Connectivity is the key to efficiency, accuracy and cost savings.

By Lisa-Jean Clifford

an you name any single area of healthcare that is more important than your data? Clinical, pathology and microbiology information represents more than 90 percent of all data related to any given patient, yet has seen little to no innovation.

You might not be surprised to hear this statement. What may surprise you is ideal databases exist. The need for a normalized, well-designed database is getting a great deal of attention lately from pathologists, physicians and clinicians alike.

The System Core

The core of any healthcare system's operation is its database. Historically, databases have been disparate systems–housing data specific to a single database's functional area. A laboratory information system (LIS), clinical information system and microbiology database would each have their own database. Imagine the challenge in trying to conduct research on related clinical versus pathology results? The reports would each need to be run out of their own databases, then manually assembled and evaluated. This is not only a tedious activity, it is also virtually impossible to be sure all tests conducted are attributed to the correct outcomes. Reporting and analysis are becoming more relevant to ensuring the best treatment plans are available to patients. These actions are a constant and ongoing necessity.

Interfacing and integration are key components to streamlining processes, automating workflows and increasing efficiency, all of which lead to higher accuracy and lower costs. Having an ideal solution means having a lean, powerful relational database designed to hold all current and historic patient and result information with modular flexibility. A truly integrated database will enable laboratories to quickly and easily conduct statistical data mining, develop graphs, produce customized reports and automatically distribute them, as well as provide outreach capabilities. Forward-thinking system developers have focused on this conundrum and have delivered the ability to automate processes, provide increased and current functionality, and to extend the life of existing laboratory and clinical information systems.

Lab Connectivity

Leverage the power of the Web to communicate with the physicians and clinicians who use your laboratory services. A system that provides current and integrated functionality will allow clinicians to place orders and receive results online. Consider the possibilities for automation, accuracy and streamlined patient care, when an LIS, anatomic pathology system, reference labs and instruments are all integrated.

The ability, through technology, to share order and result information directly between an ideal solution and the clinician's electronic medical record without the complexity of traditional interfaces now exists. With the emergence of more private pathology practices, more instrumentation use, and more challenges in growing and maintaining labs' client bases—interfacing has become a necessity.

In the past, pathology specimen diagnosis was based on analyzing morphology and tissue architecture at the microscopic level. Today, instrumentation is used to perform this testing. Flow cytometry, HPV testing and IHC staining are just a few of the more common and frequently used interfaces available. By interfacing your LIS with your instruments, you will gain a significant competitive advantage. Cultivating the one-on-one relationship between a lab and the clinician is key to attracting and retaining customers.

The bottom-line impact of having an ideal database that allows for centralized storing and retrieving pathology, clinical and microbiology records and data is as important as its ability to add modular functionality.

Fulfilling Targeted Needs

An ever-increasing number of clinicians are looking for more than just data and boring, static result reports. The ability to provide clinicians with additional information, customized result reports and the capability to place orders online right from their office is fundamental to servicing and keeping them in this competitive environment.

The power to view images associated with the results attached directly to the reports is essential to achieving higher customer satisfaction. Higher customer satisfaction leads to increased orders and means more reimbursements. Several opportunities for interfacing and capability expansion are shown in the Table.

Reporting

Clinicians require faster access to critical patient care information. By implementing a modular, truly integrated solution, physicians could quickly access completed reports from a secure Web page using any computer with a unique login identifier. Laboratories providing the same physicians with customized reports—depicting images, logos, layout and result presentation in the format the physician prefers—would gain a competitive advantage over other labs.

Reports should be customizable by individual physician or by facility location. Preferences can also be set to include all patient history on the report, including previous results for specific tests or entire result history. Imagine also allowing physicians to define their preferred delivery method for those reports (e.g., automatically printed, e-mailed or faxed).

Rules-based reporting would produce automatically distributed patient reports based on completion status, test groups, priority, physician, physician groups, location, patient type or any lab-specific demographic. Dynamic distribution options allow the lab to automatically schedule and distribute reports, or allow the physician to designate manual report release via print, fax, e-mail or secure online viewing.

Ordering

Similar to the integrated reporting capabilities, physicians should be able to quickly and easily place test orders online directly from their computer. Customizing their own order list for the tests ordered most frequently, then simply checking the boxes corresponding to a particular order on an online requisition form increases efficiency and accuracy.

Having placed orders automatically queued up and available for lab staff would give physicians the ability to track orders online to confirm the specimen was received and processed. Because of the dynamic, centralized database, when orders were placed, the patient information would be entered into the system directly from the physician's office, and all information, including the testing, instrument interface, results report, historical data and billing codes would all be married together in one location.

In all cases, orders should also be checked in real time for validity based upon established rules, and ABN forms should be generated if a test is not covered per the patient's diagnosis.

Management Interfacing

Many applications have tried, but not succeeded, in making ad-hoc result look-up possible for patient history or other parameters within the laboratory or other areas within the facility. With a powerful, intuitive interface, performing searches is based upon specific requirements, such as a single test or multiple tests, orders, result date ranges, departmentally or by instrument. A system enabling integration within the laboratory provides greater flexibility and the ability to generate views of desired patient results. Graphically representing resulting information for more timely, detailed and multiple views provides measurably improved interpretation and data analysis. Imagine having to review dozens or even hundreds of patient records to manually find, correlate and calculate this critical information.

Equipping the system manager with an integrated toolset allowing him to easily update and customize libraries, medical necessity rules, result interpretations, reference ranges, collection requirements and so on to stay current with new and evolving tests, regulations and standards increases accuracy and reimbursement.

How about providing access to cataloged tests? How much would that facilitate efficiency and speed of processing? It would certainly enable lab personnel to look up vital information for any test performed by your lab, or sent to a reference lab.

With all of this innovation and these technologically enabled efficiencies, streamlined processes and higher customer satisfaction, the results are powerful. They include better patient care and diagnosis, increased accuracy and reimbursement, decreased clerical errors and increased efficiencies. Having all the reports and results, as well as the patient record and history available in one location is key and necessary to determining effective treatment plans.

Imagine having all testing, patient data and results available to continuously analyze. Able to conduct continuous and real-time data mining and analysis, you are now better able to refine and determine patient diagnosis and treatment. This means better care, increased ability to cure and a better quality of life for the incurable.

Lisa-Jean Clifford is senior director of marketing and business development, Psyche Systems Corp., Milford, MA.

Table: Interfacing and Expansion Opportunities

easily create patient reports that feature graphical analysis

single report output from multiple data sources

fast, flexible ad-hoc search and viewing of patients and results

dynamically manage a wide range of reporting–management and statistical

give physicians secure, online access to critical patient care information

fast, accurate online order entry directly from the physician's office

Web-based outreach and easy EMR interfacing

bidirectional interfaces to clinical and anatomic pathology instruments,

devices and clinical back office systems