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This is a presentation I created for Dr. Vivek Khare to present at a national pathology conference.
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Outcome of Retreat in 2003
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
National Lab Status in 2003
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
Status in 2003
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
North East LA ( NELA)
North West LA (NWLA)
Mid LA
INPATIENT STRATEGY
Inpatient Strategy
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
CLIA Incidents in Rural Louisiana
Laboratory failed to follow their submitted Plan of Correction
Hospital faces loss of CLIA certificate and revocation of hospital certificate
Referral of proficiency testing to an outside laboratory
Between lab collaboration on proficiency testing
Components of Compliance Program
Laboratory audits
Communication of findings with facility administration
Issuance of deficiencies and tracking corrections
Oversight of equipment installation and validation process
On-site education of laboratory staff
Compliance workshops for lab leadership
Communication of issues through compliance alerts to laboratories
Maintaining professional relationships with state and regional laboratory officials
Consultation during compliance crisis events and response preparation
Maintain compliance for Delta Medical Directors’ labs
Provide value-added services when competing for hospital and physician office business
Compliance
OUTREACH STRATEGY
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
Outreach Strategy
DELTA DERMATOPATHOLOGYStatewide Dermatopathology Service And Marketing Strategy
2012
MARKETING POINTS
Louisiana based service
Infrastructure
Couriers
Client service personnel
Reporting Options
Hard copyFaxEMR InterfaceWeb portal
Molecular Diagnostics (MDx)
Requisition Branding
Report Footer
Enhanced Service
Opportunity for sub specialization
Opportunity for internal consultation
Cross coverage (sign out, teaching)
Specialized and standardized reportingWork toward standardized diagnostic terminologyTemplates for malignanciesSubspeciality footer on reports
Direct Immunoflourescence (Delta SHV)
Molecular Testing (Delta MDx)
Marketing Strategy
Direct Marketing to SpecialistsMarketing TeamSub Specialists
Co-marketing with clinical lab
Brochure/poster/booth at Clinical Meetings
Website
Collaborate teaching of Specialty Residents
Emphasize LA base to LA connected Specialists
Outreach Marketing
Expansion of specialty related MDx menu:BRAF for melanoma (already in place)Melanoma FISH panel (validation underway)T-cell receptor gene rearrangementOther
Expansion of Louisiana client base
HUBS
BILLING
TRANSPORT
EMRs-HOSPITAL-PHYSICIAN
REFERENCELABS
PHYSICIANOFFICES
PRIVATE
FAX PUBLIC
WebPortal
INTERNET
VPN WEBACCESS
Information Technology
CareEvolve client interfaces: 206
Interfaces via EMR: 61
EMR Interfaces include:
CernerARUPWebConnectCareEvolveDelta ClientACSMeditechAmazing Charts
Meditech MagicMeditech HCAHBOC StarCPSIHMSDHSNextGen
AthenaNewTechGreenwaydigiChartSevocityeClinicalWorksGE Centricity
27 PRN courier vehicles run daily
1,367,256 miles/year traveled
Logistics
The Delta Pathology Group, LLCOwnershipPathologists (100%)
ManagementPathology Resource Network, LLC
Business Models
Omega Diagnostics, LLCOwnershipPathologists (100%)
ManagementPathology Resource Network, LLC
Business RelationshipsOwns and operates AP and MDX TC infrastructurePurchases AP TC infrastructure from hospitalsEmploys all laboratory personnelExpends capital on behalf of laboratory operationsProvides IP/OP/Outreach AP and MDX TestingClose to 50 IP/OP facilities under contract for AP services
Business RelationshipsOwns and operates CP TC infrastructurePurchases CP TC infrastructure from hospitalsEmploys all laboratory personnelExpends capital on behalf of laboratory operationsProvides IP/OP/Outreach CP Testing7 IP/OP facilities outsourced their CP labs to OD15 rural facilities use OD as their reference laboratory
Facilites: 47
Cytology: 61,732
Histology: 158,544
Employees: 150
MDX: 10,300
Flow Cytometry: 62,672
Clinical Pathology: 850,000
2012 Annualized Projections
Delta Pathology
Billable Tests: 1,429,484
Employees: 189
Special Attributes: Automation
Foundation:
Social AccountabilitySupport of MT Profession and Education
2012 Annualized Projections
Omega Diagnostics
WEST 1
WEST 2
KNIGHT-BILLING
EAST
WEST
SFM
GRETNA
WJ
LOURDES
WCHCROWLEY
RAPIDES
CABRINI
ALEXANDRIA
LAFAYETTE
NEW ORLEANS
MONROESHREVEPORT
DeltaClient
DocQVoice
WEST 3
KNIGHT
CenturyLink MPLS
Region
Site RTR
North East LA ( NELA)
North West LA (NWLA)
Mid LA
Acadiana (LFY)
SELA/NOLA
FUTURE DIRECTIONS
MARKET ANALYSIS 2012
Meaningful use project mandates EMR by 2014Clinicians desire one interface with one laboratory for “one stop shop” menu of services (AP/CP/Mol/Genetics)
REGIONAL AND NATIONAL MARKET FORCES
DHH mandating Medicaid patients to enroll in CCN’s CCN’s seeking “one stop shop” menu of testing (AP/CP/Mol/Genetics)Single billing source for data mining in order to monitor quality and efficiency of care provided
Risk based contractingSubstantial quality reporting Data management services
Economy of healthcare reform outcomesReduced fee schedulesConsolidation of laboratory platforms to drive efficiencies
CLINICAL INTEGRATION NETWORKS
Allows physician in separate practices toCollectively negotiate with payors and employers.
Anti-Trust risk if not done properly.
Three part legal analysis:
Is clinical integration program real?
Initiatives actively undertaken and monitored by network involves all physicians in network Applies to physician practice patterns in fee for service
Are initiatives designed to achieve likely
Improvements in quality and efficiency?
Is joint contracting necessary to achieve
The efficiencies of the program?
CLINICAL INTEGRATION NETWORKS
Benefits to physicians:
Access to coordination infrastructure
Access to technology
Data accessible across full continuum of
care
Enhances community impact
Potential for better reimbursement
Core Components:
Comprehensive improvement
initiatives
Performance improvement architecture
Selective physician partnerships
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
National Lab Status in 2012
Hospital Inpatient
Hospital Outpatient
RuralHospital
PhysicianOffice
Referral Work
Anatomic Pathology
Cytopathology
Clinical Pathology
MolecularPathology
GeneticPathology
InfrastructureManagement
LogisticsConsultation
LABORATORY SERVICES
SER
VIC
ES
& A
CC
ESS
P
OIN
TS
Status in 2012
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