CEO SUMMARY: Health information exchanges (HIEs) are operating nationwide, but few handle lab test orders and results with ease the way HealthBridge does. This long-established HIE in Cincinnati, Ohio, allows physicians to send lab test orders from their electronic health record systems (EHRs) and to receive matched lab test results back in their EHRs. One lab taking full advantage of this HIE is Mercy Lab Services, which has boosted its outreach volume four-fold and experienced 53% growth last year.
ACROSS THE NATION, a growing number of health information exchanges (HIE) are becoming operational. As they do, local lab companies and hospital laboratory outreach programs are leveraging these HIEs to gain competitive advantage and increase their market share of tests referred by office-based physicians.
This is a significant development. Savvy hospital lab outreach programs are seizing the opportunity to use their region’s HIE as a tool to help win new outreach clients while holding down costs, particularly the cost of providing the electronic links needed to interface their laboratory information systems (LIS) with the EMR (electronic medical record) systems of their office-based physician clients.
In Cincinnati, Ohio, Mercy Laboratory Services (MLS) has proved masterful at using HealthBridge, the region’s HIE, to expand its lab testing outreach business. “Over the past five years, our lab has quadrupled test volume while keeping costs stable,” stated Tony Bull, Sales and Operations Manager for Mercy Lab Services. His laboratory serves Mercy Health, an integrated delivery system of seven hospitals with 2,954 beds in the Greater Cincinnati metro area.
“We kept costs stable as outreach testing volumes increased and our average cost-per-test declined significantly,” explained Bull. “By holding other important cost factors at a constant level, our lab increased its per-test revenue during this time period, posting growth of 53% in the last year alone! Such growth and stable costs are particularly important in a slow economy.”
Serving 50 Hospitals
Bull says that one key to Mercy Lab’s success is its partnership with HealthBridge, one of the nation’s largest and most advanced HIEs. Established in 1997, it serves 50 hospitals, 800 physician practices, and 7,500 physicians in five communities in Ohio, Northern Kentucky, and Eastern Indiana.
HealthBridge uses its secure electronic network to transmit roughly 3.2 million electronic messages each month. This includes clinical lab test orders and lab test results. Other clinical data handled by HealthBridge include radiology reports, discharge summaries, and other information on more than 2.5 million patients.
There are several ways that participating with HealthBridge helps Mercy Laboratory Services win new office-based physician clients and retain their business. “Our relationship with HealthBridge allows us to compete on a level playing field with the national laboratories,” observed Bull.
Speedy EMR Interfaces
“We regularly encounter situations with potential clients where the question is asked, ‘Can you interface your lab with our electronic health record (EHR) system?’ And by working closely with HealthBridge, we can answer, ‘Yes, absolutely!’” he noted.
“Plus, we can establish these interfaces relatively quickly, which is another way that HealthBridge helps us level the playing field,” continued Bull. “The national labs have been connecting physicians to their information systems for several years and so they can do it relatively quickly.
“Most physicians want to connect to their laboratory provider within a month or two,” he commented. “Without HealthBridge, it would have taken us a great deal longer than that, plus the added expense of writing the interface between our LIS and each client’s EMR.
“But now that HealthBridge is part of how our lab connects to physicians’ offices, it has helped our sales efforts,” he added. “It allows us to offer all the services that any other lab can offer, including the national labs. For our existing clients, we can work with nearly any EHR system now.
“This is equally true for those physicians trying to establish meaningful use,” said Bull. “Our lab can support meaningful use with the interfaces we establish to their EMRs.
Connecting to Physicians
“The reason working with HealthBridge facilitates connections to physicians is that the HIE has been establishing connections among all providers in Greater Cincinnati for 10 years,” stated Stacey Potts, the HealthBridge Product Manager, Community Order Entry. An expert in how labs and physicians exchange lab orders and test results, Potts worked in the lab industry for 12 years before coming to HealthBridge in 2005.
“The reason this whole system works is that for physicians, we have one connection to HealthBridge,” Potts explained. “Once the physician’s EMR is connected to HealthBridge, that EMR is then able to access data from multiple hospitals and multiple labs. We now connect to the EMR products of 26 different vendors.”
“Such simplicity is significant for physicians, added Bull. “Physicians appreciate the fact that one connection to HealthBridge eliminates the need to establish multiple interfaces with their EMR and each different ancillary service provider that serves their practice. It also greatly shortens the time needed by any new lab to connect with their EMR.
Less Cost for Interfaces
“Because HealthBridge eliminates the thousands of dollars typically required to create an interface between a lab’s LIS and the physician’s EMR, this greatly reduces our lab’s cost to connect to the EMRs of our clients,” he said. “To connect to HealthBridge, the medical practices typically pay as little as $25 per physician per month for the EHR interface. Plus, HealthBridge has a level of expertise in informatics that we don’t have, which means we don’t have to devote our internal resources to getting physicians up and running.”
Outreach Labs at Three Large Hospitals Gain Advantages by Working Together with HealthBridge
ONE UNUSUAL ASPECT of HealthBridge of Greater Cincinnati, a health information exchange (HIE), is that it allows three competing hospital lab outreach programs to work together in a collaborative manner.
Mercy Laboratory Services, which serves Mercy Health, an integrated delivery system of seven hospitals with 2,954 beds in Cincinnati, is working with labs from two other large hospital systems in order to get a volume discount from the HIE, said Tony Bull, Sales and Operations Manager for Mercy Lab Services.
“We have the laboratories from three health systems collaborating in our relationship with HealthBridge,” noted Bull. “HealthBridge gives us a volume discount based on the number of lab test orders we put through. It’s a cost advantage for us because of the combined volume our three lab outreach programs generate.”
Along with Mercy Lab Services, the other two participating health systems are TriHealth, an integrated health care system in Cincinnati that includes Good Samaritan Hospital (460 adult and 130 newborn beds) and Bethesda Hospital, Inc., (360 adult and 60 newborn beds), and St. Elizabeth Healthcare, a large integrated delivery system in nearby Covington, Kentucky. This system has six hospitals with 1,187 beds.
The three hospital systems are similar in that they each run outreach programs in the Cincinnati metro area and each one competes with the other.
HealthBridge assesses a per-click charge based on the number of orders each hospital sends through the system. HealthBridge bills each hospital separately at the end of each month. The hospital lab organizations do not share any information with each other. “It’s an arms-length relationship,” Bull explained. “But it is one more way that HealthBridge helps each of our respective outreach programs to compete more effectively against the national labs.”
Doctors Can Speak to Local Pathologists
HEALTHBRIDGE MAKES IT EASY for local pathologists to work with local physicians practicing throughout the Cincinnati metropolitan area.
“Working with the labs here in Cincinnati, I’ve found that the physicians want to pick up the phone and talk with a local pathologist.” observed Stacey Potts, the HealthBridge Product Manager, Community Order Entry. “Physicians value the customer service that local labs can offer. Helping local labs and other providers leverage our HIE to serve our physicians and hospitals was part of the vision when the chief information officers of the city’s hospitals started HealthBridge in 1997.
“While there is friendly competition among these hospitals, they put patient care first,” she said. “One problem they wanted to solve was delivering lab test results to physicians. And now, 10 years later, we have a portal that allows physicians to access any of their hospital applications directly—even while working outside the physical hospital.
“We also have a clinical messaging system that delivers patient lab results; radiology reports; patient admission, discharge, and transfer reports; and transcription reports into a clinical messaging in-box,” noted Potts. “This system allows physicians to read their patients’ results from all content providers in one place and they can forward this information to their EMRs.”
