Speakers at the Executive War College discuss how their laboratories are supporting integration in support of better information flows and clinical service enhancements
As you read this, the second day of the 15th Annual Executive War College on Clinical and Pathology Laboratory Management is taking place in New Orleans, Louisiana. There is an enthusiastic crowd of pathologists, administrators, and lab managers in attendance.
During the opening session yesterday morning, a common theme among the speakers was the tighter integration of clinical pathology laboratory testing within the healthcare continuum. Probably the most innovative example was offered by Scott W. Binder, M.D., Senior Vice Chair of the Department of Pathology and Laboratory Medicine at the Geffen UCLA School of Medicine in Los Angeles California.
Over the past 24 months, the departments of pathology and radiology at the UCLA Medical Center have collaborated to create an outpatient service center that provides an integrated diagnostic service for certain types of cancers. The goal is to offer patients a one-stop experience to conduct the imaging studies and collect needed biopsies, followed by a single, integrated diagnostic report sent to the referring physician which incorporates all of the radiology and pathology findings.
“It is intended to create a new service in imaging and molecular diagnosis by combining state-of-the-art, minimally invasive image-guided biopsy with rapid cytological review and tissue processing for bio-molecular markers,” stated Binder during his presentation.
One of the challenges in delivering a single, integrated imaging and pathology report within 48 hours is the need to integrate the software systems. “There are between six and nine separate and proprietary software systems that must be interfaced in order to consolidate the imaging, reporting, laboratory results, and patient record data that are required to produce an integrated report,” explained Binder.
Next up on the Executive War College podium was Jack Shaw, Executive Director of Joint Venture Hospital Laboratories (JVHL), based in Detroit Michigan. JVHL is probably the nation’s oldest regional laboratory network. Founded in 1992, it has been a solid success and as many as 124 hospital-based laboratories in Ohio and Indiana participate in the various managed care contracts that it holds with a number of health insurance plans.
Now preparing for its third decade of operations, Shaw said that the big push at JVHL was to enable a seamless flow of information to all the stakeholders in the healthcare community served by JVHL. “In our healthcare market, years of discussion as to how to electronically connect laboratories, hospitals, physicians, and payers are ending,” he observed. “Now there is action. At JVHL, we are implementing interfaces with managed care plans and with the physician organizations that we serve.
“As well, JVHL is stepping up to feed laboratory test data to contracted data registries, regional health information exchanges in our service markets,” added Shaw. “We want to add value by delivering the requested information on laboratory test utilization, along with the laboratory test results. Clinical integration in our region is actually beginning to break down long-standing silos of care.”
Closing out yesterday morning’s session at the Executive War College was a fascinating overview of the laboratory consolidation and integration activity unfolding in Ireland. Tom Moloney, Executive Officer of the Academy of Medical Laboratory Science in Dublin, explained how the Irish Health Service Executive (the national health service) has proposed a radical restructuring of clinical pathology laboratories throughout the nation. In this nation of 4.2 million, the national health service needs to have the capacity to meet increased utilization of testing while achieving economies by consolidating the pathology and clinical laboratory testing services across the country.
“It was early in 2009 when the Health Service Executive published the report on this proposed laboratory restructuring program,” noted Moloney. “The general plan has two primary elements. First, the 46 existing hospital laboratories will be consolidated into between eight and 14 sites located within acute care hospitals. These are termed ‘hot labs’ because of the need to provide fast turnaround times for hospital inpatients.
“Second, to serve the general practitioners and consultants, it is proposed that three stand-alone laboratory facilities will be constructed,” he continued. “These are described as ‘cold labs’, since turnaround times can be shorter. The proposals put forth by the Health Service Executive represent major changes to our current system of laboratory testing.”
As these examples demonstrate, whether in the United States or other countries such as Ireland, clinical and pathology testing laboratories are being asked to more tightly integrate their laboratory testing activities with the clinical services of the hospitals and physicians they serve. Collectively, these speakers offer examples that the integration trend within healthcare is active and ongoing.
Your Dark Daily Editor,
Robert L. Michel