ROI equals return on investment. In one of its simplest forms, it is the duration of time it takes for the labor/operating savings to outpace your monetary investment. As the author of this HIMSS blog post notes, in Healthcare that may be short sighted. We can't always measure in dollars. We have to measure in positive outcomes that impact patient care.
http://blog.himss.org/2012/09/21/roi-in-health-it-is-more-than-just-the-pricetag/
So how do we justify the cost of solutions like Software Testing Solutions in an environment when everyone is thinking about the bottom line? How do we get management to think outside of budget and consider impact on patient care, project deadlines, and overall operational improvement?
As I prepare budget proposals for our current and future clients, I often struggle to balance the needs of operating and maintaining the LIS with the limitations of the enterprise budget. There are so many projects with parallel or synchronized deadlines. There are everyday maintenance times to complete. And there is a lack of skilled LIS staff to complete the every growing list of tasks.
We here at STS understand those problems. After 13+ years working with LIS teams and hospitals, we have seen almost every kind of project and submitted almost every justification for automated testing tools. Some have been more successful than others, but one that seems to work well is to make an outline of projects with projected man hours to complete, deadline dates, and possible project impact.
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Project
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Labor Effort
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Deadline
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Impact
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Health Information Exchange Integration
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80 Hours
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12 Weeks
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Failure to meet timeline will result in delay of delivering patient lab data to portal. Could impact MU filing.
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Lab Application Upgrade
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1200 Hours
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6 Months
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Failure to meet deadline will delay HIS upgrade project completion.
Failure to meet deadline will delay HIS upgrade
FDA inspection likely - regulatory impact
Hardware maintenance increasing. OS and DB upgrade needed.
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EMR Interface Implementation
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100 Hours
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10 Weeks
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Failure to deliver will delay ambulatory rollout to physicians.
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Instrument Implementation – Blood Gas
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80 Hours
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12 Weeks
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Leasing contract expiration imminent. Reagent costs will increase significantly.
Improved results to physicians.
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The goal of this matrix is to give management a context for your submission. We can explain what the tool does. We can talk about dollars and ROI, but until they see the impact on the enterprise, they may not understand that providing tools for your team has a direct impact on many other teams and projects.
Good luck budgeting! Give us a call at 877-765-0100 if you need any assistance.
http://labsoftnews.typepad.com/lab_soft_news/2013/03/api-and-and-ascp-sign-mou-.html
API will bring ASCP members more knowledge in informatics. Education is at the forefront of this alliance. API will hold its fall Annual Meeting in conjunction with the 2013 ASCP Annual Meeting, Sept. 18–21, in Chicago. Participants from both organizations can select 19 hours of education in informatics delivered by API faculty experts.
I was reviewing some of my old emails and came across this post from earlier in the month. I remember reading it the first time and thinking it was a good idea, but upon further reflection it’s actually an amazing idea. With the average age of medical technologists increasing, the number of medtech programs shrinking, and the complexity of LIS management exploding, there has never been a better time to merge these two programs.
As a system manager, I struggled with filling positions. Many Lab Directors and System Managers are also struggling to replace exiting staff. Finding someone with the necessary computer skills who also has knowledge of lab process and operations is incredibly difficult. The skills needed to manage the laboratory have changed so much in the last 10 years. It’s a big step forward for our education and certification options to reflect that.
Last year I had my first opportunity to attend APIII. I was extremely impressed with the information sharing and thought leadership. I remember thinking that every LIS manager should be attending the conference and sharing best practices regardless of which clinical applications they used. It presented an opportunity to discuss change, prepare for it, and educate the next generation of LIS administrators. For the ASCP to now include the opportunity for this effort to count toward ASCP hours and to offer a corresponding certification bodes well for the future of our industry.
In addition, API will present its regular “Pathology Informatics” conference (PI-2014) on May 13–16 in Pittsburgh.
The ASCP offers Qualification in Laboratory Informatics (QLI). The API will be taking full advantage of the various ASCP communication channels to reach out to this key group of lab professionals and encourage their attendance at PI-2014.
LIS management is only going to increase in complexity, but with the right course laid out you can conquer it all. Take advantage of this conference. It’s worth the investment. And while you are there, swing by the STS booth and learn how we are partnering with these same thought leaders to revolutionize clinical application testing.
Richard Atkin of Sunquest had some very interesting things to say concerning LIS software becoming a medical device.
“I’m a strong believer that [LIS applications] are medical devices. I really don’t understand the position that others seem to take that they’re not medical devices, and therefore they should not be subject to things like FDA review. I take a contrary view to most of my colleagues on that.”
Read the full HISTalk interview here.
As we continue the discussion of “enterprise” vs. “best of breed” LIS, this change in thought process could have a dramatic effect on the LIS marketplace. If Atkin is correct and all aspects of the LIS become medical devices, then the 510k like effort for Blood Bank vendors could extend to all LIS vendors and applications. Would all aspects of the lab become “specialty” science removing the entire the “enterprise” discussion? And the vendors who don’t or can’t accommodate the effort required for a 510k type validation, would they be summarily pushed out of the market?
The next big question is what impact this would have on the labs themselves. Is this is a good thing for the lab? How would this impact the level of testing and documentation each lab is required to complete? Are we really getting better quality or does this just reduce our choices? I’d love to hear what you think.
STS had the chance to attend APIII this month in Chicago. STS had been there before, but it was my first opportunity to attend. Weather was beautiful, and the brain power was amazing.
http://www.pathinformatics.pitt.edu/
http://www.pathinformatics.pitt.edu/2012schedule/fullschedule
APIII is definitely a gathering of LIS “Thought Leadership”. People from all over the world were discussing the future of Pathology Informatics. The discussions ranged from imaging in reports, advances in diagnostic process, and even cutting edge tools/software to improve workflow.
Over and over, we heard discussions about Lab merging with the EMR, both the good and the bad. Several discussions centered on what systems or configurations will deliver the “total LIS functionality” in the future. It seemed to me the consensus was that “LIS” won’t be about one system doing everything. Thought leadership sees it as a spectrum of systems working together.
Ironically, GenLab and Microbiology functions may leave the typical LIS applications to become part of the general EMR, but Blood Bank and Anatomic Path will most likely fall under the “specialty” category and will require standalone systems. Seems to me that we will always have separate systems, but a game of Red Rover is happening with some of our functionality. The EMR/CPOE has called GenLab and Micro over. Will be interesting to see if/how they make it to the other side.
Regardless of where GenLab and Micro may live, the need for functional and volume testing will be more demanding than ever. EHRs, EMRs, interfaces, and data integration are here to stay. Add new acronyms like LOINC and HIE, and the picture only increases in complexity. Organizations like CAP, Joint Commission, AABB, and the FDA will be revising and tightening guidelines more than ever. Having tools to conquer both daily maintenance and upgrade validations will be vital to the success of the laboratory. And STS plans to be in the thick of it making testing better, faster and smarter.
Anyone who knows the laboratory knows that its complexity is a specialty science. We know our LIS functions and hire certified experts to support them. We stay connected to groups like APIII to plan for the future. More importantly, we actively engage LIS system managers and analysts about daily operations and make sure our products respond accordingly.
We here at STS will always be keeping our ear to the ground and listening to make sure we are prepared for the next wave of changes in the LIS. We plan to be an active partner with our clients as we conquer the ever-changing LIS landscape together, whatever it may look like.
Information Week: Healthcare recently posted an article about the 5 trends that will reshape healthcare in 2013. While most of these affect healthcare outside the Laboratory, the last two, EHR vendor shakeout and Clinical Analytics, will impact the Lab greatly.
I think we would be hard pressed to find a laboratory not processing inbound orders from several different ambulatory systems. For those of us involved in private Outreach, the number of EHRs has dramatically increased as has the electronic demands of the downstream users. Synchronizing compendiums, maintaining interfaces, and verifying outbound results take up a significant part of our days. And as some of these EHRs fall out of the marketplace and physician groups and health systems consolidate, complexity and testing needs will only pick up pace.
As for Clinical Analytics, one needs only mention DOH and LOINC in a room of LIS professionals to see the impact these initiatives are having on the laboratory enterprise. Add to that the number of HIE (health information exchange) initiatives across the country and LIS staff will have their hands full. It won’t be enough to properly link all the LOINC codes in your database, to be truly meaningful they will need to be transmitted downstream via HL7 interfaces.
Shrinking staff in the LIS field will combine with both these trends to create resource constraints within the Laboratory. Even if the budget was available, you can’t always hire the right skillset to tackle these problems. The need to test better, faster and smarter is going to become a necessity for every laboratory, and I believe are going to be the only way labs will be able to keep up with the ever-growing demands of their healthcare enterprise.
The rush of the healthcare industry to achieve "meaningful use" in an effort to increase patient safety may, in fact, be causing unnecessary errors through the implementation of unsafe and untested systems. In this article published by Healthcare IT News, Doug Duncan, MD of the Mayo Clinic states that "providers already have too much on their plate trying to provide patient care with the current financial strains, coding challenges, keeping up with government regulations, demand for information and the medical legal climate."
With the need to improve the quality and safety of patient care comes the necessity of thorough and exhaustive healthcare system testing. “There is no question that widespread use of untested, unproven EHRs and health technologies will potentially cause injuries and deaths and different kinds of medical and human errors," says patient privacy rights advocate Deborah Steel.
Read the full article here.
STS is happy to announce the upcoming release of STS Version 4! The newest version of the powerful STS solutions will be released in January 2012. The release introduces a totally re-designed front end to make your testing easier and more intuitive than ever before. A few of the new features include:
For Scenario: The ability to have up to 10 functions in each test case as well as the ability to identify Expected Failures. Now when you are doing negative testing or testing to ensure a warning message appears, the appearance of that warning signals success, and the test case goes to the Pass Report. If the warning is not displayed, the test case goes to the Review/Suspect Report.
For Blood Bank: Added support for Manufactured Products and the LINK function in Sunquest
For General Laboratory: Support for the LINK function and the ability to receive orders in from your HIS with just a patient’s medical record number.
To learn more, please contact us directly or connect with us via Twitter @stshealth.
A recent article in CAP TODAY states that "when it comes to protecting patients in the hospital, the presence or absence of a culture of safety can make a very tangible difference, one that can be measured in concrete units related to potential patient harm: error rates, length of stay, morbidity, and mortality."
Two members of the CAP Public Health Policy Committee, Michael B. Cohen, MD, and Emily E. Volk, MD, argue that pathologists should address patient safety as a whole, and consider that the role of clinical pathology in the overall patient experience affects safety more than many realize. In fact, "with about 70 percent of medical decisions being made on the basis of information from the laboratory, pathologists and other laboratory professionals are front and center in caring for patients." As a result of this, the responsibility of pathologists to be unyieldingly safe and accurate is "tremendous," says Dr. Volt, and pathologists are in a great position to advocate for investing in technology to help ensure patient safety.
To learn more about building a culture of patient safety in hospitals, and to read the original article, click here.
A recently published Institute of Medicine report commissioned by the Office of the National Coordinator for Health IT (ONC) recognizes the need and opportunity for building safer systems for health IT.
“It is important to recognize that health IT products generally cannot be installed out of the box. Users need to customize products judiciously to appropriately match their needs and capabilities – in both functionality and complexity of operation. The process of implementing software is critical to optimizing value and mitigating patient safety risks. A constant, ongoing commitment to safety – from acquisition to implementation and maintenance – is needed to achieve safer, more effective care. Testing at each of these stages is needed to ensure successful use of health IT.”
The report mentions the features of safer health IT, noting that a well tested, safely implemented health IT should “provide easy entry and retrieval of data, have simple and intuitive displays, and allow data to be easily transferred among health professionals.” This is often not the case, leaving problems like a poor user interface design, workflow issues, and complex data interfaces as significant patient safety issues.
Recommendations for improving technology development and design include standardized testing procedures and safety promotion funding from the ONC, as well as collaboration between the ONC, AHRQ, and health IT vendors to significantly reduce EHR-related patient risk. “Creating safer systems begins with user-centered design principles and continues with adequate testing and quality assessments conducted in actual and/or simulated clinical environments.”
For more information, and to read the original report, click here.
Dark Daily finds that medical laboratory accreditation and CLIA compliance are becoming increasingly more difficult. “One sign that laboratory accreditation and compliance is getting tougher is the increased number of hospital laboratories willing to publicly acknowledge that a recent assessment, survey, or inspection resulted in serious deficiencies.” Laboratory-Developed Tests – LDTs are a growing topic which has captured the attention of lab regulators and resulted in a lot of discussion, leading to a session at the Fifth Annual Lab Quality Confab titled: “The Dos and Don’ts of Validating a Laboratory-Developed Test to Meet Regulatory Requirements.”
For more information, and to read the original post, click here.
