CEO SUMMARY: When faced with the choice of implementing Web-accessed lab test ordering or Web-accessed results reporting, most early adopter laboratories started with results reporting. It requires much less money and effort to accomplish. Vendors recognized this fact and are introducing a variety of products that enable labs to give their physician clients Web access to lab test results.
It seems the marketplace has spoken. During the year 2000, most early adopter laboratories decided to implement Web-accessed laboratory results reporting, leaving Web-accessed lab test ordering as a project for the future.
This is certainly not what was predicted by most experts, including the Dark report. During the fall of 1999, several credible vendors were actively signing contracts with some of the nation’s most influential laboratories to implement Web-accessed lab test ordering and results reporting.
It’s significant that the first generation of labs to embrace Web-accessed information services decided to begin with test results reporting. assuming this trend continues, it is strong evidence that use of the Web for lab test ordering will lag behind test results reporting. In the following story on pages 10-13, the Dark report analyzes the market forces behind this unexpected outcome.
Cost, relative simplicity, and working software solutions are the three primary reasons why laboratories selected test results reporting as the first Web-based service to offer referring physicians. Both labs and vendors tell the Dark report that it is a reasonably simple task to sit a software package on top of the existing laboratory data repository.
This software package then delivers lab test results via the Internet and accepts queries from physicians who use a Web browser to access their patients’ lab test data. Issues of security, privacy, and access can be handled by existing technology solutions.
Some early adopter labs recognized that Web-accessed lab services could provide competitive advantage at low cost. Clinical Laboratories, Inc. (CLI) of Throop, Pennsylvania created its own software solution for Web-accessed test results reporting. By its own estimate, CLI took only $70,000 and about 12 months to convert off-the-shelf software into a robust system for reporting lab test results via the Internet.
Cost-Effective To Implement
It was a similar experience at UMASS Health System Laboratory, Inc. in Worcester, Massachusetts and Centrex Clinical Laboratories, Inc. of New Hartford New York (using products from Metricom, Inc. and iMcKesson.com, respectively). Both labs found it cost-effective to implement Web-accessed tests results reporting. Implementation was straightforward and free of the complications usually associated with major LIS conversions.
From the experience of these and other labs actively offering Web-accessed tests results reporting to physicians, three basic success secrets can be identified.
SUCCESS SECRET ONE:Introduce this new service as an addition to the existing reporting arrangement in a particular physicians’ office. “We leave the PC or teleprinter right where it is,” said Richard Faherty, Chief Technology Officer at Bio-Reference Laboratories, Inc. in Elmwood Park, New Jersey. “After all, the doctor is concerned that anything new and unfamiliar might interrupt his office’s current work routine.
“When we demonstrate how the physician, and his authorized staff members, can use a Web browser to get lab test reports in real time, at any time, and query for past results, we also emphasize that this is extra, it costs him nothing, and everything else continues ‘as is’,” explained Faherty.
Some early adopter labs recognized that Web-accessed
lab services could provide competitive advantage at low cost.
“When introduced this way, there is generally a high acceptance rate by physicians,” he added. “We then let the physician and his office staff grow accustomed to using the Web browser to get lab test reports. once this has become routine, they generally ask us to remove the pc or teleprinter because it is taking up valuable space in the office.”
SUCCESS SECRET TWO: Pick physicians who are already Internet-savvy as the first to get this new Web service. these physicians are “centers of influence” in use of the Internet to aid their medical practice. Their enthusiasm about Web-accessed results reporting helps to convert their colleagues.
“This was a no-brainer for us,” said Kuo Cheng, chief operating officer of CLI. “When the time came to introduce this to our physician-clients, we went directly to the doctors who were already Internet-savvy.
“They needed little convincing to accept this service,” recalled Cheng. “Moreover, they quickly learned that they didn’t have to carry reams of paper home at night and could access their patient’s test results from any computer that had Internet access.
“The pay-off for us was that these physicians were a walking testimonial for the benefits of using the Web for accessing lab test results,” he noted. “Before long, their colleagues were calling the lab to ask when we could come and set them up for this same feature!”
SUCCESS SECRET THREE: Go beyond simple reporting of lab test results. Offer enhanced features for cumulative reporting, utilization, and the like. Most physicians are quick to recognize the benefits of doing a speedy log-on to look at their patients’ cumulative test data in ways not available before the Web.
“For those of us who believe in the power of lab test data to positively influence healthcare outcomes, this is a double-benefit,” stated Faherty. “Doctors love the added value of this feature. they also become more loyal to the laboratory which provides them with this added value.”
These three laboratories have learned that there is a segment of the physician community which is not only ready for lab services delivered over the Web, but eager to embrace it. this is particularly true in cities where Internet access is available and a higher portion of the population is regularly using the Internet.
Web-Enabled Systems
Web-enabled systems for reporting test results between laboratory and physicians’ office have only been available for a short time. At the close of 2000, a limited number of independent labs and hospital labs provided such services to their physician-clients.
However, this situation is changing rapidly, for an interesting reason. Growing numbers of integrated health systems (IHN) are beginning to introduce Web-based clinical reporting systems across their enterprise. clinical laboratory data plays an essential role in these arrangements. IHNs are thus leading their labs in this direction.
As IHNs incorporate such capabilities into their enterprise-wide intranets and the Internet, it means laboratories affiliated with the IHN gain the capability of reporting lab test results via intranet/Internet. Because these projects are initiated by the IHN’s senior administration, it eliminates most of the organization politics which often delay capital requests proposed by lab administrators.
Commercial Lab Segment
In the commercial laboratory segment, the two blood brothers are working to implement Web-accessed lab test reporting capabilities. Quest Diagnostics Incorporated has business relationships with Caresoft, Inc. and MedPlus, Inc. which are pointed toward making lab test data available to physicians using Internet access. Laboratory Corporation of America is working on similar initiatives, but has made few public comments on the details.
Within the hospital lab segment, there are a number of lab organizations which, with the blessing of their parent hospital, have initiated programs to acquire and implement systems to enable test results reporting between their labs and their physician-clients.
Taken collectively, there is considerable activity now taking place in IHNs and laboratories around the country. Web-accessed lab test results reporting between lab and physicians’ office will be more widespread by year’s end.
Survey of Vendors
On the pages which follow, The Dark report provides a survey of the current crop of leaders among companies offering information solutions to labs involving Web-accessed lab test ordering and results reporting.
