Jul 29, 2009 | Laboratory News, Laboratory Pathology, News From Dark Daily
New care delivery model might emerge from collaboration between two partners
Guess which famous health provider is partnering with Microsoft (NASDAQ:MSFT) to encourage patients using home self-testing devices to regularly upload those data into an electronic medical record? It’s the Cleveland Clinic Health System. This project may point to a disruptive new model for laboratory testing.
It’s a pioneering arrangement. Microsoft’s HealthVault is interfaced with the eCleveland Clinic MyChart patient portal to create an interactive feature that collects data on from in-home medical devices used by patients with chronic conditions. The pilot project includes 460 patients with diabetes, congestive heart failure and hypertension. These patients use home blood pressure monitors, glucometers, and weight scales which are linked to the HealthVault platform personal health record (PHR) system.
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Jul 23, 2009 | Laboratory Management and Operations, Laboratory Pathology, Management & Operations
Across the country, many hospital laboratory outreach programs continue to grow and prosper, despite a sour economy and higher rates of unemployment. That’s true in Chicago’s northern suburb of Evanston, Illinois, where the laboratory outreach program of Evanston Hospital enjoys solid rates of growth in specimen volume and revenue.
This week, Dark Daily visited Evanston Hospital and spent time with Thomas A.Victor, M.D., Ph.D., Chair of the Department of Pathology and Laboratory Medicine, and his laboratory team. Evanston Hospital is the anchor facility for Northshore University Healthsystem, which includes Glenbrook Hospital, Highland Park Hospital, and Skokie Hospital. These four hospitals total 1,043 beds. Northshore is affiliated with the University of Chicago School of Medicine.
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Apr 13, 2009 | Laboratory News, Laboratory Pathology
Recent consensus sets stage for further progress with universal patient health records (PHRs)
Efforts to advance use of a universal electronic patient health record (PHR) got a boost recently. The creation of a Nationwide Health Information Network (NHIN) moved closer to reality with announcement of consensus among more than 100 stakeholders on guidelines for ensuring consumer-friendly features, operational efficiencies, privacy, and security.
Connecting for Health, a public-private collaboration of health sector organizations and technology innovators, developed a common framework for building a network of networks. The framework provides specific technology, practice and policy approaches for consumers to securely obtain copies of their personal health records (PHRs) from various provider sources that support an online PHR service. Once stored on services like GoogleHealth or Healthvault, PHRs can be instantly shared with trusted health providers.
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Apr 23, 2007 | Laboratory News, Laboratory Sales and Marketing
Earlier this month, news reports stated that Wal-Mart is forecasting that more than 6,600 in-store medical clinics will open in the next 5 years in Wal-Mart stores. Wal-Mart’s pilot program began with 75 clinics in Wal-Mart stores in 12 states. The company has declared the clinics a success and now plans for a speedy roll-out of additional clinics nationwide.
These clinics will have numerous implications for the medical community. First, according to Alicia Ledlie, senior director for Wal-Mart’s health business development, Wal-Mart is considering providing is in-store clinics with a common electronic medical records (EMR) system so patient care can be tracked from store to store. Dark Daily reported earlier this year in Corporations Take Electronic Health Records into their Own Hands that Wal-Mart is one of five large employers who created the Dossia Founders Group with the goal of providing digital health records (DHRs) for their 2.5 million workers, plus dependents. Assuming that Wal-Mart agrees on a unified electronic health record format for both its employees and the shoppers in its stores, there will soon be millions of people with the same type of electronic health record.
Second, through the pilot program, Wal-Mart has established that the “if you build it, they will come” principle works when it comes to walk-in medical clinics in Wal-Mart stores. By establishing 6,000 in-store clinics across the United States, Wal-Mart could conceivably have a major influence in shifting how people access healthcare services in this country. The convenience of obtaining routine laboratory tests at in-store clinics may prove quite attractive to many Wal-Mart patrons. CLIA-waived tests that produce instant results could make lab testing become like getting your oil changed at the Wal-Mart lube while you shop for your groceries.
Remember: the key to this is providing consumers with a service that they value. In this case, it is getting medical services quickly and at a fair price. It is likely that some smart laboratories will adjust to this age of convenience by accepting this trend and getting whatever piece of the lab testing pie that they can. In fact, for laboratories serving small towns—where Wal-Mart thrives—this may help them to pick up additional specimen volume, since time to result will be a competitive benefit that Wal-Mart wants from any laboratory provider that it uses to supplement on-site testing.
Finally, it should be noted that these changes are a few years down the road. Currently, walk-in medical clinics that operate from retail stores are using a nurse practitioner and only offer medical services for common ailments that can be diagnosed in a few minutes and are treatable with an over-the-counter remedy or a routine prescription. However, once Wal-Mart has 6,000 of these clinics in operation, it will definitely begin expanding the menu of medical services it offers with its in-store, walk-in clinics.
Related Articles:
Wal-Mart sees medical clinic boom in retail stores
Corporations Take Electronic Health Records into their Own Hands
Mar 9, 2007 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Pathology
Physicians continue to migrate toward larger group practice settings. Consolidation of physician group practices continues, although the pathology specialty seems to be resisting this trend. The American Medical Association reported in 2005 that about 40% of physician groups had 3 or 4 physicians, but those groups employed only about 11% of all group-practice positions. Conversely, only 1.4% of these groups had 100 or more doctors, but they represented almost 32% of the 247,000 physicians in group practices. By contrast, the predominant group practice model in pathology tends to be four physicians or less.
This gradual migration of physicians away from one to three doctor groups and into larger group practice settings has long term implications for both clinical laboratories and community hospital-based pathology groups. Larger physician groups refer greater volumes of specimens and this larger volume can help a laboratory justify adding customized services that add value to the referring clinicians.
For anatomic pathologists, in particular, consolidation of physician groups into regional super-groups comes with an interesting downside. Urology and gastroenterology groups, particularly those with eight or more physicians, generally have enough specimen volume to profitably internalize their biopsy referrals. That is why many of these groups are establishing in-house anatomic pathology laboratories. Because urology and GI group mergers were extensive during past decade, supergroups in these specialties control a proportionally larger volume of anatomic pathology case referrals. Thus, when they build their own laboratory, the loss of business to pathology labs can be significant.
Dark Daily observes that anatomic pathology groups are now seeing some unpleasant consequences from the lack of group practice consolidation in pathology during the 1990s. Even as their physician colleagues in the local community were merging and creating larger groups – primarily to gain leverage in managed care contracting – hospital-based pathology groups resisted this trend. After all, they often had patient access through their hospital’s managed care contracts.
During the 1990s, just a small number of regional pathology “super-practices” emerged. Examples of these groups, with more than 20 pathologists, are Bayless Pathmark Pathology in Cleveland, Ohio; ProPath in Dallas, Texas; UniPath in Denver, Colorado; and Pathology, Inc in Torrance, California. However, these pathology groups report greater success compared to their smaller peers. Their size allows them to finance sales programs to increase specimen volume and revenues, as well as to set up and offer new molecular pathology tests. With more resources, these pathology supergroups have tended to weather the healthcare storms with more stability.
Experts tend to believe that consolidation among physician groups will continue. There are many economic forces which make such mergers attractive. Not the least is the ability to spread the cost of EMR (electronic medical record) and practice management software systems across more doctors. The clinical laboratory industry has already undergone extensive consolidation. That is one reason why there are many competitive hospital laboratory outreach programs in the market today. Multi-hospital health system laboratories have more resources with which to develop an outreach program.
The question mark is what will happen to the private pathology group practice based in community hospitals. For the past 12 years, “bigger is better” has been a major strategy by all classes of providers and most medical specialties. How long will the profession of anatomic pathology resist the same market forces that motivated other physician specialties to merge and consolidate as a strategy to protect income and access to patients?
