atlas-Branding Your Lab in the Age of the EMR Presentation ... · – Branding issues • Labs are in a strong position to own/control the network – Already providing solutions

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Copyright 2009. Atlas Development Corporation. All Rights Reserved

Branding Your Lab in the Age of the EMRTurning Your EMR Interface Challenge into an Integration Advantage

Robert D. AtlasPresident & CEO

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Presentation Outline

• Physician Office Connectivity – The Last Ten (plus) Years

• The Age of the EMR – Challenge and Opportunity

• The Strategy – The Lab’s Role in Connected Healthcare

• The Tactics – Interfacing, Integration and Orchestration

• Beyond Interfacing in the Connected Care World – Connected Care Engine

• Extending the Lab’s Brand and Reach in the Age of the EMR – Examples

• Conclusion

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Physician Office Connectivity – The Last Ten (plus) Years

• For more than a decade, outreach laboratories have used information technology to differentiate their service offerings and eliminate the inefficiencies associated with paper orders

• The return on investment from driving electronic ordering is demonstrable

• Labs that assert control over the order entry (“pre-analytic”) workflow can realize substantial operational efficiencies and reduce billing errors

• Control of results delivery (“post-analytic”) workflow drives increased customer satisfaction

– Fewer calls (“Where are my results?”)

– Customized reports tailored to individual physician preferences

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• Competitive Drivers for Labs– Respond to national labs with something better– Win new business– Retain customers

• Operational Drivers for Labs– Clean electronic orders – Fewer problems – lost specimens, wrong tests ordered, etc.– Eliminate inefficiencies, reduce expenses - deliver ROI– Improve revenue cycle management

Ten (plus) Years of Increasing Efficiency

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Ten (plus) Years of Strengthening Connections

• Added benefits of providing physician office connectivity – Customer Service

• Increased service levels, fewer errors, better TAT• Increased customer satisfaction• Higher retention rates

– Branding• User interface for your solution – logo, lab name, etc.• Requisitions• Reports (electronic and paper)

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• Key Driver: Government Policy

– Dramatic increase in IT investment means (theoretically) greater efficiency in exchange of healthcare data

• EMRs• Regional Health Information Organizations (RHIOs)• Health Information Exchanges (HIEs)• Personal Health Records (PHRs)• Payors

– The challenge is that labs produce a large percentage of the information, but will not control the systems they must interact with to do the job

• Technological Hurdles• Financial Hurdles• Threats to the Core ‘”Physician’s Office to Lab” Business Model

Connected Healthcare is Accelerating

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• Growing Sophistication of Laboratory Discipline– Molecular diagnostics and the merging of AP, Clinical and Diagnostic Imaging– Complexity of testing decisions and cost of testing means payers will strictly enforce

reimbursement – Reports are more complex – the need for added consultation– Must control pre-analytic and post-analytic workflow

• Opportunity

– Adding decision support integration to pre-analytic workflow allows labs to extend the consultative relationship with clinician customers

– Control over post-analytic workflow lets labs incorporate other value-added services into the reporting process that differentiate them from the competition

– Providing the IT solution ensures that the lab gets the test, gets paid for it and strengthens the relationship with the customer

The Age of the EMR – Challenge and Opportunity

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• Wide adoption of EMRs threatens the reference/outreach lab’s business model

– Undermines the lab’s control of pre-analytic and post-analytic workflow– Diminishes the number of clean orders – Branding issues

• Labs are in a strong position to own/control the network– Already providing solutions – Labs are key producers of information– Allows for value-added services that ensure labs are not merely “factories”– Natural extension of the lab’s traditional role as consultant

• Community-based medicine• Knowledge and experience

The Age of the EMR – Challenge and Opportunity

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The Strategy – Lab’s Role in Connected Healthcare

• The complete Connected Care strategy for labs will include:

– Robust best of breed product offering

– Where possible, partnerships with EMR, e-prescribing and other third party vendors

– Capability to interact with all the disparate systems touching the lab enterprise

• “Connected Care Engine”

– Capability to increase pre- and post- analytic touch points with physicians

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The Tactics - Interfacing vs. Integration vs. Orchestration

• Interfacing– Point to point transmission, transformation and mapping of data between systems

• Integration– Interfacing plus:

• Point to point workflow control• Point to point in-line exception management integrated with workflow

• Orchestration– Integration plus:

• Parallel workflows and data flows triggered to facilitate completely clean orders and appropriately delivered results

• Normalization across multiple, disparate systems

• Benefits of Orchestration– Greater scalability– Enhanced operational efficiency and reduced costs– Expanded pre-order data collection ensuring more clinically complete orders– Improved billing– More responsive customer service

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Ordering Information and Process may come in separate stages. Examples:

• Multi-Stage Ordering:

- First stage Select the patient, test codes, diagnosis codes- Second stage Ask-at-order questions - fasting, weight, LMP, etc.- Third stage Billing information, medical necessity checking, eligibility- Fourth stage Specimen collection

• An HL7 order is received from an EMR, and then after running validation, requires further workflow processing:

At the Physician OfficeAt the Lab by Customer ServiceAt the Patient Service Center

Concept of Multi-Stage Ordering

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EMR Multi-stage Order Entry Orchestration

Connected Care Engine

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The Tactics - Interfacing vs. Integration vs. Orchestration

LIS 1AP 2LIS 3

Orders

Results

Workflow and Data Orchestration Platform

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Orders Orchestration

LIS 1AP 2LIS 3

Orders Workflow & Business Rules EngineEMRs

Multi-Staged OE

OE Systems

Referring Labs

User Interface Layer

DataIntegrationLayer

Internal Lab OE

PMS Data

EMR Order Sync.

Accession Info

Patient Service Center

Med. Nec.

Check

Eligibility Check

Customer Service Processing

Issue Notification

Client Issue Resolution

ADT / MPI Registration

ADT / MPI Registration Resolution

Billing Data

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Results Orchestration

LIS 1AP 2LIS 3

User Interface Layer

DataIntegrationLayer

ImagesImage Review Approval

Other Images Upload

Other Images

Customer Service Processing

Issue Notification

Client Issue Resolution

Billing Data

Results Release Filters

Results Viewer

Patient Access

Auto Printing

Auto Faxing

EMRs

Payer Data Decision

Support AnalysisGov’t

Disease Reporting

Results Workflow & Business Rules Engine

Referring Labs

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Beyond Interfacing – The Connected Care EngineSources of Orders/Destinations for Results

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Beyond Interfacing – The Connected Care Engine

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Extending Your Lab’s Brand and Reach – Examples

• Maintain (regain) Control and Enhance Your Brand

Pre-analytic Workflow (even when the order comes from an EMR)– Queue up Orders at the Physician Office for Further Processing and Cleanup

– Auto-print Requisition Slip

– Auto-print Directions to YOUR PSCs

– Auto-print Specimen Labels (perhaps instrument ready)

– Auto-print ABN

– Auto-print Alternate Lab Requisitions (based on payer/plan, lab network rules, etc.)

– Enable Exception Management (queue issues for Lab Customer Service, or notify office…)

– Perform Eligibility Checking and Pre-authorization of Procedures (same as above)

– Provide Test Ordering Decision Support

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Extending Your Lab’s Brand and Reach – Examples

• Maintain (regain) Control and Enhance Your Brand

Post-analytic Workflow– Auto-print Results Report (even when HL7 results are being delivered to the EMR)

• Medical Director may require it for some EMRs

• EMR may not support images, partials, unsolicited results

– For Thick Client EMRs, Enable Physician to View Results from Outside the Practice

– Provide Decision Support for Follow-up Testing and Treatment Protocols

– Allow Physician Office to Initiate “Fax to” or “Copy to” Request to Consulting Physicians

– Send a Message to Lab Customer Service, or Electronically Request a Call, or IM/Chat

– Enable an e-Consult

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Connected Care and the Age of the EMR - Conclusions

• Connected Care presents challenges and opportunities

• EMR adoption will accelerate and interfere with lab to client relationships

• The lab’s efficiency and brand is in jeopardy

• The lab must ensure IT systems are capable of addressing these challenges

• A powerful Connected Care Engine is essential

• The lab can use orchestration techniques to control pre- and post- analytic

workflow

• The lab can deploy value-add services to compete, retain customer relationships

and keep the lab’s brand flourishing

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Robert D. AtlasPresident & CEO(818) 340-7080

[email protected]

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atlas-Branding Your Lab in the Age of the EMR Presentation ... · – Branding issues • Labs are in a strong position to own/control the network – Already providing solutions