The value of in-house genomic testing. Lessons learned and operational + patient 'wins' from HNL Lab Medicine and Lehigh Valley Health Network

As healthcare organizations face greater demand for streamlined services and delivering value-based care, effective partnerships between care entities have become essential.

Twenty-five years ago, Allentown, PA-based Lehigh Valley Health Network launched a stand-alone clinical laboratory to support a focused approach to optimizing laboratory operations. This was the genesis of HNL Lab Medicine.

Today, HNL Lab Medicine is a leading multi-regional, full-service medical laboratory that provides testing and related services to hospital systems, physician offices, long-term care facilities, employers, and industrial accounts. It comprises more than 50 patient services centers in Pennsylvania and works with more than 30 hospitals and 12,000 healthcare providers. They have recently added more sophisticated genomic testing to provide a higher level of service for their physicians and patients. 

Becker's Healthcare recently spoke with three leaders from HNL Lab Medicine and Lehigh Valley Health Network about their experience and lessons learned with in-house, Noninvasive Prenatal Screening (NIPS) and Next Generation Sequencing-based (NGS) solid tumor genomic testing: 

  • Warren Erdmann, Chief Operating Officer, HNL Lab Medicine
  • Robert X. Murphy, MD, Executive Vice President and Chief Physician Executive, Lehigh Valley Health Network 
  • Jordan Olson, MD, Chair, Department of Pathology at Lehigh Valley Health Network, and Medical Director of HNL Lab Medicine

In-house testing reduces unnecessary delays in providing test results for patients and their physicians

Improving patient outcomes was one of the main drivers behind HNL Lab Medicine’s decision to bring NIPS and NGS solid tumor testing in-house. The answers these tests provide can profoundly impact patients' lives, and getting those answers faster means appropriate care can begin sooner.

Mr. Erdmann says, “Noninvasive Prenatal Screening and NGS-based solid tumor genomic testing offer patients answers that significantly impact their lives. For Noninvasive prenatal screening, turnaround time paired with unparalleled accuracy improves both the quality and speed of results.”

"We've had several instances of patients with aggressive forms of cancer," Dr. Olson said. "In those cases, every moment matters. By testing in-house, our partner physicians got information that gave them a head start on creating personalized treatment plans." 

Since HNL Lab Medicine is located close to Lehigh Valley Health Network, specimens are delivered to the lab within a few hours. In addition, HNL Lab Medicine’s agile workflows enable the team to further reduce turnaround time for results. With outside labs, it can take a day or more just to receive specimens.

"The partnership between Lehigh Valley Health Network and HNL Lab Medicine means that it's possible to tailor testing, resulting, logistics and programs to meet the health system's specific needs, rather than asking physicians to adapt their protocols to those of a national laboratory," Mr. Erdmann said. 

From a strategic perspective, two of Lehigh Valley Health Network's goals are to elevate its women’s care and cancer care programs to better serve the community and to differentiate the institution in the market. In-house testing is playing a key role.

"Lehigh Valley Health Network's oncologists are striving to keep their patients local," Dr. Olson said. "No one wants to drive to Philadelphia for care if they can get the same or better care locally. HNL Lab Medicine ensures that physicians get the best test results in the shortest amount of time. Patients recognize that they don't need to leave the system to get great care." 

Close alignment between entities means true integration, cost transparency and seamless billing

HNL Lab Medicine specializes in operating within hospital environments. The result is a seamless experience for physicians and patients alike. After clinicians determine that a patient needs a test, they can turn their attention to other matters until the results come back. By aligning with the health system and conducting tests in-house, HNL Lab Medicine minimizes the logistical difficulties that can add time and complexity to care. 

"We ensure that ordering systems work flawlessly in both Lehigh Valley Health Network's medical record and our laboratory," Dr. Olson said. "We also make sure that, through medical record integration, we deliver results that are seamlessly integrated into clinical workflows, allowing for downstream reporting."

In addition, Lehigh Valley Health Network's clinicians know HNL Lab Medicine's genetic counselors, laboratory managers, scientists and medical directors on a first-name basis. If they have questions or concerns, those get resolved quickly.

The integration between HNL Lab Medicine and Lehigh Valley Health Network isn't limited to the clinical arena, however. The billing teams at the two organizations also are closely aligned. "HNL Lab Medicine provides cost transparency and billing options that really reduce the hassle associated with genetic testing," Dr. Olson said. 

Robert Murphy, MD, Executive Vice President of Lehigh Valley Health Network adds, “LVHN has been pleased with the partnership thus far. Having genomic testing in-house at our laboratory partner allows for faster results, collaboration on test menu needs and an overall better experience for our patients. Lehigh Valley Health Network and HNL Lab Medicine work together to determine which tests would be most beneficial to our patient population. Once tests are brought in-house, our relationship allows us to collect critical information at a much faster speed than if we had to send tests out. It's a great value-add."

HNL Lab Medicine is poised to support new business and value-based care with in-house testing

As personalized medicine continues to grow, HNL Lab Medicine’s Genomic Division is in daily conversations with Lehigh Valley Health Network clinical colleagues to discover what they need to support new programs. "In the near term, we plan to increase our testing related to hematology, cancer, women's health and cardiology," Dr. Olson said. "Our goal is to deliver greater efficiency, provide better data faster and align with health system needs." 

Bringing a test in-house is usually a multifactorial decision that starts with a simple question: Will it better serve patients and clinicians? "HNL Lab Medicine works with hospital partners to ensure that our services improve the quality of information that clinicians receive, speed the time to diagnosis and provide a better patient experience," Mr. Erdmann said. 

Value-based care is also becoming more prevalent in the healthcare environment, which represents a significant opportunity area. 

"In-house testing promotes the appropriate use of diagnostics and prevents over-testing," Dr. Olson said. "At the same time, rapid turnaround times for test results help physicians make the right diagnosis sooner and get people into the right treatments. All of these factors reduce the overall cost of care."

Mr. Erdmann said, “Our health system integration approach to laboratory management is a model that provides services, advanced test results, and cost control that is mutually beneficial to everyone involved. Our laboratory professionals provide expertise on the highest-value, most cost-effective testing options available, while collaborating closely with our partner physicians and medical staff to optimize access and speed to testing, resulting in improving patient care.”  

Mr. Erdmann went on, reinforcing how the entities are uniquely positioned to create a win-win-win partnership between health networks, patients, and providers. "HNL Lab Medicine employs strategies to reduce the number of diagnostic tests needed per patient and to create a test menu that provides the answers that our partners and patients need, when they need them," he said. "We understand what the future holds, we are staying ahead of the technology curve.

To learn more about how genomics-powered precision health can help your health system visit, click HERE.

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