By Don Burt, Sales Services Advisor - Interfacing Sunquest Information Systems 2012 Sunquest Information Systems. All Rights Reserved.
Laboratory testing affects up to 80% of the clinical decisions made by healthcare providers and demand for testing is increasing, a well-run and profitable outreach program may define your success or failure in this changing healthcare environment. A lean, profitable outreach program will position your laboratory for the highest level of success. Sunquest Information Systems understands that getting outreach right is complicated. Surveys of hospital outreach programs show that the greatest challenges are: 1) Delivering results to physicians rapidly 2) Physician connectivity 3) Getting paid for the work you perform 4) Developing client loyalty through extraordinary service Sunquest Outreach Advantage is the industry s most comprehensive suite of laboratory outreach software solutions. Our solutions help you overcome the challenges mentioned above by enabling a continuum of growth and service that lead to improved patient outcomes and quality of care in your community. Through our closed loop design, Sunquest ensures that all of the tools your health system needs to build a strong outreach program are at your fingertips, enabling you to: Acquire new business Provide excellent customer service Connect to physicians Get paid Transport and track specimens Manage the business Process and test specimens January 2012 Page 2 of 7
Sunquest Outreach Advantage is a natural extension of Sunquest s industry leading lab information systems and specimen management solutions for both anatomic and clinical pathology. This creates a more dynamic and integrated workflow process, and the result is an unparalleled solution for managing your outreach business. LABORATORY OUTREACH CONNECTIVITY Laboratory Outreach Connectivity integrates the workflow between the doctor s office, the hospital, and the lab. Connecting the lab to physician offices via electronic medical record (EMR) interfacing is one of the most important, yet most challenging, steps to ensuring the lab provides the service its physician clients are looking for. Effectively interfacing with EMR systems is key to the success of a lab outreach program. Within the healthcare market a fully-functional interfacing solution enhances patient care and improves outcomes, establishing an environment that fits within the established strategy defined by the Sunquest four pillars. SUNQUEST PILLAR BENEFIT 1. Physician and Patient Affinity 2. Patient Safety à Enhanced Patient Care 3. Diagnostic Workflow Excellence 4. Predictive Medicine à Improved Outcomes Due to the positive impact on patient care and the ability to increase revenue and order intake, EMR interfacing is a highly competitive segment of the healthcare information technology (IT) market. Leading vendors are aggressively vying to establish big growth differentiators. The goal being to provide a clear and customerfriendly solution, with a templated library of interfaces that facilitates automated billing. DEFINED Lab outreach is defined as community based physicians who refer patients to a laboratory s outreach and outpatient services. EMR connectivity is the process whereby the EMR, the hospital information system (HIS), and the laboratory information system (LIS) establish an automated flow of requisitions, results, and billing data. While interfaces between the EMR, HIS and LIS have been in the field for several years, their integration has not been widespread. The convergence of several factors has moved the need for an improved connectivity solution to the forefront of healthcare IT planning. January 2012 Page 3 of 7
DRIVING FACTORS Lab outreach connectivity sits at the junction to two multi-billion dollar markets, LIS revenue and growth (1) and North American IT spending (2). EMR interfacing represents a growing segment of IT spending due to the tremendous potential to enhance service levels, facilitate relationships, and key revenue growth. The need for reliable transmission of patient data between three patient-centric systems represents a workflow that is unique within healthcare. There is a high degree of interoperability between systems that is above and beyond simple data exchange, with several factors driving demand. Among the top reasons are changes in patient demographics, supply and demand, and U.S. government programs designed to create accountable care organizations (ACOs). A review of each illustrates why software solutions will be increasingly relied upon for efficiency and automation. Demographic changes 60 to 80 million baby boomers are turning 65 within the next year. Combine this with historical Centers for Medicare & Medical Services (CMS) data that reveals people over the age of 65 increase their utilization of lab tests by approximately three times and it s safe to assume the lab test market will grow at a significant rate through the next several years (3). Supply and Demand Lab test volumes are growing. The tests that are growing at higher rates are high value tests that require interpretive and knowledge-based reports beyond the reporting requirements of routine testing. The increased test volume contrasts with the decrease in the number of trained technologists going into the HC industry (4). Government s Active Role To address rising U.S. healthcare costs (5), several government programs have been created and provide compelling reasons for immediate action. The highest profile programs that exist today: ARRA American Recovery and Reinvestment Act of 2009. Companies are eligible for stimulus funds from the government across a broad range of industries. Meaningful Use Certification The use of certified electronic health record technology in a meaningful way. Hospitals and physician practices are given ARRA funds as an incentive to update their software to Meaningful Use compliant software versions. HITECH Health Information Technology for Economic and Clinical Health Act is financial incentive legislation created to stimulate the adoption of electronic health records (EHR) and supporting technology. As an evolving population utilizes lab services, increasingly taxed LIS resources required to do more with less must leverage IT tools designed to manage the business aspects of outreach. With a focus on taking advantage of government stimulus funds tied to measurable progress. January 2012 Page 4 of 7
WHAT ARE THE PIECES? The latest market share reports show that hospital-based outreach programs are competing effectively against the national providers (6). Continued success requires a service and product excellence in the following four areas: Integration Inter-connectivity in healthcare is vital. The automated delivery of orders and results provides a higher level of service to all customers in the market region. Physician Portal (PP) A web-based EMR application that electronically connects community physician s workflow with the HIS and LIS. An ideal solution provides strong similarities between the ordering screen and a paper requisition. There is no significant learning curve and it is quickly adopted with minimal change from the current paper workflow. Middleware An intelligent middleware solution includes the ability to: Configure alerts and perform message tracking Enable rapid deployment of interfaces Provide specific templates to facilitate deployment Logical Observation Identifiers Names and Codes (LOINC ) translational mapping Hospital Information System Provides long-term retention of the patient record and often performs billing. The patient s HIS medical record number (MRN) and account number must be made available to the LIS in order to reconcile LIS work with accurate HIS billing. Laboratory Information System Lab is central to patient diagnostics and is a key and profitable revenue source for the rest of the enterprise. Lab results are the most requested piece of information by all constituents in the healthcare value chain, including the patient, and contribute to 70% of diagnostic decisions (7). Integration that is able to connect community-based physicians with the HIS and LIS helps drive additional revenue for other services. A sound integration solution extends the community and drives relationships with referring physicians. INTEROPERABILITY An outreach connectivity solution that fits any given outreach market enables an intricate exchange of admits, orders, results, and billing data. Carefully embedded business and communication logic establishes a multi-directional exchange of transactions and integrates workflow. It allows the LIS to perform services and facilitate billing for a single patient that is known in the EMR and HIS by different MRNs. January 2012 Page 5 of 7
The process begins with an order electronically transmitted from the EMR to the LIS, containing an EMR MRN and order number. Since most HIS systems perform patient billing the HIS must be in the loop with all processes between the EMR and LIS. Complicating matters, the HIS doesn t originate the transaction yet requires its own MRN, order number, and account number in order to perform billing. One approach is for the HIS to accept the EMR order from the middleware solution, have the HIS move the EMR MRN and order number to user-defined fields and overlay the HL7 transaction with the pertinent HIS data. The transaction is then returned to the middleware solution and forwarded to this LIS and contains the key information from both the EMR and HIS. While HIS vendors generally do not accept electronic admits and are reluctant to implement customized code to perform the required data massage, progress has been made. Middleware solutions are ideally suited to create a standardized and repeatable process and minimize the involvement of the HIS. This leaves the LIS to manipulate, store, and return the data to both systems. The processing within the LIS includes the need to create an admit from an order, accurately process key identifiers from multiple systems, and perform the HIS to LIS order number update. Upon completion the LIS must have the ability to release results to the correct system and send an accurate billing file to the HIS. All of which should be considered standard LIS functionality. A complicated process made easy when the LIS is partnered with a robust middleware solution. CONCLUSION Sunquest s Outreach Advantage solution set provides comprehensive management tools for the entire outreach business delivering a proactive solution to create, improve, and maintain community relationships critical to service line expansion. Outreach Advantage optimizes efficiencies, profitability, and patient and physician satisfaction promoting the laboratory as a strategic asset. The Outreach Advantage modules work in concert with one another and the Sunquest Laboratory and Sunquest CoPathPlus applications through integration with OA Connect. Outreach Advantage provides the most comprehensive solution on the market today to manage, promote, build, and run the most successful outreach programs in the country. January 2012 Page 6 of 7
Outreach Advantage modules: Connect Powerful toolset which supports Meaningful Use Portfolio Integration Mobile Improves efficiency and profitability Extends patient safety beyond the hospital CRM Single comprehensive view of customer Proactive management and key performance monitoring Clinical Financial Improves Reimbursement rates Financial Transparency Physician Portal Creates order intake with instrument ready labels Improves result turnaround time (TAT) (1) Source: Washington G-2, Lab Industry Strategic Outlook: Market Trends & Analysis 2009 (2) Source: IDC, Worldwide IT Spending by Vertical Market Forecast (3) Source: Opening keynote at the Executive War College, April 2010, by Robert Michel. (4) Source: American Society for Clinical Pathology. (5) Source: CMS. (6) Source: Lab Outreach 3rd Edition, 2009. (7) Source: The Value of Laboratory Screening and Diagnostic Tests for Prevention and Health Care Improvement, The Lewin Group, Inc. January 2012 Page 7 of 7