New Lab, Pathology Trends at Executive War College 2021

Success of this conference may help encourage other laboratory associations to schedule live events

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CEO SUMMARY: Hundreds of lab leaders traveled to San Antonio last week for the 27th annual Executive War College on Laboratory and Pathology Management. After almost two years of virtual conference and meetings using Zoom, attendees were ready to gather for a live event, complete with speakers, networking, meals, and receptions. Speakers addressed the need for labs to become more proficient at gathering data and using that data to add value for physicians, patients,and payers. 

IT WAS A LIVE EXECUTIVE WAR COLLEGE FOR THE FIRST TIME SINCE 2019! Last week, 400 lab executives, managers, and pathologists traveled to San Antonio to attend the conference in what turned out to be a high-energy learning and networking event. 

That may be one of the most interesting and relevant outcomes of this year’s Executive War College on Laboratory and Pathology Management. Attendees were eager to attend the sessions and enthusiastic about the networking opportunities. 

“It was obvious that this group of attendees came prepared to fully participate in all the activities of this year’s conference,” observed Robert L. Michel, Founder of the meeting and Publisher of The Dark Report. “At the same time, all participants respected the need to follow the health and safety protocols for social distancing, use of masks, and daily screening procedures required of everyone each day before they could enter the conference area.” 

The success of this Executive War College—the 27th since its founding in 1996—is a good omen for other lab industry meetings and gatherings. For example, each attendee was screened before entering on all three days and no attendee was flagged as requiring an on-site rapid PCR COVID-19 test before entry. 

As clinical laboratory professionals, they understood the need for compliance with CDC recommendations at live gatherings and were appreciative of the need to clear the temperature check and related procedures before entering the event each day. Rapid PCR tests were also available for some attendees who required a negative COVID-19 test result before returning to their hospital or organization after their travel to San Antonio. 

Having cleared the safety and screening protocols each day, participants could give their full attention to the sessions and speakers. One primary theme found in a large proportion of the presentations was the importance of having a strategy to collect, store, and analyze data, and use these capabilities to deliver more value to hospitals, physicians, patients, and payers.

Importance of Mastering Data

“This was true whether the session was conducted by a lab manager, consultant, or lab vendor,” Michel noted. “On the vendor side, more companies now sell products to their lab customers that use artificial intelligence (AI), machine learning, and other digital technologies to give their products and services more punch for the labs using them. 

“A theme common to speakers from lab billing/coding/collection companies is how they are incorporating ‘smart’ features in their software offerings,” he continued. “For example, these AI-powered functions can instantly verify the identity and health insurance coverage of patients upon their arrival at a patient service center. This helps speed the billing and collection of a patient’s claim because the information on the claim is more accurate and more complete. This also contributes to cutting the lab’s labor cost of billing a claim. 

More Use of Digital Tools

“Clinical laboratory administrators speaking at this year’s Executive War College also described their increasing use of digital tools and computerized analytics solutions,” Michel said. “These are often middleware solutions that are used to streamline daily lab operations, help manage lab test utilization in near-real time, and produce timely management reports to support continuous improvement projects in all areas of the laboratory.”

One interesting facet of this year’s Executive War College is that both speakers and attendees wanted to learn what is ahead for healthcare and the clinical laboratory industry. Because of their front-line role in fighting the pandemic, lab executives and pathologists had little interest in hearing presentations about how labs responded to the unprecedented demand for huge volumes of COVID-19 tests. For them, this story was old news.

By contrast, interest was keen in learning more about what is different in healthcare today—compared to the pre-pandemic era. Speakers discussed those changes. 

Two healthcare trends accelerated by the pandemic and discussed by some speakers involve increased use of telehealth and more self-testing by consumers in their homes. One dynamic accelerating the adoption of these two trends is the preferences of Millennials. 

Millennials Use Telehealth

Millennials—Gen Y—will make up 75% of the workforce by 2025. That’s just 25 months away. It is recognized that Millennials are more comfortable seeing their physicians via a telehealth visit, compared to older generations. 

Millennials are also one factor in the growing acceptance of consumer self-testing at home. But, as pointed out by Larry Worden, Principal of IVD Logix, LLC, in Dallas during his presentation, it is not only the preference of Millennials. The COVID-19 pandemic introduced consumers of all generations to the ease of doing a SARS-COV-2 test in the safety and comfort of their own homes. Worden predicts that the in vitro diagnostics (IVD) market has been changed significantly by these aspects of the pandemic.

More broadly as a force for change is the interest more clinical labs and pathology groups have in developing novel testing services that, because they add value, produce new streams of revenue. Many speakers described the mix of testing services they are launching that are expected to generate new streams of revenue. These new testing services invariably incorporate AI or machine-learning technologies that assess large pools of data to create intelligence that is actionable by physicians and payers. 

Test Utilization, Care Gaps

“What we heard from numerous speakers at this Executive War College is that innovative lab organizations are building their clinical, operational, and financial strategies around intense use of data,” Michel observed. “Two of the most common initiatives labs are developing specifically to add value involve managing lab test utilization and helping physicians and payers identify and close gaps in the care of individual patients. 

“To achieve these goals, the lab needs do two things,” he said. “First, the lab must gain access to additional data beyond the lab test results it has always produced and stored. For instance, to help close gaps in care, the lab wants access to the EHRs of the parent hospital and/or referring physicians so as to gather ICD-10 codes and other relevant information about individual patients. 

“Second, the lab must have data analysis tools that can work with these expanded sets of data,” Michel stated. “The data analysis tools identify opportunities to improve lab test utilization and to identify patients with care gaps, particularly those patients at high risk for an acute event.” 

Recordings of All Speakers

All the sessions at this Executive War College were recorded. These recordings include the powerpoints used by each speaker. Lab leaders who were unable to attend in person can use these recordings to catch up on all the innovations and insights shared at the conference. These recordings can also be shared with team members as part of strategic planning activities. Information about the recordings and how to order can be found at www.executivewarcollege.com. 

Presentation Highlights from Speakers at the 27th Annual Executive War College

LAST WEEK’S EXECUTIVE WAR COLLEGE FEATURED 44 SESSIONS AND 52 SPEAKERS OVER 2 DAYS. The unifying theme was “preparing your clinical laboratory and pathology group for post-pandemic success.”

Speakers recognized the unusual circumstances of healthcare today. The good news is that the daily number of new cases of COVID-19 has declined substantially from peak levels last January. The troubling news is that—despite the ongoing increase in the number of people vaccinated (or with antibodies from an earlier SARS-CoV-2 infection)—hospitals throughout the United States continue to admit and treat patients with COVID-19 at a worrisome rate. 

Recognizing this situation with the pandemic, many speakers noted that their respective parent hospitals and lab organizations were again developing strategies to serve the regular, ongoing needs of patients, physicians, and payers. Collectively, these speakers stated the importance of finding new sources of revenue, as both government and private health plans continue to reduce reimbursement for lab tests and other services. 

To illustrate this, Monique Dodd, PharmD, PhC, MLS(ASCP)CM, spoke about how she is working with integrated delivery networks, labs, and physicians in New Mexico in what is one of the nation’s first examples of placing pharmacists in a laboratory’s patient service centers with the goal of reducing gaps in care and improving patient health. 

As patients arrive to provide lab samples, pharmacists meet with them one-on-one to discuss gaps in care, develop a plan of action with the patient, and update prescriptions as appropriate. Dodd is the Manager of Enterprise Clinical Solutions, for Rhodes Group in Albuquerque, N.M. She explained that New Mexico is one of a handful of states that has passed medical scope-of-practice laws for specified health conditions that allow pharmacists to diagnose, treat, and monitor patients in the same manner as physicians. 

Another opportunity for clinical laboratories to develop a new source of revenue is to approach self-insured employers with proposals that incorporate lab test data in ways that improve the health and workplace productivity of their employees. That was one recommendation made by Kristine Bordenave, MD, FACP, Strategic Consultant, Precision Medicine, KKBordenave Consulting Group, based in Chicago. 

Bordenave encouraged clinical lab leaders to approach the health benefits administrators at self-insured companies and demonstrate how a well-designed program of lab testing could solve a major problem for employers: presenteeism. 

This was a new term for the audience. Bordenave defined presenteeism as productivity loss resulting from real health problems. As a practicing physician, earlier in her career Bordenave had worked with employers and her patients to address health conditions that reduced the productivity of employees who were on the job.

One example caught the full attention of the audience. Bordenave said that multiple published studies showed that an individual with elevated levels of A1c above 7.0 is 20% less productive. She used this example to illustrate how a clinical laboratory could work with a self-insured employer to identify employees with elevated A1c scores, then help these employees and their care teams to bring the A1c score into the normal range, thus improving daily productivity of those workers.

Michigan Health Info Network Helps to Develop Use Cases

ONE TECHNIQUE THAT HELPED the Michigan Health Information Network (MiHIN) encourage collaboration and exchange of data across different organizations is the “use case” approach. 

During his presentation, MiHIN’s Executive Director Tim Pletcher, DHA, explained that MiHIN identifies a specific function that MiHIN could provide that would be valuable to a broad range of stakeholders. It then organizes working teams to define the use case, identify needs, and begin developing a solution. 

At one MiHIN-sponsored “connectathon,” MiHIN reported that attendees developed solutions incorporating HL7 “to streamline the data flow from clinical settings to payers to facilitate quality measurement and care coordination.” Solutions presented at the end of this connectathon included: 

• An A1c data exchange solution using Salesforce that enables patients to receive discounts on their health insurance by regularly checking their A1c level and working to keep it within the normal parameters. 

• A mobile medication reconciliation tool for health insurance members to log in to confirm the medications they are taking following a hospital discharge. 

• An emergency department tool that measures HEDIS (Healthcare Effectiveness Data and Information Set) and identifies potential unnecessary visits to the ED. 

• An application that reduces the number of a patient’s hospital admissions, while improving quality measure scores by calculating risk measures and notating these in the electronic health record to be addressed at the patient’s next office appointment.

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