How to help your customers successfully establish, and maintain, a CLIA moderate complexity laboratory.
By Jim Poggi
Investing time and energy in creating best-in-class customer solutions is a top-of-mind activity for the experienced distribution account manager. Nowhere is this truer than guiding customers to consider establishing a laboratory. While PAMA reimbursement cuts have impacted the economic benefits of a lab somewhat, the clinical value continues to be a powerful enhancement to even the best medical practices.
In this article, I plan to outline key steps in a sound consultative approach in establishing and maintaining a CLIA moderate complexity laboratory. Our customers are constantly on the look out for solutions that provide improved clinical outcomes, better office efficiency and financial benefits. A physician office lab provides all three while providing the tests needed to initiate or modify a patient treatment program during the office visit.
Setting the stage
This key first step involves comprehensive customer discussions that identify key needs and wants of the practice. Which clinical conditions do they see most frequently that would benefit from an in-office lab? Where do you draw the line between adding tests for improved patient care and adding cost and complexity to the lab? What is the staff viewpoint on lab testing? Are they ready or reluctant? Don’t forget site readiness for power, space and water needs. Your key lab supplier will perform a site survey to alert you and the practice to site requirements for a properly functioning lab. They can also help with assessing training and CLIA compliance issues to smooth the transition and provide sound management post installation. Finally, the best-in-class office labs consider LIS and EMR connectivity for staff and patients alike.
Getting the deal right
Expectations are everything at this stage. You need to consult and provide a realistic view of time and budget considerations related to needed equipment, staff training, regulatory and space considerations and down stream management time and effort. While a test menu that rivals that of the local hospital looks impressive on paper, it is likely to lead to inefficiency, reagent waste, staff frustration and potential issues with maintaining high quality results. The classic “crawl, walk, run” approach allows the fledgling POL to grow into its laboratory at a reasonable pace, with staff and management learning along the way. A good quarterback leans heavily on their key lab suppliers and is not afraid to advise the customer to take establishing a laboratory “one step at a time.” Needs for ancillary supplies like centrifuges and lab accessories are often neglected or poorly planned. Make sure your key lab supplier is prepared to address connectivity and result availability issues for LIS and EMR.
Customer satisfaction is an ongoing time investment
While it may be tempting to help the customer get the lab established and then “move on to the next opportunity” neglecting proper follow-up inevitably leads to customer frustration and headaches for all over time. The savvy distribution account manager plans time to assure their customer’s on-going satisfaction with periodic structured post installation visits. It is not enough to do “fly by” visits to the lab during your routine customer visit, asking if everything is ok and heading down the hall. Meetings dedicated to spending structured time with the clinical and lab teams are critical to a properly functioning lab and meeting customer expectations. Quarterly business reviews with agreed upon agendas make all the difference. Assign someone to keep notes on action items and follow up. Be sure to focus on both “what is working well” and “what needs to be addressed or improved.” Often new testing opportunities present themselves during these business reviews. While management of the customer experience takes time, it pays big dividends down the road.
Stumbling blocks that lead customers to consider closing their in-office lab includes staff frustration based on new and unfamiliar duties. Ongoing training with your key lab supplier in the lead and a commitment to management by the practice medical director are important elements to emphasize up front in the sales process and to keep in view after the laboratory is up and running. Assume there will be staff turnover and integrate it into your planning activities. Be sure to take the lead in making ordering reagents and ancillary supplies easy and convenient. Standing orders for frequently needed supplies and tracking practice spend and stocking levels are necessary tools. Be sure to proactively manage these elements to avoid customer remorse and dissatisfaction. Avoid being blind sided by customer issues that seem to crop up quickly if you do not actively pay attention to customer needs and feedback post sale.
Every piece of capital equipment comes with a substantial initial customer investment. The skilled distribution account manager works with their key lab suppliers to create credible and appealing financial proposals. But, where many could improve relates to product life cycle management. Have you informed the customer of the importance of system maintenance? Do they know the supplier schedule for routine maintenance they need to perform as well as preventative visits?
Service contracts keep expectations in line and avoid surprise repair bills down the road. Every multiple year lease needs to include a service contract. Make it a part of every proposal you create. At the same time, plan for system upgrades and replacement early in the lease term. Too often customers do not plan for end-of-lease term issues until they receive a notice from the leasing company that their lease is ending and they need to decide whether to keep the equipment, upgrade it or go month to month. The best practice of skilled account managers is to begin discussing end-of-term options well before the lease is due to end. Many account managers begin these discussions while there is still one year left on the lease. This allows the practice to plan for budget and site needs for new equipment and provides time to assure that the new equipment is up and running smoothly without disruption to the practice or patients.
A commitment to planning every step of the way from the initial recommendations to consider a lab through implementation of the exciting new solution, solving issues uncovered effectively as they occur and planning for life cycle management keeps your customers happy, avoids unpleasant surprises for all and leads to excellent, patient centric solutions.