Contributing lab leaders: Jason Bhan
Article
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
Article highlights:
- Laboratorians are experts at applying data for a spectrum of clinical purposes
- You may be surprised at the multitude of applications for your data—beyond clinical
- Hear from data expert Jason Bhan, M.D., on how you can leverage lab data in unexpected ways to advance your business
Sign up today to receive a free gift as well as our latest insights and more in your inbox!
Lab data provide unique value vs. other health care data
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:
| Lab data | Claims data | EMR/EHR data | |
|---|---|---|---|
| Clinical depth | Tests administered with comprehensive clinical results | Only tests administered, not clinical detail | Clinical data are often incomplete (gaps range from 35%-65%) |
| Reliability | High degree of quality control from source labs | Dependent on provider scrutiny; frequent coding errors | Dependent on physician effort and connectivity to data |
| Responsiveness | Rapid, near real-time results | Weeks to months in lag time, depending on claims processing | Rapid, near real-time results |
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
Less obvious applications for lab data
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.
Secondary use cases
- Identify major health care problems the lab can help solve
- Determine access to new markets
Access to medical workflow
- Determine if the lab can play a role as a distribution channel for data-enabled services in the medical workflow
ACO-specific
- Report quality measures back to government
- Help resolve risk adjustment (accounting for patient complexities/comorbidities)
Having access to the data in a meaningful, usable format helps dictate which charts you should be pulling for your risk-adjustment scores.
Jason Bhan, MD
Chief Medical Officer
Prognos
Results
- Identify lab coverage
- Validate whether lab data are sufficient or need to be integrated
You can apply clinical data alongside socioeconomic data, claims data and other transactional stuff to come up with real models as to how we should be reimbursing for particular patients.
Jason Bhan, MD
Chief Medical Officer
Prognos
Outreach
- Target patients who could potentially benefit from further care
If you have a patient who’s diabetic and the lab data are showing other comorbidities, that can be an outreach opportunity for you to work with his or her provider.
Jason Bhan, MD
Chief Medical Officer
Prognos
Profitability analysis
- Resolve average reimbursement rates in a given test category
Economic analysis
- Demonstrate downstream costs/savings from assay utilization
Market share analysis
- Determine lab volume vs potential volume for a test category within a geographic area
Market sizing
- Forecast assay launches
Volume leakage
- Identify missed opportunities within a health system’s affiliated practices
Pharma-specific
- Inform profiling, market sizing and field force planning
- Determine sales force effectiveness and multichannel marketing
- Shape call planning and messaging
3 essential steps before putting your data to work
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
If you look across multiple labs, you can build fairly complete pictures of patients, like, which patients need a proactive disease management program. This has tremendous value for population health, reporting or all those other things you’re beholden to from CMS.
Jason Bhan, MD
Chief Medical Officer
Prognos
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
You need to harmonize your data so you can put it together at a scale that allows you to actually engage and do something with it..
Jason Bhan, MD
Chief Medical Officer
Prognos
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
More data-driven insights. More lab-delivered power.
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.”
Want to be the first to receive the latest insights from industry leaders? Sign up for our newsletter.
Contributing lab leaders
Jason Bhan, MD
Chief Medical Officer, Prognos
...