Cracking the Lab Utilization Nut

AACC Annual Meeting & Clinical Lab Expo 2014 - July 28-Aug 1 - Chicago

In This Issue...

Lab Utilization in the Wake of the Affordable Care Act

Dr. Michael Laposata, a highly regarded educator, will speak on July 29
learning technologies

In the brave new world of the Affordable Care Act—also known as Obamacare—and broad pressures on cost containment and efficient care, labs find themselves under the gun to deliver more value to the healthcare system. That value can come in different ways: making the best use of lab tests; integrating lab tests into care systems, protocols and algorithms; and demonstrating how lab tests contribute to better outcomes and more efficient care. Several Annual Meeting & Clinical Lab Expo sessions will arm participants with knowledge and tools to accomplish these value-related goals.

In a morning Symposium on July 31 from 9:30 a.m. to 12:00 p.m. Laboratory Test Utilization: Leading the Charge Towards Lab Stewardship (351103), a trio of seasoned lab leaders will discuss how labs themselves hold the cards for achieving better utilization of lab tests. Whether it be by curbing inefficient ordering patterns, implementing test ordering algorithms, or providing electronic health record system-based decision support, Drs. Jonathan Hoyne of the Mayo Clinic in Rochester, Minnesota, Robert Benirschke of the Peoria (Illinois) Tazewell Pathology Group, and Kevin Foley of Kaiser Permanente will discuss strategies laboratorians can employ to see lab resources used more productively and efficiently.

In an afternoon Short Course on July 30 from 2:30 p.m. to 5:00 p.m. (74217) three Mayo Clinic laboratorians, Drs. Melissa Snyder, Paul Kurtin, and Bobbi Pritt, will look at how lab-driven testing algorithms can improve test ordering practices and decrease healthcare costs. Through case examples involving bone marrow examinations, celiac disease, and evaluation for parasitic infections, the speakers will demonstrate how lab-driven testing algorithms can break through the inertia associated with effecting change via traditional measures such as educating providers or creating testing panels.

The Affordable Care Act also encouraged development of Accountable Care Organizations (ACOs), networks of doctors and hospitals that share financial and medical responsibility for providing coordinated care to patients with the goal of limiting unnecessary spending. By one estimate, 428 ACOs—involving both Medicare and private payers—now exist, covering 14% of the United States population. Hospitals participating in ACOs typically form clinical teams to streamline care processes, prevent medical errors, and see that patients receive the right care at the right time and conversely, do not undergo unnecessary procedures.

In an afternoon Symposium on July 30 from 2:30 p.m. to 5:00 p.m. (34212), a trio of respected lab experts—Drs. James Faix of Stanford University in Palo Alto, California, Michael Laposata of Vanderbilt University in Nashville, Tennessee, and Eugenio Zabaleta of MedCentral Health System in Mansfield, Ohio—will share their experiences with ACOs and look at how real-time review of lab test orders improves diagnostic accuracy and reduces costs. These speakers also will describe how lab information systems (LIS) have been brought to bear to achieve ACO utilization objectives.

Annual Meeting & Clinical Lab Expo attendees will have another opportunity to look at how LIS and other information technologies (IT) are being used to achieve financial and clinical goals of the lab. In an afternoon Short Course on July 28 from 2:30 p.m. to 5:00 p.m. (72226), Drs. James Harrison of the University of Virginia School of Medicine in Charlottesville, Jorge Sepulveda of Columbia University and New York-Presbyterian Hospital in New York City, and Timothy Skelton of the Lahey Hospital and Medical Center in Burlington, Massachusetts, will pull the curtain back on some of the IT solutions they've implemented to improve lab operations and management.

A Perfect Storm of Analytics: Aberrant Results, Errors and Autoverification

Autoverification: A very effective strategy to eliminate lab errors
meet the expert

The AACC Annual Meeting & Clinical Lab Expo always features plenty of programming around lab analytical issues, and this gathering is no exception. In a morning Short Course on July 30 from 10:30 a.m. to 12:00 p.m., Reducing Patient Risk from Aberrant Results—Proactive Strategies for the Laboratory (74108), Drs. Julia Drees of Kaiser Permanente in California and Daniel Holmes of St Paul's Hospital in Vancouver, British Columbia, will look at the tricky issue of aberrant lab results. Through an extended case study involving falsely undetectable thyroid stimulating hormone levels in a cohort of euthyroid patients, Drs. Drees and Holmes will explain how this problem was detected and measures taken to keep it from recurring. The data mining that this involved will be contrasted with an approach more fitting for a smaller organization, daily review of individual patient results.

Case studies also will feature prominently in an afternoon Short Course on July 29 from 2:30 p.m. to 5:00 p.m., Troubleshooting Clinical Laboratory Errors: A Collaborative Case Study (73222) developed in cooperation with AACC's Management Sciences and Patient Safety Division. Drs. Sol Greene of BD Diagnostics–Preanalytical Systems, Jack Zakowski of Beckman Coulter, and Geoffrey Baird of the University of Washington in Seattle, will examine in detail strategies for troubleshooting clinical laboratory errors. Through a series of case studies, they will explore how blood collection device manufacturers, instrument vendors, and laboratorians all share responsibilities for ensuring accurate laboratory results. These speakers also will discuss three sources of lab errors: preanalytical variability and analytical errors and interferences.

Autoverification as a strategy to eliminate lab errors will be the focus of an afternoon Short Course on July 29 from 2:30 p.m. to 5:00 p.m. (73220). Dr. Sihe Wang of the Cleveland Clinic, joined by Mark Shearer of CompuNet Clinical Laboratories in Moraine, Ohio and Frank Polito of Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, will take a close look at how autoverification helps labs regardless of their size. For example, very automated labs with high throughput need quick validation and release of test results on their automation lines. On the other hand, smaller labs might use autoverification as an important first step to reduce human errors in result reporting. The speakers will review exactly what autoverification involves and how lab staff can be organized to support an autoverification program.

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