Value-Based Care through IT Laboratory Information Strategies

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Major changes in healthcare systems globally offer new opportunities and challenges especially for clinical laboratories and other providers of diagnostic services. The shift in the ground rules relating to healthcare towards value-based care provision in turn affects the business models governing operation of labs and diagnostic facilities.

In order to renegotiate satisfactory contracts and become a successful part of the value-based healthcare systems, labs and diagnostic facilities must prove their capabilities in terms of value addition to the core objectives of the organizations they serve.

Data collected and results produced by diagnostic facilities is a potentially highly valuable source of information to assist value-based healthcare organizations to meet their business objectives – offering quality care and keeping costs controlled.

However, the realization of this potential is dependent on various factors, including quality, timing and type of information given by the IT systems of diagnostic facilities. Labs and diagnostic facilities must implement their own electronic health records systems (EHRs) and laboratory outreach systems to enable successful healthcare integration and migration in the quest for a rounded value-based healthcare system.

Defining Business Contextual Settings

Many diagnostic facilities have contractual arrangements with multiple healthcare institutions, each of which would require different strategies to ensure successful integration. These institutions include:

ACOs – the lab should be able to meet the quality of care and economic objectives laid out by the ACO, beyond conventional methods relating to cost testing.
Narrow care networks – labs will be in stiff competition to become preferred labs by financiers in this category. This will require price allowances as well as strict controls in test utilization.
Conventional fee-per-service: many labs will still offer lab testing for individual paying patients, though the composition of such services may change in time. For instance, standardized low-costs tests will be more available at retail pharmacies and doctors’ office labs, so that specialist diagnostic facilities concentrate on high-end tests.

Implementing Electronic Order systems with Decision support 

Despite the tremendous movement towards EHRs, many lab tests are still paper-based. Many healthcare providers downplay the importance of having an electronic lab order system, hence fail to demand for the same from the diagnostic service providers. Challenges in interoperability keep costs of integration high, especially with bidirectional interfaces to enable intercommunication of lab and provider.

It’s rare to find lab order platforms that are both easy-to-use and efficient; the available vendors models have been adopted in limited places, since physician adoption is necessary for effective functioning. can enable effective integration of electronic lab procedure ordering and result reporting with currently existing EHR workflows. This offers more leverage for increase in the value offered by digital ordering platforms.

To date, quite a number of laboratories have pioneered the implementation of electronic order systems that are compatible with several HER systems. This has been through forming partnerships with outreach vendors whose applications can apply as standalone information portals and integrated with pre-existing EHRs using various approaches. These include web service integration, HL7 messaging or demographics only integration.

Implementation of these systems must be in a way that minimizes performance of unnecessary test procedures. They should also adhere to standardized testing protocols and ensure that routine tests to detect chronic conditions are properly done. For maximum efficacy, decision support frameworks should be available at the order point. 

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