Using the Web for Blood Utilization Reviews: Innovative Business Model Offered by a New Company

Here’s another use of the Internet to lower the cost of laboratory operations. Now hospital laboratories can have blood utilization reviews performed via a Web-based service. The goal of the new company is to provide laboratories with dramatically lower blood supply costs by providing hospital laboratory clients the information they need to improve blood transfusion services.

David Jadwin, a pathologist at Kern Medical Center in Bakersfield, CA, recently launched a new business venture performing blood transfusion utilization review over the Web. The name of the company is Columbia Healthcare Analytics. Columbia Healthcare Analytics uses the Web to deliver its primary service and also uses the Web to market itself by making an informational video available at its Web site. Columbia Healthcare Analytics has also applied for a patent to cover its unique technology and intellectual property.

Columbia Healthcare Analytics can benchmark physician and institutional performance against regional, national, and international standards through the use of objective, rules-based techniques. Traditional compliance review models require external reviewers to travel to the laboratory site to access data. Columbia Healthcare Analytics will use new informatics technology to dynamically deliver electronic patient care data to qualified reviewers outside the institution. All HIPAA-sensitive patient information is carefully redacted to provide only clinically pertinent data. The hospital lab client transmits this data to off-site data servers. There it is reformatted and processed through algorithms that assess the appropriateness and effectiveness of patient care. This enables the reviewer to make a rapid qualitative and quantitative analysis and report the utilization review results immediately back to the client.

Columbia Healthcare Analytics provides case study examples that demonstrate the potential savings from an effective review of blood transfusion utilization. In one case, the review process triggered a reduction of packed red blood cell transfusions by more than 30%, a reduction in PRBC blood usage of 1,146 units with a corresponding savings of $223,000 in blood supply costs. Fresh frozen plasma use dropped 45%. Substantial reductions in nursing time and costs for treating adverse reactions to unnecessary blood transfusions were also realized as a consequence of implementing the review recommendations. By contrast, during this same time, other hospitals in the same community saw their blood utilization increase by 21% for packed red blood cells and 79% for fresh frozen plasma.

According to Jadwin, “At most hospitals, traditional blood usage committees are inefficient. There is often poor medical staff participation and members are reluctant to criticize a colleague’s performance. Consequently, many medically unnecessary or ineffective transfusions go without notice. Review comments, when made, are often so far after the fact that little improvement of physician performance occurs. These are important reasons why current hospital utilization review processes rarely result in better transfusion practices or lower costs. Additionally, hospitals may also lack staff trained or interested in current transfusion practices.”

Blood costs are a major expense, often exceeding $1 million per year in moderately-sized hospitals and costing millions of dollars per year in large health systems. That is motivation for hospital laboratories to identify ways to reduce unnecessary blood usage and improve the expense and quality of blood transfusion services. For that reason, Columbia Healthcare Analytics has a major business opportunity once it demonstrates to hospitals that it can deliver effective utilization reviews of blood transfusion services over the Web -and that its recommendations consistently unlock improvements in quality and worthwhile reductions unnecessary use of blood units and the costs related to this service. Dark Daily observes that laboratories are likely to see other compliance services offered via Web-based arrangements. Such services, which lower a laboratory’s cost of compliance while improving compliance effectiveness, are likely to be successful.