Population health management strategies for optimal lab workflow and healthcare quality

The COVID-19 pandemic demonstrated the urgency of population health management and how this concept is critical in ensuring patients' needs are promptly and efficiently met. During the height of the pandemic, the necessity for lab directors and managers to play a vital role in population health management became glaringly evident. With the vast amounts of sample collection and analysis, lab leaders were tasked with adapting to the changing and growing needs of the population. 

Clinical laboratories continue to play a critical part in medical research, doing more than just the analysis and reporting of samples, they are helping the entire healthcare industry understand the health of entire populations. It is apparent that the role of the lab in population health is evolving. Therefore, lab leaders must focus on maintaining quality assurance, optimizing staff support, standardization and automation of processes and procedures, and utilizing data analytics, thereby becoming a central part of population health management.

Population health management is a concept for addressing and delivering healthcare to improve individuals' well-being and health needs within a defined population. By identifying groups of individuals with similar traits, like illnesses or socioeconomic backgrounds, population health management responds with interventions tailored to people with those traits. These interventions can include specified clinical or community-based care, like social services. Applying an approach tailored to every member of a population improves the entire population's health.

In 2019 the National Committee for Quality Assurance (NCQA) developed a Population Health Management Conceptual model which points to critical components for improving patient outcomes. This model includes stratification, measurement, care delivery system, health plans/payers, community, population identification, and data integration.¹

An essential part of this model is the role of the lab, in which lab operators support population health management by setting gold standards.

Incorporating quality assurance in healthcare

Quality assurance in healthcare involves identifying problems, incorporating resources and behaviors to improve those problems, then examining the subsequent results to integrate new activities as needed.²

Within population health management, quality assurance helps ensure that each person experiences tailored services and resources and close monitoring of these activities for any changes. Quality assurance measures as defined by NCQA include:³

• Structure - medical staff and policies
• Process - evidence-based guidelines
• Outcome - effect on patient’s health
• Patient experience - the quality of care

Agencies like the World Health Organization (WHO) are also advocating for building laboratory quality management and assurance systems for potential outbreaks and international emergencies, offering essential, functional training and tools.⁴
 

How lab leaders can improve clinical laboratory workflow efficiency

A typical clinical lab workflow involves the ordering of tests, collection of samples and labeling, storage, and transportation of the sample to the lab, sample testing, a post-examination report, and interpretation of results. Each point in the workflow is time sensitive and critical for healthcare providers to ensure the best possible outcome for the patient. Therefore, lab managers should identify bottlenecks within their labs, including allocating laboratory staff, resources, and equipment, which will help improve overall clinical laboratory workflow.

One area to focus on is the allocation of laboratory staff. In the U.S., there were a reported 329,200 clinical laboratory technologists and technicians in the workforce, which is approximately one lab professional for every 1,000 people, indicating a significant shortage.^5,6 This lack of medical lab scientists was especially evident during COVID-19.

While the lab technician profession is predicted to grow 7% from 2021 to 2031,6 lab managers should know how best to support their staff to guarantee the retention of personnel and attraction of new hires. In a study published in the American Journal of Clinical Pathology to understand the satisfaction, well-being, job stress, and burnout rate among laboratory professionals, the report showed high job satisfaction and also high stress and burnout. The main issues include work-life balance, workload, and understaffing.⁷

Lab directors can incorporate several steps into the workplace for personnel retention, including focusing on career development, offering competitive compensation, and adopting an engaging work environment.⁸ As the needs of the population continue to grow, lab operators need to focus on supporting their staff's needs. 
 

Standardizing and automating workflow efficiency and quality control

In the U.S. alone, lab technicians perform over 7 billion clinical lab tests yearly.⁹ Additionally, NHS England reports 500 million biochemistry and 130 million hematology tests are conducted yearly, 300,000 tests are performed every working day, and 50 million reports are sent from labs to physicians annually.^10,11 Additionally, the global clinical laboratory tests market size, estimated at USD 103.7 billion in 2022, will expand by almost 10% in the next decade.¹² To help account for the continued growth and need for lab tests, standardization and automation of procedures will be critical in supporting population health management. 

Disparate and siloed systems prevent the tailored approach in population health management. Standardizing laboratory procedures can help improve the entire healthcare system. Minimizing variability among methods, equipment, reagents, resources, and analytical tools can ensure that labs operate efficiently within a network, from emergency rooms to physician’s offices to medical centers. This standardization can reduce costs and errors, leading to more reliable and consistent clinical results. Ultimately, a standardized workflow can allow physicians to make data-driven decisions for patients, ensuring they receive the best and most personalized care possible.

In addition to lab standardization, automation makes sure that lab specimens are processed efficiently, and patients receive accurate results on time. Many labs are incorporating total lab automation, encompassing the entire workflow, from sample processing to slide placement to imaging and reporting. Automation can increase efficiency, productivity, and safety cost-effectively.¹³ Minimal hands-on time from lab personnel can reduce errors while enabling worker safety and improving the usage of their time for other tasks. 

Standardizing lab practices and adding automated operations are two areas of laboratory quality control that can lead to better lab workflow optimization. 
 

Incorporating data analytics into the laboratory information systems

While lab operators are responsible for running a facility effectively, daily tasks can be time-consuming due to manual processes. As technological advances continue to grow, machine learning and artificial intelligence will become more commonplace in the industry, increasing worker safety and efficiency, and guaranteeing clinical mistakes are minimal. These capabilities can transform the speed of diagnoses and treatment for patients.

Utilization of data analytics can help in maintaining day-to-day routines, improving workflow and sample turn-around-time, predicting workload and staffing, and enhancing value-based reimbursement, thereby leading to better overall performance and productivity.¹⁴

According to the American Association for Clinical Chemistry, data analytics include:¹⁵

• Using real-world data
• Visualization
• Statistical and exploratory analysis
• Machine learning
• Communicating results

Together, these components can help the lab manager identify helpful information and recommendations for improving lab systems in the future. 

Beyond sample collection, analysis, and data reports, labs can play an expanded role in population health management by offering predictive analyses for an entire population. In a paper published by Shotorbani and colleagues, labs can accomplish this by engaging consumers for information, delivering timely and accurate results, providing short- and long-term patient-centric solutions and actionable insights, and implementing new strategies and policies through partnerships.¹⁶

With COVID-19, healthcare stakeholders witnessed the need for more efficient, accurate, and timely population health management as well as the necessity for more predictive modeling. The pandemic identified new opportunities such that health systems are better prepared for other public health crises and developing new approaches tailored to the betterment of entire populations. Because each population differs in clinical traits or socioeconomic status, stakeholders must incorporate the most efficient and cost-effective tools to treat each individual.

As part of population health management, laboratories need to optimize lab workflow and healthcare quality because their participation helps health organizations successfully integrate new and predictive strategies in disease control and meet the daily needs of patients within specified population groups.