Over the past 20 years, Leah Stevens, director of laboratory services for Carolina Health Specialists (CHS), a multi-specialty practice located in Myrtle Beach, S.C., has seen her fair share of change. But nothing compares to what she faces now. With looming reimbursement changes, new payer rules and government mandates, planning has become difficult. “It’s hard to plan for the future when you’re unsure of the direction healthcare is headed,” says Stevens.
In addition to pending regulatory changes, CHS has had to deal with the fact that reimbursements keep going down, while costs don’t. As a result, staff has to continually find ways to improve efficiency and productivity. For Stevens, this meant finding a sophisticated laboratory information system (LIS) that would help her add value to her organization and the customers – both providers and patients – she serves.
CHS processes almost 100,000 lab requests a year, roughly equivalent to that of a community hospital. The practice also works with a network of reference labs, and it was becoming increasingly challenging to interact with these labs using their existing system. So, in 2010, staff started looking for a new system that would enable them to achieve their goal of providing the best quality product – meaning lab information or test results – quickly and efficiently so their physicians could use that information to determine their patients’ healthcare protocol.
After eight months of due diligence, it was clear to CHS that not all LIS were created equal. However, with Merge LIS, CHS found a robust solution that not only interfaces with their EMR system and reference labs, but also securely provides access to lab information anywhere, anytime.
Because it’s Web based, Merge LIS provides access throughout a facility or remote locations to a central database for orders, inquiries, quality control and reporting. “Our physicians appreciate being able to access lab results from anywhere,” says Stevens. “They can review results from their laptop or smartphone and put together treatment regimens in a fraction of the time it used to take.”
Another unique feature to Merge LIS is the customization of pick lists based on specialty utilization. The selection process is different for each specialty; therefore, it’s much more efficient for a technician to scroll through a customized list of top-50 tests versus a never-ending list containing thousands.
Results can be accessed from any Web-enabled device. Once logged in securely, the lab results are presented in a PDF format that is easy to read and interpret. Physicians can quickly see which test results are in or out of range based on color-coded boxes. Results in green boxes are within expected range, results in yellow boxes are out of range and results in red boxes are critically out of range and need immediate attention.
Patient-centric needs are driving LIS adoption as well. Generally speaking, specimen samples are viable for only a certain amount of time. “If a sample is drawn in the morning in our laboratory, it is typically tested the same day,” says Stevens. “If you don’t have a dependable LIS and the system goes down, it makes it difficult to test your samples. And any type of delay in test results can have a negative impact on patient care and provider confidence in the laboratory’s reliability.”
One of the most anticipated features on the horizon for Merge LIS is the code-check functionality.
Using an LIS with a code-check feature can improve customer satisfaction in terms of billing and reimbursement. A sophisticated LIS will inform staff when a CPT code is not the best match for the testing that was ordered. A message can be sent immediately to the provider to request an additional diagnosis code(s). This saves the practice valuable time and money that might otherwise be spent on administrative functions related to reverse billing and/or billing resubmission. The code-check feature will also help to reduce the lab’s accounts receivable time (ART) by providing an additional level of billing claim review prior to claim submission to insurance. And it saves the patient the headache and potential financial burden associated with denied claims.
Keys to a successful implementation
For CHS staff, the key to a successful implementation was preparation and communication. They involved all stakeholders in the process and did their homework beforehand, so that when the implementation team arrived, they could begin building the LIS according to CHS’ specific needs.
They also developed a contingency plan to account for the possibility of interrupted workflow. While the goal is to have a seamless implementation, you should always assume there will be interruptions and plan accordingly. Make sure your staff knows what to do in case of interruptions, and you will be ahead of the game.
CHS also has a long-term vision. “We see technology continuing to help us improve our productivity and patient care,” says Stevens. “Merge LIS is helping us do that now, and we see even more potential with technology in the future, such as cloud applications. For example, we see many ‘snowbirds’ in our community. Someday soon, I envision their patient data being available to our physicians, which will only improve our ability to care for them as they spend winters here in Myrtle Beach.”
Do your homework
What should you consider when selecting an LIS vendor? First, you need to decide what’s most important for your organization. Is it to be more efficient or more productive? How important is ease of use? Cost? Scalability? “As obvious as it sounds, do your homework – watch product demos, ask questions,” says Stevens. “Because you can find a system that has everything you are looking for.”
Do not forget to explore technical support with your vendor. “When a system goes down, it affects everyone; therefore, you need a support team that is quick and reliable,” Stevens says. “Get to know your support team and develop a relationship. It will be worth its weight in gold.”
What to look for in an LIS:
- Web based: Must provide anywhere, anytime access to lab information and results.
- Interconnectivity: Must interface with reference labs and immediately funnel results into EMR, thereby removing manual work/human error.
- Scalability: Must be flexible enough to expand with the organization as it grows.
- Intuitive: Look for a system that has easy-to-use screens and menus that make training quick and painless.
- Security: Must provide ability to see who’s accessed what files and customize access to specific patient reports for different locations or providers. HMT