By Louise Lazear
Advances in technology are often a double-edged proposition: along with the promise of new assays for disease detection and risk assessment comes the challenge of integrating new tests into the workflow of the clinical laboratory. Many new assays are simply too expensive or infrequently demanded to justify implementation at the local or even regional level. But physicians and patients expect access to this technology, and look to their clinical laboratorians for answers. The solution may lie in an innovative hospital-driven approach designed to improve access to a broad menu of esoteric tests and innovative technology, helping hospital laboratories to upgrade their service and enhance the quality of patient care.
Scene inside Quest Diagnostics laboratory facility
In September 2002, Quest Diagnostics launched a new initiative with a dedicated customer service team of over 130 professionals to singularly focus on the specific needs of the hospital laboratory market. With this new program, hospitals have a streamlined approach to esoteric testing, as well as access to new laboratory management and connectivity solutions and tools to assist in development of the hospital’s outreach market.
Building a network
Quest Diagnostics is well positioned to focus on hospitals with a nationwide presence that includes over 1,350 patient service centers, 100 rapid response and 30 full service regional laboratories located throughout the country. And with the recent acquisition of American Medical Laboratories (AML), esoteric testing is now provided at both the company’s Nichols Institute in California, and Nichols Institute Chantilly located outside of Washington, DC. Completed in April of this year, this $500 million transaction brought to the company an additional full-service laboratory in Nevada, 51 more patient service centers, and a dedicated hospital customer service capability.
“The whole concept came together with the acquisition of AML,” said Scott LaNeve, vice president of hospital marketing at Quest Diagnostics. “We spent a significant amount of time researching and defining the specific needs of hospitals, and we developed a plan to provide them with the best possible level of service. With the AML acquisition, we are able to complement Quest Diagnostics’ commitment and dedication to research and development with AML’s superior reputation in serving hospitals.”
According to LaNeve, Quest Diagnostics saw an opportunity to fill the gap that many hospitals face when new assays become available, but are not yet feasible for local implementation. With its enhanced service network, Quest is able to provide top-level service across the country. “Before our network was complete, hospitals and sometimes other reference laboratories had to send samples for esoteric testing to our Nichols Institute laboratory located on the west coast. For healthcare providers especially on the east coast, this logistical challenge sometimes resulted in longer turn-around times and problems with sample integrity. Some hospitals turned to local or regional laboratories, but quickly found that they didn’t provide the breadth of services or capabilities required,” he explained.
The demands of complex testing
Providing laboratory services for hospitals goes beyond logistical support and is significantly different from routine services to physician offices. “Perhaps the most significant difference in these two settings is the level of complexity,” explained LaNeve. “Physicians in hospitals often require a higher level of support with interpretation. Through our staff at the Nichols Institute, we not only provide pathologist to pathologist consultation, we also offer physician to attending consultation. Doctors are able to discuss not only test results, but also how to manage a patient based on those results. This is a key feature of our new service focus.”
According to LaNeve, streamlining access to esoteric testing will be the responsibility of service representatives specifically dedicated to hospitals. Along with the laboratory manager and send-out supervisors, these representatives conduct a careful analysis of the laboratory’s current workload. Based upon cost, time and sample integrity, a logistics strategy for routing tests to the appropriate laboratory is developed. When a hospital comes online, the routing procedure is transparent: the hospital directs all its samples to one location where the sort is processed by Quest.
To introduce its new services to the medical community, a secondary team of hospital account executives is available to organize and coordinate informational efforts, including presentations at grand rounds and continuing education seminars. Education is an important element to this new initiative, particularly with the complex genomic and esoteric testing that is becoming available. “When a hospital enters a relationship with our company,” said LaNeve, “they become plugged in to a network that helps them to maintain a cutting-edge focus on new technology, and to get the word out to their clinical and non-clinical providers.”
Creating connectivity and partnerships
Quest Diagnostics now offers enhanced connectivity solutions for both hospital and physician clients. Recently, the company integrated two products into its connectivity menu: Lab Portal, a solution that provides internet access for laboratory ordering and results reporting; and MedPlus’ ChartMax, a patient-centric electronic medical record that overlaps a facility’s HIS. “Our customizable solutions now range from autofax and teleprinter to integration of our results data with the hospital’s LIS and HIS, all the way up to web connectivity where one can review patient results online,” said LaNeve.
While providing esoteric testing services will be the initial focus, the company also realizes the importance of developing partnerships with hospitals at a number of different levels. Its new initiative will include consultative services to help hospital laboratories with process improvement, automation, and equipment selection and integration. Quest Diagnostics plans to develop a shared service approach with hospitals. For example, a hospital may be designated to perform STAT testing for Quest Diagnostics on a local or regional basis. Further, consultative services offered by Quest can help hospitals to develop their own laboratory outreach programs. Quest’s services to the hospital would include an analysis of the logistics involved in sample handling and support for coding and billing. This joint program would assist hospitals in providing new diagnostic tests to their community.
This fall, Quest Diagnostics will begin to launch these hospital-focused initiatives initially through group purchasing organizations (GPOs). At first, the company will focus on esoteric testing services, which will include assays for women’s health, endocrinology, oncology, cardiac, HCV and HIV phenotyping. “What’s unique about this initiative,” said LaNeve, ” is that we can help hospitals anywhere in the country, whether they are small, rural facilities, university teaching hospitals or large networks in metropolitan areas. We want to become partners with hospitals to help provide both access and interpretation for new laboratory methods, with the end goal of improving patient care.”
Louise Lazear is a freelance writer based in Charlotte, N.C.