Leveraging technology to create an information eco-system that Leveraging technology to create an information eco-system that supports and drives a successful lab outreach programsupports and drives a successful lab outreach program

Today’s Agenda

• Outreach Laboratory Programs• PAML background

• Opportunities and challenges

• Outreach Advantage• The tool set – products and services

• How the workflow is improved and information is exchanged

• New product offerings and patient engagement strategies

Pathology Associates Medical Laboratories• Based in Spokane, WA

• 1,300 employees

• $200 million in Enterprise revenue

• 5 state core service area, 6 joint ventures

• Virtual lab running 9 LIS, 18 databases

• 90 IT staff – 8 integration engineers, 14 in physician connectivity

• $12 million operating $3 million capital IT budget

• 17 different EMR interfaces – 290 + total and growing quickly

• 12 different LIS interfaces – 48 total

• 4 web products – 700+ practices

• 5 hospital portals integrated – fed from CDR with 170 million results

• 57 active connectivity cases – 4 months of work – 2008 210 complete

• Regional data sharing collaborative – outpatient lab, radiology and inpatient data

• EMPI with 7.2 million patients – 46% of core service area population

Outreach Laboratory Programs

• Opportunities:

– Incremental lab testing can be highly profitable

– Hospitals and IDNs can leverage brand

– Combined inpatient and outreach data is a competitive advantage

• Challenges:

– Investment capital for business expansion is tight

– Lack technology tools – resources and implementation risk

– Genetic and molecular testing proliferation, consumer driven healthcare

As Managing Partner of several JV’s, PAML needed to As Managing Partner of several JV’s, PAML needed to develop a set of products and services to ensure the develop a set of products and services to ensure the

success of her Partnershipssuccess of her Partnerships

LOGISTICS MANAGEMENT

OE / REPORTING / EMPI

CUSTOMER RELATIONSHIP MANAGEMENT

SALES AND MARKETING

DEPARTMENT SCHEDULING

OAMobile

OAConnect

OACRM

OASFA

Schedule Labs

OAMobile

OAConnect

OACRM

OASFA

Schedule Labs

OA MobileOA Mobile

What is it: Integrated route planning, scheduling, dispatch and specimen tracking system

Value: improved efficiency in logistics combined with specimen integrity process. When paired with OAConnect and OA CRM, laboratories can reconcile ordered tests to specimens received.

OA ConnectOA Connect

What is it: A set of integration tools and web products to provide flexible connectivity for diagnostic orders and results in a patient centric fashion

Value: flexible branded products and integration suite that includes EMPI support and robust EMR interfaces, greatly improves outreach program effectiveness and competitive positioning

OA has established a comprehensive library of OA has established a comprehensive library of electronic interfaces with advanced architecture and electronic interfaces with advanced architecture and

integration resourcesintegration resources

Billing Edits

Connectivity workflow and process with EMRs

1. Client orders in EMR

JavaCAPS Interface Engine

2. Order goes to JavaCAPS

LMRPs

EMPI

MCDB

UMCT3. JavaCAPS validates

order using web services

Exceptions

4. Exceptions are returned to the EMR, if applicable

5. Test codes and message structure are denormalized6.Orders go to LIS systems in native format

PAML or Testing Partner LIS

Order for CBC

7. Testing is performed and results enteredResults for

CBC

8.Results go to JavaCAPS

9.JavaCAPS translates and normalizes results

10.Normalized results go to client EMR

OA CRMOA CRM

What is it: Customized laboratory CRM with end to end workflow and business analytics tools that document client activities and patterns

Value: intimate client relationships and business intelligence that assists management with the appropriate monitoring and analysis of operational trends and client issues

OACRMCRM Case StudyOACRMCRM Case Study

OA Sales Force Automation “SFA”OA Sales Force Automation “SFA”

What is it: Sales and marketing system to target and obtain customer accounts and build outreach market share within a given region

Value: incremental revenues over a highly fixed cost structure drives improved financial performance; Sales Force Automation provides management tools, forecasting and sales campaign utility

Schedule LabsSchedule Labs

What is it: automated platform to create, change and communicate your lab department schedules

Value: reduced workload, saves time, optimized scheduling and credentialing and competency feature ensures appropriate resources are available for scheduling

OAOAConnectConnect

The information eco-system

1. CRM SFA• Targets prospects• Documents sales process• Administers & approves

pricing

in an EMR, web

Product,

or Sunque

stLab

Specimen detail

3. The client places an order

2. A new client is set up

4. OAConnect• Normalizes codes• Matches ID• Applies business

rules for clean orders

6. OA Mobile• Receives order detail• Courier tracks &

reconciles• Aggregates data• Provides accessioning

dashboard for specimen volume by route completion

10.Reports route back to the client

5. PAML or Partner LIS • Specimens tracked &

racked• Reports generated

7. Automation line• Orders to/results

from instruments• 80% of volume• Testing &

reporting

Exceptions

8. OACRM• Contains all

customer service cases & activities

• Drives customer contact

Client report

11.Periodic publication to data warehouse • Data marts• Business

intelligence• Analytics &

dashboards

Data

Data

Data

Data

Data

Exceptions

Da

ta

Data

Billing Billing SystemSystem

LISLIS

OAOAMobileMobile

OAOACRMCRM

Order for CBC

Results for CBC

Claim

s D

ataEDI

ERA

$

$ $

Payor

EO

B

ERA

ADRADR

SharepointSharepoint

9. LIS sends claims data to Billing

OA Business IntelligenceOA Business Intelligence

Ensure that all appropriate clinical and member elements are correlated for each result (CPT, ICD9, NPI, Payer ID, Member ID, Age, Sex, Result)

Consolidate provider data to mine utilization trends and benchmark payers (NPI, specialty, procedures, payer distribution, abnormal/normal result ratio, avg. age of patients, ICD9 frequency)

Ensure that key elements from external systems populate data in discrete data marts (Billing, Supplies, logistics, CRM, EMPI/PMPI) for full picture of all touch points throughout our Enterprise

The result – rich information on all of our customer behaviors, patterns, profitability and relationships to better target services and proactively provide an optimum set of

lab services that are relevant to them

PAML, like other laboratories in the United States is also pursuing strategies to further link the patient to their Laboratory Joint Ventures and help their physician

customers manage health in partnership with the patient

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HealthVault: Software + Services Platform

SOFTWARE SERVICES

HealthVault Connection Center is a utility that allows users to add data from health and fitness devices such as heart rate monitors, blood pressure monitors, peak flow meters, glucometers, and pedometers.

Microsoft HealthVault is an online personal health database with a set of XML interfaces that allows third parties to create valuable health, wellness, and fitness services for HealthVault users.

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Devices

Partner Applications

HealthVault Platform Architecture

18

Application CompaniesSigned and Live as of 07/22/08

19

Device CompaniesSigned as of 07/22/08

20

Consumers As The Aggregators

21

Health Information

labs, images, procedure notes

scheduling, contact information,medication history

manage my health

22

Health Information

labs, images, procedure notes

scheduling, contact information,medication history

manage my health

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Health Information

labs, images, procedure notes

scheduling, contact information,medication history

manage my health

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The IDN ModelTools that are personal

Data that is actionable

Top consumer preferred tools:• Lab results online

• Talk to my doctor via e-mail

• After-visit summary (handed out at the end of each visit, but also available online in case you lose it)

Kaiser Learnings:• At KP they are signing up new portal users at the rate of 80K / month – by eoy they

will have 3MM users, or 47% of their base. They are 25% overdeveloped from an adoption standpoint amongst younger users.

• KP did a survey recently and found that their ratings on trust, usefulness, and privacy were really high – and their conclusion is that because it’s your personal information, as a user you find it relevant and powerful.

Summary take away pointsSummary take away points

Technology is driving business growth, efficiency, insight and further brand recognition with patients and providers

Outreach support tools to ensure specimen integrity, seamless data exchange and integrated reporting

CRM and SFA are driving better customer relationships and targeted marketing of services and diagnostic campaigns

Business intelligence tools are providing managers and customers with comprehensive views of business process, operations and diagnostic trends

Patient engagement strategies are an important way to build brand and empower consumers to manage their health