When clinical laboratories agree to share their patient data and encounter information with physicians engaged in population health management, they help improve the health of thousands of people, as well as secure financial rewards through participation in alternative payment models (APMs), such as the Medicare Shared Savings Program for accountable care organizations (ACOs).
That’s the premise behind a population health informatics program from Sonic Healthcare called iMorpheus. The program—in conjunction with Sonic Healthcare USA (SHUSA) laboratories throughout the US—provides physicians with “real-time clinical decision support and advanced healthcare informatics capabilities utilizing an agile pattern recognition software.”
This program is also a noteworthy example that demonstrates two characteristics vital to the future success of the clinical laboratory industry. First, the program is an early example of how clinical laboratories and anatomic pathology groups can use lab test data to collaborate with physicians in ways that add value in patient care. Second, this program also shows that providers and others are ready to pay labs for that added value.
Sonic Healthcare is a global company serving the laboratory medicine/pathology, radiology/diagnostic imaging, and primary care industries.
“If we have the laboratory data to identify people, what we can do is help bring them in and get taken care of before a catastrophic event happens. That is what our program is all about—how we use laboratory data to identify people with chronic disease who are not being managed according to clinical guidelines,” Philip Chen, MD, PhD, a board-certified pathologist and the Chief Strategy Officer at Sonic Healthcare USA, told Dark Daily.
Dr. Chen will be speaking on “How Labs Can Support Precision Medicine and Shared Saving Initiatives” during a General Session at the 24th Annual Executive War College April 30-May 1 in New Orleans.
Medicare Shared Savings Program and Sonic’s iMorpheus Program
Data provided by Sonic Healthcare suggest its program—along with services provided by clinical laboratories and physicians—can reduce healthcare costs while helping providers earn rewards for their initiatives. “Laboratory data are very strong. And a lab needs to have a basic knowledge of the population. So, labs should look at their database, find out what they have, and reach out to physician partners and find out what they have,” he added.
Medicare designed the Shared Savings Program to reduce costs while incentivizing physicians to continue providing quality healthcare services, explained a 2017 OIG report from the U.S. Department of Health and Human Services Office of the Inspector General (OIG). According the report, ACOs engaged in the Shared Savings Program reduced Medicare costs by about $3 billion over the first three years of the program.
Sonic Healthcare aims to use iMorpheus to identify care gaps and leverage clinical laboratory data to identify and help people manage their chronic conditions, such as diabetes and other chronic diseases.
As clinical laboratory leaders know, diabetics need to obtain a hemoglobin A1c (HbA1c) test every three to six months to gauge blood glucose levels over a period of time. When Sonic Healthcare and ACO physicians roll out an iMorpheus program, practice partners deploy Sonic’s automated technology to share voice alerts with patients informing them that it’s time to follow-up with their physicians. Patients also can connect to a scheduling center to set an appointment.
The iMorpheus alerts encourage diabetics to get their lab tests done in advance of the physician office visit, thereby saving the time and expense of a second office visit.
“There are a lot more details to executing this. But what the technology does is identify high-risk patients and bring them in before they run into trouble,” Chen said.
The cost of treating diabetes in the US has risen to $327 billion in 2017, up from $245 billion in 2012, according the American Diabetes Association (ADA). The ADA study also indicated hospital inpatient care is 30% of cost, while physician office visits make up 13% of medical expenditures.
iMorpheus Gets People to Medical Labs, Physicians’ Offices
Sonic Healthcare studied the effectiveness of automated patient engagements and pre-visits for lab services. They surveyed 39 primary care practices with 207,248 patients, 14,438 of which are diabetics. According the data, through the iMorpheus program:
- The average days between visits for a diabetic fell from 278 days to 218 days;
- 44% of patients returned to the clinic and had care gaps and lab test needs fulfilled;
- Half of the patients returning to outpatient clinics had lab tests done within 24 hours;
- 35% to 45% of patients did not return to the physician’s office (largely due to wrong phone numbers or new home addresses); and,
- 7% of patients chose to opt out of the automated engagement service.
Clinical Laboratories as Agents of Change
Sonic Healthcare’s program also contributed to lowering Medicare costs, while enabling providers to share in the savings, according to case study data shared by Chen. “With our program, the Shared Savings went from $12.8 million in the first year to $26 million in the second year of the program—with payouts to laboratories,” Chen said.
Chen wants the clinical laboratory profession to be widely recognized for its strategic use of big data. “This is one of those transformational practices that labs can provide to fill a significant gap in the healthcare ecosystem,” he said.
At the Executive War College, April 30 to May 1, Chen will lead a General Session on “How Labs can Support Precision Medicine and Shared Savings Initiatives [through the] Use of Healthcare Big Data, Lab Results, and Analytics to Support Office-based Physicians in Managing Diabetes and Chronic Diseases.”
He describes the key takeaway: “We have been talking for years about the medical laboratory being 3% of the healthcare spend, while it influences 70% of healthcare decisions. We need to show that value and tie things together.”
—Donna Marie Pocius