Realizing the true value of your data: how to increase revenue without increasing test volume

It’s no secret that your lab data are invaluable to your institution, especially if you’re part of an ACO. You have likely used these data for a host of clinical applications, including identifying high-risk patients, tracking quality of care, targeting data management investments, developing treatment algorithms and advancing proactive care.

But are you aware of the many ways your data can be leveraged beyond clinical applications?

Here’s your essential guide on how you can put your data to work, from our data expert, Jason Bhan, M.D.

Labs are great at performing tests and analytics and understanding what’s in the data. But there’s also significant information in there that you can use to improve your business.

Jason Bhan, MD
Chief Medical Officer
Prognos

It’s well understood that lab data—derived from 2%-3% of the health care spend—influence 70%-80% of physician decisions. That’s because they provide a distinct level of depth and timeliness.¹

See for yourself in this comparison:

You can do all kinds of mental gymnastics with claims and Rx data to try to figure out which patients are in control or out of control, or at risk or not at risk. Or you can just look at the lab values.

Jason Bhan, MD
Chief Medical Officer
Prognos

You don’t need to increase your volume to increase your value—or your revenue. Be inspired by these practical applications and see which ones you can put into practice.

• Identify major health care problems the lab can help solve
• Determine access to new markets

• Determine if the lab can play a role as a distribution channel for data-enabled services in the medical workflow

• Report quality measures back to government
• Help resolve risk adjustment (accounting for patient complexities/comorbidities)

Results
 

• Identify lab coverage
• Validate whether lab data are sufficient or need to be integrated

Outreach
 

• Target patients who could potentially benefit from further care

• Resolve average reimbursement rates in a given test category

• Demonstrate downstream costs/savings from assay utilization

• Determine lab volume vs potential volume for a test category within a geographic area

• Forecast assay launches

• Identify missed opportunities within a health system’s affiliated practices
  

• Inform profiling, market sizing and field force planning
• Determine sales force effectiveness and multichannel marketing
• Shape call planning and messaging

1. Aggregate your data

 
Required steps

• Lab connectivity: Accept lab data directly from any laboratory information system (LIS) or in any other delivery format
• Member match: Identify plan-specific members
• Data extraction: Perform a daily call to member labs to pick up results that were logged in the preceding 24 hours

2. Standardize your data

 
Required steps

• Refinement: Format data fields appropriately, confirm fields have valid data and redistribute data in single records to individual results
• Non-numeric terminology alignment: Ensure the same term is used for a particular lab test output across different labs
• Units of measure conversion: Ensure same units are used for the lab test output across different labs

3.  Enrich your data

 
Required steps: non-clinical

• Logical Observation Identifiers Names and Codes (LOINC®) mapping: Missing LOINC codes must be populated by unsupervised machine learning models based on laboratory test menus and LOINC organization reference data
• Practice enrichment: Reference datasets must be used to populate practices missing a name, address or type
• Provider enrichment: Reference datasets must be used to populate provider information missing a National Provider Identifier (NPI), name or specialty

Clearly, your traditional data create untraditional opportunities to support accountable care. Dr. Bhan concludes, “Getting your lab data to the provider is great, but also getting it to the ACO, the payer and anyone else for business purposes—that’s how the lab can create higher-level value.”