfaction with the new health system. Rules-based test routing also promotes insourced testing by providing the control to route tests to the most appropriate labs in the network. Based on order volume, tests can be routed to sister labs to speed turnaround time. If a lab has equipment down for maintenance, system rules can route tests to another lab in the network to keep the results flowing. Conversely, each lab having specialized equipment can use it to capacity by serving all entities in the network, maximizing ROI and reducing send-outs.
A key needmanage multiple test catalogs
A system of newly-networked labs must address the thorn of multiple lab compendiums which exist within the new test-sharing business model. An integrated solution should provide customized catalog views tailored to each lab or physician preference, and allow definition of site / physician-specific service directories while incorporating tests from the multiple performing labs.
Enhance efficiencieselectronic results delivery
Health systems digging deeper to improve efficiencies will seek to eliminate manual lab result report deliveries (faxing versus electronic delivery to the physician EMR). Considerations include the need to support multiple result delivery methods such as discreet or textual HL7 results transactions, manual uploads or embedded PDF formats. A broad-based, multi-lab networking solution will ensure seamless electronic results delivery along with support for consolidated results delivery from multiple labsall in one, integrated report format. Consolidated reportstailored to physician preferencescan include partials, finals and critical / abnormal results, and typically deliver high customer service marks for the lab network.
Taking integration to the next level – engage patient-centric Identification
Hospitals and health systems that embrace an integration platform with embedded enterprise master patient identification capabilities enable patient-centric benefits for data sharing between other entities or systems. Adding patient-centric identification capabilities to the lab network will improve patient identification, reduce duplicate patient records and tests, promote patient safety and elevate care.
Patient-centric identification will enable a longitudinal view of patient results. Physician satisfaction and patient safety are elevated when physicians can see test results irrespective of when or where the tests were run. Longitudinal reports are a stand-out value to providers and contribute to elevated care quality.
Laboratory servicesan often-overlooked revenue center
Skillful management and integration of diagnostic services offered by newly merged or acquired health or lab systems can yield high visibility benefits. A synchronized lab network operating at peak efficiency is a powerful engine to drive outreach, laboratory business and promote growth.
Deliberate and focused integration will set the stage for increased operational efficiencies, decreased costs and decreased turnaround times along with greater physician satisfaction and better patient outcomes. The ultimate rewards include greater insourcing of tests which may otherwise land in non-system labs, and the bottom line will reflect the value of tests retained and consolidated within the network.
How to begin
These are ambitious objectives, but goals that can be accomplished with thoughtful selection of a vendor partner. Seek strategies from vendors that can demonstrate a history of focus on the specialized needs of laboratory outreach and workflow, along with the ability to seamlessly support a variety of connectivity needs, including orders and results to and from physician offices and EMRs.
Also importantselect a solution that can work with existing infrastructure to avoid the need to replace the LIS(s) or other enterprise solutions. With a targeted platform in place as a foundation for connectivity and established tools to support multiple lab workflows for optimized test routing and results delivery, health systems can emerge from a merger or acquisition with a strong diagnostic services revenue centerand the ability to expand system outreach even further.
Michelle Del Guercio is a 30-year veteran of the healthcare industry. Ms. Del Guercio has industry technology experience both with LIS and outreach solutions that support the success of hospitals, health systems and independent laboratories.
Claudia Pederson creates targeted business-to-business communications, specializing in focused, benefit-driven material for complex technology solutions.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.
