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Binary Fountain Survey Finds 70% of Millennials Share Their Healthcare Experiences Online and 70% of Americans Say Online Reviews Influence Their Healthcare Choices

Online reputation management is increasingly becoming a critical function that all providers, including clinical laboratories, must address or risk losing revenue

Recent surveys cite growing evidence that Facebook (NASDAQ:FB) and online review sites such as Yelp (NYSE:YELP) are swiftly becoming healthcare consumers’ preferred sources for researching doctors, hospitals, medical laboratories, and other medical service providers.

Healthcare consumers are using the Internet to review information on healthcare providers prior to visits. More important, data show a majority of Americans share their healthcare experiences publicly online following visits with providers.

This should serve as a wakeup call for clinical laboratories and anatomic pathology groups that have not developed effective social media strategies, as they are clearly among the health services being evaluated.

Significance of Online Reputation Management

Healthcare Dive reported research conducted by Binary Fountain indicated that:

  • More than half of Americans (51%) reported sharing their healthcare experiences online, an increase of 65% over just one year ago;
  • Among Millennials (people born between 1981 and 1996) that number jumps to 70%, a 94% increase over last year;
  • 70% of Americans overall say online ratings and reviews influenced their choices of physicians and facilities;
  • More than 40% of respondents admitted they researched doctors online even after being referred to them by another healthcare professional.
“The survey results underscore the significance of online ratings and reviews as online reputation management for physicians becomes ever-more important in today’s healthcare environment,” said Aaron Clifford, Senior Vice President of Marketing at Binary Fountain, in a statement. “As patients are becoming more vocal about their healthcare experiences, healthcare organizations need to play a more active role in compiling, reviewing, and responding to patient feedback if they want to compete in today’s marketplace.”

Healthcare Dive also noted that Millennials are likely to consider online reviews and ratings of healthcare professionals to be trustworthy.

  • 97% of 24- to 34-year-olds report believing online comments are reliable;
  • While 100% of the 18- to 24-year-olds surveyed felt similarly.

Pathologists and clinical laboratory administrators should consider the two findings above as evidence that a major change has already happened in how the younger generations look for—and select—their hospitals, their physicians, and their clinical laboratory providers. Thus, every pathology group and clinical laboratory should have a business strategy for managing the Internet presence of their labs. Failure to do so means that competing labs that do a good job of managing their Internet presence will be more successful at winning the lab testing business of Gen Xers (born 1965-1980), Millennials (Gen Y, born 1981-1996), and Gen Z (born 1997-2009).

In addition, the survey discovered that the most important qualities consumers look for in a doctor are:

  • Friendly and caring attitudes;
  • Physicians’ ability to answer questions; and
  • Thoroughness of examinations.

Those polled reported the most frustrating issues when dealing with healthcare professionals were:

  • Office wait times;
  • Cost and payment concerns;
  • Wait times for exam and medical laboratory results; and
  • Scheduling appointments.

It’s All in a Word

Earlier this year, Healthcare Dive also reported on research that examined online reviews and their content conducted by Penn Medicine. Researchers at the University of Pennsylvania used digital tools and data analytics to help healthcare providers better understand and improve the patient experience.

The researchers analyzed 51,376 online reviews about 1,566 hospitals posted on Yelp over a 12-year period. They published their findings in the Journal of General Internal Medicine (JGIM).

They concluded the word most often found in positive Yelp reviews was “friendly.” Their example of how positive review writers used this word: “The doctors, nurses, and X-ray technician who helped me out were all so cool and friendly. It really restored my faith in humanity after I got hit on my bike.”

Other words the researchers commonly found in good online reviews include “great, staff, and very.”

“Told” was the word most often found in negative reviews. The researchers’ example: “I constantly told them that none of that was true and the nurse there wouldn’t believe me.” It appears from the JGIM study that Millennials often felt healthcare professionals did not listen to them.

The researchers identified “worst, hours, rude, said, no and not” as other words often found in negative reviews.

“As providers, we need to take a moment to think about how we talk in hospitals, but also what patients are hearing,” said lead author of the Penn Medicine study Anish Agarwal, MD, Assistant Professor of Emergency Medicine at the University of Pennsylvania. “I may say something, but the way it’s heard and interpreted and then processed within patients when they’re going through a vulnerable time can be different.” (Photo copyright: University of Pennsylvania.)

Half of Millennials Prefer Internet Research and Online Virtual Healthcare

Another survey conducted by Harmony Healthcare IT, a health data management firm based in South Bend, Ind., found that more millennials are researching the Internet for medical advice in lieu of actual doctor visits.

PC Magazine reported Harmony Healthcare IT’s survey found:

  • 73% of Millennials reported following medical advice found online instead of going to a doctor; and
  • 93% reported researching medical conditions online in addition to a doctor visit. 

The survey also found that 48% of millennials trust online resources for medical information and that 48% prefer virtual doctor office visits over in-person visits.

In addition, 24% of this age group have gone five or more years without a physical and 57% prefer high-deductible health plans (HDHPs).

“With an emphasis on convenience, low cost, and technology, it will be interesting to see how this generation helps shape the future of health and how both patients and providers will adapt to those changes along the way,” Harmony Healthcare IT wrote in a blog post.

The results of these surveys illustrate why clinical laboratories and anatomic pathology groups must have a social media strategy for managing their reputations and presence on the Internet, especially where Millennials are concerned.

That strategy should include easy and informative ways for patients to learn about medical laboratory services, pricing of lab tests, quality of work, and methods consumers can use to leave online feedback and receive responses to their comments. 

—JP Schlingman

Related Information:

More than Half of Americans Share Doctor Experiences Online, Survey Shows

“Told”: The Word Most Correlated to Negative Online Hospital Reviews

No. 1 Word in Online Negative Hospital Reviews is ‘Told’

Doctors? Nah; Most Millennials Get Medical Advice Online

Millennials Forge New Paths to Healthcare, Providing Opportunities for Clinical Laboratories

JAMA Study Shows American’s with Primary Care Physicians Receive More High-Value Care, Even as Millennials Reject Traditional Healthcare Settings

Could Biases in Artificial Intelligence Databases Present Health Risks to Patients and Financial Risks to Healthcare Providers, including Medical Laboratories?

Clinical laboratories working with AI should be aware of ethical challenges being pointed out by industry experts and legal authorities

Experts are voicing concerns that using artificial intelligence (AI) in healthcare could present ethical challenges that need to be addressed. They say databases and algorithms may introduce bias into the diagnostic process, and that AI may not perform as intended, posing a potential for patient harm.

If true, the issues raised by these experts would have major implications for how clinical laboratories and anatomic pathology groups might use artificial intelligence. For that reason, medical laboratory executives and pathologists should be aware of possible drawbacks to the use of AI and machine-learning algorithms in the diagnostic process.

Is AI Underperforming?

AI’s ability to improve diagnoses, precisely target therapies, and leverage healthcare data is predicted to be a boon to precision medicine and personalized healthcare.

For example, Accenture (NYSE:ACN) says that hospitals will spend $6.6 billion on AI by 2021. This represents an annual growth rate of 40%, according to a report from the Dublin, Ireland-based consulting firm, which states, “when combined, key clinical health AI applications can potentially create $150 billion in annual savings for the United States healthcare economy by 2026.”

But are healthcare providers too quick to adopt AI?

Accenture defines AI as a “constellation of technologies from machine learning to natural language processing that allows machines to sense, comprehend, act, and learn.” However, some experts say AI is not performing as intended, and that it introduces biases in healthcare worthy of investigation.

Keith Dreyer, DO, PhD, is Chief Data Science Officer at Partners Healthcare and Vice Chairman of Radiology at Massachusetts General Hospital (MGH). At a World Medical Innovation Forum on Artificial Intelligence covered by HealthITAnalytics, he said, “There are currently no measures to indicate that a result is biased or how much it might be biased. We need to explain the dataset these answers came from, how accurate we can expect them to be, where they work, and where they don’t work. When a number comes back, what does it really mean? What’s the difference between a seven and an eight or a two?” (Photo copyright: Healthcare in Europe.)

What Goes in Limits What Comes Out

Could machine learning lead to machine decision-making that puts patients at risk? Some legal authorities say yes. Especially when computer algorithms are based on limited data sources and questionable methods, lawyers warn.

Pilar Ossorio PhD, JD, Professor of Law and Bioethics at the University of Wisconsin Law School (UW), toldHealth Data Management (HDM) that genomics databases, such as the Genome-Wide Association Studies (GWAS), house data predominantly about people of Northern European descent, and that could be a problem.

How can AI provide accurate medical insights for people when the information going into databases is limited in the first place? Ossorio pointed to lack of diversity in genomic data. “There are still large groups of people for whom we have almost no genomic data. This is another way in which the datasets that you might use to train your algorithms are going to exclude certain groups of people altogether,” she told HDM.

She also sounded the alarm about making decisions about women’s health when data driving them are based on studies where women have been “under-treated compared with men.”

“This leads to poor treatment, and that’s going to be reflected in essentially all healthcare data that people are using when they train their algorithms,” Ossorio said during a Machine Learning for Healthcare (MLHC) conference covered by HDM.

How Bias Happens 

Bias can enter healthcare data in three forms: by humans, by design, and in its usage. That’s according to David Magnus, PhD, Director of the Stanford Center for Biomedical Ethics (SCBE) and Senior Author of a paper published in the New England Journal of Medicine (NEJM) titled, “Implementing Machine Learning in Health Care—Addressing Ethical Challenges.”

The paper’s authors wrote, “Physician-researchers are predicting that familiarity with machine-learning tools for analyzing big data will be a fundamental requirement for the next generation of physicians and that algorithms might soon rival or replace physicians in fields that involve close scrutiny of images, such as radiology and anatomical pathology.”

In a news release, Magnus said, “You can easily imagine that the algorithms being built into the healthcare system might be reflective of different, conflicting interests. What if the algorithm is designed around the goal of making money? What if different treatment decisions about patients are made depending on insurance status or their ability to pay?”

In addition to the possibility of algorithm bias, the authors of the NEJM paper have other concerns about AI affecting healthcare providers:

  • “Physicians must adequately understand how algorithms are created, critically assess the source of the data used to create the statistical models designed to predict outcomes, understand how the models function and guard against becoming overly dependent on them.
  • “Data gathered about patient health, diagnostics, and outcomes become part of the ‘collective knowledge’ of published literature and information collected by healthcare systems and might be used without regard for clinical experience and the human aspect of patient care.
  • “Machine-learning-based clinical guidance may introduce a third-party ‘actor’ into the physician-patient relationship, challenging the dynamics of responsibility in the relationship and the expectation of confidentiality.”    
“We need to be cautious about caring for people based on what algorithms are showing us. The one thing people can do that machines can’t do is step aside from our ideas and evaluate them critically,” said Danton Char, MD, Lead Author and Assistant Professor of Anesthesiology, Perioperative, and Pain Medicine at Stanford, in the news release. “I think society has become very breathless in looking for quick answers,” he added. (Photo copyright: Stanford Medicine.)

Acknowledge Healthcare’s Differences

Still, the Stanford researchers acknowledge that AI can benefit patients. And that healthcare leaders can learn from other industries, such as car companies, which have test driven AI. 

“Artificial intelligence will be pervasive in healthcare in a few years,” said

Nigam Shah, PhD, co-author of the NEJM paper and Associate Professor of Medicine at Stanford, in the news release. He added that healthcare leaders need to be aware of the “pitfalls” that have happened in other industries and be cognizant of data. 

“Be careful about knowing the data from which you learn,” he warned.

AI’s ultimate role in healthcare diagnostics is not yet fully known. Nevertheless, it behooves clinical laboratory leaders and anatomic pathologists who are considering using AI to address issues of quality and accuracy of the lab data they are generating. And to be aware of potential biases in the data collection process.

—Donna Marie Pocius

Related Information:

Accenture: Healthcare Artificial Intelligence

Could Artificial Intelligence Do More Harm than Good in Healthcare?

AI Machine Learning Algorithms Are Susceptible to Biased Data

Implementing Machine Learning in Healthcare—Addressing Ethical Challenges

Researchers Say Use of AI in Medicine Raises Ethical Questions

Are Recent Predictions Regarding the Future of Healthcare Positive or Negative for Clinical Laboratories?

Medical laboratories that develop appropriate clinical strategies may find opportunities to leverage several new technologies expected to have a big impact on providers

Industry experts often speculate how developing technologies will impact healthcare. However, clinical laboratory leaders may be surprised by how much blockchain, medical malls, and Uber Health are expected to alter healthcare delivery in the next decade.

An article in FierceHealthcare states that “Healthcare is on the cusp of a technology revolution. Technology is primed to disrupt healthcare more explosively than it has any other industry.”

Medical advancements certainly impact clinical laboratories and anatomic pathology groups, and any acceleration in these developing technologies applied to healthcare will certainly be of interest to lab leaders who want to ensure their labs are ready.

Blockchain Provides Healthcare Security, Privacy, and Interoperability

Authored by Sloan Gaon, CEO, PulsePoint, the FierceHealthcare article predicts that blockchain will be an important feature in the future of healthcare. It will allow patients to have an online, accurate health record that is accessible only to necessary parties in real time. Consumers will be able to maintain, control, and share their data as they wish while increasing the security, privacy, and interoperability of their health information.

“A primary care physician could access a complete medical history of the member, while the radiologist could be limited to only the specifics he or she needs to perform the task at hand. For each, it’s about accessing the right data at the right time, and the blockchain technology could enable this type of specific ‘need-to-know’ medical history access,” wrote Bruce Broussard, President and CEO of Humana in a LinkedIn article.

The blockchain records can be shared among a network of computers and kept secure via cryptography. And the technology allows for easy transferability among different networks, improving performance and outcomes for patients. Broussard also stated that blockchain technology will provide more efficient payment for insurance claims.

“With transparency and automation, greater efficiencies will lead to lower administration costs, faster claims, and less money wasted. Blockchain enables claims to be paid without an intermediary, since health plan members are connecting directly with their providers. These consumers can also access their permanent electronic health records in a secure fashion, enabling them to have a real-time understanding of their health,” he wrote.

Should blockchain achieve widespread adoption as a platform for patient health information, the clinical laboratory industry will need to address the problem of different test methodologies and different reference ranges for test results. If blockchain makes it feasible to bring all pieces of a single patient’s cumulative health data into a single record, then clinical labs will need to address that problem in an effective way.

In his FierceHealthcare article, Sloan Gaon, CEO of PulsePoint, said “Technology will drive innovation, automation, transparency and efficiency, rendering the current healthcare landscape unrecognizable. As technology garners healthcare’s gold seal of approval, its effects will upend the industry, shrinking costs and improving outcomes.”

Medical Malls a Win-Win for Healthcare Providers and Retail Locations

With big shopping malls dying due to economic recessions and the emergence of online retail destinations, property owners are seeking new tenants. In the summer of 2017, there were still about 1,100 malls remaining in the US, however, a quarter of them were at a risk of closing within five years, Time noted that year.

As healthcare organizations expand, there is an overwhelming need for suitable space that is accessible for consumers at a reasonable price. Fading shopping malls with their convenient locations, sturdy foundations, and large parking lots could fill that gap.

In February of 2017, Avita Health System opened a boutique hospital in a space once occupied by an anchor store in a mall located in Ontario, Ohio. The healthcare provider purchased a 185,000 square-foot space that was formerly a Lazarus department store.

Mansfield News Journal reported that when the hospital opened, it included a walk-in clinic, an emergency room, surgical suites, pre-operative and post-operative areas, an onsite pharmacy, imaging services, a clinical laboratory, and 30 acute care beds.

Other services, including a Level II Cath lab, a maternity center, and the installation of a 3T Magnetic Resonance Imaging (3T MRI) machine, have been added since the facility opened. And there’s room for more expansion at the site.

Vanderbilt Medical Group (VMG) now occupies the entire second level of One Hundred Oaks Mall, in Nashville, Tenn. Their services at the once-struggling retail shopping center include 22 specialty clinics in 450,000 square feet of space designed by architecture firm Gresham Smith.

Patients can pick up a pager at the VMG facility and then shop on the lower level while waiting to be paged to see a healthcare professional or receive test results.

“More important than the significant increase in our available clinical space is the overall concept and design which is focused on providing our patients, faculty, and staff with a new paradigm for health and wellness. The convenience, accessibility, and innovative ways of providing care for our patients are a true transformation of both the architecture and the way our patients experience healthcare,” said Cyril Stewart, former Director of Facility Planning for Vanderbilt University Medical Center (VUMC) in a testimonial on the Gresham Smith website.

Non-Emergency Medical Transportation and Uber Health

Kaiser Family Foundation (KFF) reported in 2016 that “Medicaid’s non-emergency medical transportation (NEMT) benefit facilitates access to care for low income beneficiaries who otherwise may not have a reliable affordable means of getting to healthcare appointments. NEMT also assists people with disabilities who have frequent appointments and people who have limited public transit options and long travel times to healthcare providers, such as those in rural areas.”

The Hospital and Healthsystem Association of Pennsylvania (HAP) reported that an average of 3.6 million Americans miss their healthcare appointments annually due to lack of or unreliable transportation. These missed appointments can cause an avalanche of future problems, including increased visits to emergency rooms, extended hospital stays, and higher costs for providers.

Uber Health is positioned to become a major player in the field of non-emergency medical transportation (NEMT). The Verge reported in 2018 that independent research organization Transit Cooperative Research Program (TCRP) estimated that the NEMT market was worth more than $3 billion.

“If there are people who are missing their appointments because they’re using an unreliable bus service to get to and from their healthcare provider, this is a great solution for them,” Christopher Weber, General Manager and Senior Project Manager at Uber Health, told The Verge. “The types of individuals this is valuable for really is limitless.”

Uber health’s mobile device application (app) enables patients and healthcare providers to schedule non-emergency medical transportation for medical appointments within a few hours or up to a 30-day notice. It is also available both as an online dashboard and as an application-programming interface (API) for software developers to integrate the service into their proprietary healthcare tools.

An Uber (NYSE:UBER) account is not required, as notifications about rides can be sent to patients via text messages.

Clinical laboratory leaders may want to develop strategies around these three predictions to increase business and maximize profits. Since more healthcare organizations will soon be linked via blockchain, and an increased number of consumers could start using non-emergency medical transportation, such as Uber Health, to get to medical appointments, becoming familiar with these technologies could prove to be beneficial to labs.

In addition, medical facilities cropping up in former mall spaces will require medical laboratories to be onsite to support care and provide lab test results within an acceptable turnaround time.

—JP Schlingman

Related Information:

Industry Voices—How the Future of Healthcare Will be Shaped by the Likes of Uber, CVS

Blockchain: Transformational Technology for Health Care

Why the Death of Malls is about More than Shopping

Avita Ontario Hospital Poised to Open

Mall Landlords Welcome Medical Clinics as Retail Ails

Fighting the Blight: Reinventing Retail space for Vanderbilt Health

Uber is Driving Patients to Their Doctors in a Big Grab for Medical Transit Market

Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments: A Clinical Trial

Study Finds Missed Medical Appointments Not Affected by Free Ride Services

Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers

Preparing Clinical Laboratories for Invasive Federal Enforcement of Fraud and Abuse Laws, Increased Scrutiny by Private Payers, New Education Audits, and More

Medical laboratory leaders need to take opportunities to stay abreast of government and payer activity, particularly as payer audits become tougher, say legal experts

Even compliant clinical laboratories and anatomic pathology groups are reporting tougher audits and closer scrutiny of the medical lab test claims they submit for payment. This is an unwelcome development at a time when falling lab test prices, narrowing networks, and more prior-authorization requirements are already making it tough for labs to get paid for the tests they perform.

Clinical laboratory leaders can expect continued scrutiny of their labs’ operations and financials as government and commercial payers move forward with invasive programs and policies designed to ferret out fraud and bad actors.

Federal officials are focusing their investigations on healthcare providers who mismanage or inappropriately use Medicare and Medicaid programs, while commercial payers are closely scrutinizing areas such as genetic testing prior authorization, say healthcare attorneys with Cleveland Ohio-based McDonald Hopkins, LLC.

“The government is looking at fraud, waste, and abuse, and all the different ways they come into play,” said Elizabeth Sullivan, Esq., a Member and Co-Chair of the firm’s Healthcare Practice Group, in an exclusive interview with Dark Daily. “We anticipate there will be more enforcement [of fraud and abuse laws] centered around different issues—anything that can be a false claim.”

Specifically, government officials will key in on violations of the Stark Law, EKRA (the Eliminating Kickback in Recovery Act of 2018), and other anti-kickback statutes and laws, Sullivan said.

“And clinical laboratories, by virtue of the type of services and service arrangements they offer, will continue to be a target,” she added.

Medical laboratory leaders also must prepare for aggressive tactics by insurance companies. “On the commercial side, payers are getting more aggressive and more willing to take things to ligation if they don’t get what they want and don’t see a settlement that satisfies their concerns over issues,” said Courtney Tito, Esq., also a Member with McDonald Hopkins, in the Dark Daily interview. 

Current Investigations Likely to Impact Clinical Laboratories

Sullivan and Tito advise clinical labs to be aware of the following issues being fast-tracked by government and private payers:

The TPE audits program, according to CMS, is focused on providers with high claim error rates or unusual billing practices. During a TPE, a Medicare administrative contractor (MAC) works with a provider to identify and correct errors.

“The TPE audits are real hot right now. We are seeing a lot of clients go through this,” Tito said.

Feds Crack Down on Genetic Testing Fraud Schemes

Genetic testing is another “hot button” issue for enforcement by government and private payers, Sullivan and Tito state.

In fact, the US Department of Justice (DOJ) and the US Department of Health and Human Services (HHS) in September announced charges against 35 people including nine physicians for allegedly participating in healthcare fraud schemes involving genetic cancer testing of seniors nationwide, states a DOJ news release.

CMS is taking action against testing companies and practitioners who submitted more than $1.7 billion in claims to Medicare, the statement added.

The scheme involved medical laboratories conducting the genetic tests, McDonald Hopkins noted in an Alert about the DOJ investigation. The alert described how the scam operated:

  • Scam recruiters approached Medicare beneficiaries at health fairs;
  • In exchange for a DNA sample (in the form of a cheek swab) and a copy of the victim’s driver’s license, the “representative” offered a free genetic test;
  • Representatives allegedly asked the seniors’ doctors to sign-off on test orders. If the seniors’ physicians refused, the scammers offered kickbacks to doctors already in their group;
  • Clinical laboratories that performed the tests were reimbursed from Medicare and, allegedly, shared the proceeds with the scammers.

“Although these opportunities may seem appealing as an additional revenue source for providers, it is always important to review the regulatory requirements as well as the potential anti-kickback statute and Stark implications for any new arrangement,” Sullivan and Tito wrote in the McDonald Hopkins Alert article. 

Criminal Behavior in CMS Programs

Effective Nov. 4, 2019, CMS issued a final rule intended to stop fraud before it happens by keeping “unscrupulous providers” out of the federal healthcare programs in the first place, states a CMS news release.

The rule (CMS-6058-FC), called “Program Integrity Enhancements to the Provider Enrollment Process,” has new revocation and denial authorities to stop waste, fraud, and abuse, the news release points out.

Reasons CMS can revoke or deny enrollment to providers, according to another McDonald Hopkins Alert, include:

  • Outstanding debt to CMS following overpayment to the provider;
  • Coming back into CMS programs with a new identity;
  • Billing for services from non-compliant locations;
  • Abusive ordering or certifying under Medicare Part A or Medicare Part B.

Additionally, EKRA establishes “criminal penalties for unlawful payments for referrals to recovery homes and clinical treatment facilities,” Dark Daily recently reported. However, as the e-briefing points out, it is unclear whether EKRA applies to clinical laboratories.

Nevertheless, Sullivan points out that, “Even without EKRA, the anti-kickback statute applies to any arrangement between individuals. And, it is good to have an attorney look at those arrangements. What your sales reps are doing in the field, how they are communicating, and their practices warrant oversight. EKRA just makes it all the more important.”

During an upcoming Dark Daily webinar, attorneys Elizabeth Sullivan (left) and Courtney Tito (right) of McDonald Hopkins, LLC, will advise clinical laboratory leaders and financial staff on how to prepare for future aggressive payer audits, rigid enforcement of fraud and abuse laws, and more. (Photos copyright: LinkedIn/Dark Daily.)

Clinical Laboratories Need Compliance Plan, Focus on Payers

With so many legal requirements and payer programs, Sullivan advises medical labs and pathology group practices to work with resources they trust and to have a compliance plan at the ready. “Have resources in place, including but not limited to a compliance officer, a committee, and someone who is spending time on these issues. Monitoring government enforcement and payer activity is the most critical,” she said.

To assist labs in remaining fully informed on these critical compliance topics, and the federal government’s latest legislation to combat fraud, Dark Daily is offering a webinar on November 20th at 1pm Eastern time. Sullivan and Tito will offer their insights and advice on how labs should prepare for CMS’ battle to reign in fraud and commercial payers’ increased scrutiny into prior authorizations.

Clinical laboratory leaders, compliance officers, and finance staff will benefit greatly from this crucial resource.

Register for “Bracing for Aggressive Payer Audits, Rigid Enforcement of Fraud and Abuse Laws, and More” at https://www.darkdaily.com/product/payor-audits-webinar/ or by calling 512-264-7103.

—Donna Marie Pocius

Related Information:

Dark Daily Webinar: What Lab Leaders Need to Know About How to Prepare for 2020: Bracing for Aggressive Payer Audits, Rigid Enforcement of Fraud and Abuse Laws, and More

Federal Law Enforcement Action Involving Fraudulent Genetic Testing Results in Charges Against 35 Individuals Responsible for Over $2.1 Billion in Losses is One of the Largest Healthcare Fraud Schemes Ever Charged

OIG Focusing on Laboratories Involved in Genetic Testing Scams

CMS Announces New Enforcement Authorities Reduce Criminal Behavior in Medicare, Medicaid, and CHIP

CMS Aims to Combat Criminal Behavior Through Enrollment Process

Does New Opioid Law Require Clinical Laboratories to Change How They Pay Sales Employees?

17 Former Employees Accuse Orig3n of Clinical Laboratory Test Inaccuracies, Contamination, and Fabricated Test Results

This is not the first time genetic-testing company Orig3n has been scrutinized by state and federal investigators over its business practices

It’s not often that multiple employees of a clinical laboratory company go public with criticism about the quality of their lab company’s tests. But that is what is happening at Orig3n. Problems at the Boston-based genetic testing company were the subject of an investigative report published by Bloomberg Businessweek (Bloomberg).

In September, Bloomberg reported that 17 former Orig3n employees said the company’s Deoxyribonucleic acid (DNA) tests sometimes failed to deliver the intended results or were often contaminated or inaccurate. The individuals had been employed by the company as managers, lab technicians, software engineers, marketers, and salespeople between 2015 and 2018.

The former employees claimed that Orig3n “habitually cut corners, tampered with or fabricated results, and failed to meet basic scientific standards,” Bloomberg reported. The individuals also stated that advice intended to be personalized to individual consumers’ genetic profiles was often just generic information or advice that had no scientific basis.

According to Bloomberg, the individuals also alleged that Orig3n’s lab was careless in its handling of genetic samples in several ways, including:

  • Multiple samples being labeled with the same barcode;
  • DNA and blood samples for stem cell bank misplaced or mixed up;
  • No controls to ensure accuracy;
  • Handling methods that could lead to contamination; and
  • Fabricating results when a test outcome was unclear.

The former employees also stated that “Orig3n ran tests without proper authorization in its lab at the 49ers’ stadium, and that managers regularly compelled them to write positive reviews of Orig3n’s tests on Amazon.com and Google to offset waves of negative feedback,” Bloomberg reported.

“Accurate science didn’t seem to be a priority. Marketing was the priority,” said a former lab technician who spoke with Bloomberg on the condition of anonymity. Orig3n denied the accusations in a statement, describing them as “grossly inaccurate,” and claimed the former employees were simply disgruntled.

“In some cases, former employees are former employees for a reason,” Orig3n Chief Executive Officer Robin Smith told Bloomberg. “We’ve found after employees are gone that they have not done things appropriately.”

Jessica Stoll, MS, CGC (above), a certified genetic counselor and Associate Director of the Gastrointestinal Cancer Risk and Prevention Clinic at the University of Chicago Medicine, told NBC, “The majority of genetic testing is still a gray area and there’s always the possibility of uncertain results. I don’t find them particularly useful, and in some cases I can actually find them harmful.” (Photo copyright: Cancer Wellness Center.)

Is it Dog or Human DNA?

In 2018, NBC Chicago (NBC) conducted an investigation into various consumer DNA testing kits. NBC sent DNA samples to several different testing companies. This included non-human samples, which NBC’s investigators had obtained from a female Labrador Retriever.

With the exception of Orig3n, all of companies identified the DNA as non-human and did not process the kits. Orig3n did, however, process the canine DNA. It then returned a seven-page analysis that suggested the subject of the sample “would probably be great for quick movements like boxing and basketball, and that she has the cardiac output for long endurance bike rides or runs,” NBC reported.

This would be funny if it weren’t so concerning.

Following reports that it had processed dog DNA, Orig3n stated it had made changes and improvements to the company’s testing methodologies. Smith also stated Orig3n’s lab protocols had been improved as well.

“Sometimes we look at the accuracy of things and go, ‘Man, that’s not working,’” Smith told Bloomberg. “Our approach and our philosophy is [sic] to constantly improve the products.” 

Serious Accusations of Clinical Laboratory Malfeasance

Founded in 2014 with the intent of creating the world’s largest stem cell bank, by 2016, Boston-based Orig3n had refocused its attention on the burgeoning field of direct-to-consumer DNA testing. On its website, Orig3n sells several DNA-testing kits with varying costs.

Orig3n’s attempt to offer free genetic tests to large numbers of people at a professional sporting event in the fall of 2017 may be what caught the attention of federal investigators and led to a deeper investigation. Dark Daily previously covered this controversy, which centered around Orig3n’s plan to distribute free genetic testing kits to fans at a Baltimore Ravens football game.

In that situation, state and federal healthcare regulators blocked the giveaway over concerns about protected health information (PHI). Now, Orig3n is being accused of questionable business practices by 17 of its former employees. 

The former employees’ statements that the company’s genetic testing lab did not follow appropriate test protocols—and that it allegedly mishandled specimens and even reported false test results—are serious allegation of malfeasance and warrants an investigation.

Pathologists and clinical laboratory managers know that patient harm can potentially result from inaccurate genetic test results if used for clinical purposes. Dark Daily will continue to follow the investigation into Orig3n.

—JP Schlingman

Related Information:

DNA Company Tampered with Results, Former Employees Say

Home DNA Kits: What Do They Tell You?

Orig3n Holds Inaugural Ravens DNA Day on September 17 at M and T Bank Stadium to Kick Off the Season

Orig3n Partners with San Francisco 49ers to Reward Fans for Contributions to Advancing the Future of Medicine through Genetics and Regenerative Medicine Research

State and Federal Agencies Throw Yellow Flag Delaying Free Genetic Tests at NFL Games in Baltimore—Are Clinical Laboratories on Notice about Free Testing?

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