Jim Poggi
By Jim Poggi
Wholly MACRA!
In my experience working with highly skilled and professional distributor account managers, LIS systems remain one of the product lines they shy away from. In this article I intend to de-mystify LIS, make sense of it in light of MACRA requirements and give you confidence to hold discussions about this key connectivity tool.
As the world continues to become more connected and interdependent, EMR and LIS are necessities for customers managing moderate complexity or high complexity labs. The distribution account manager who masters “the language of connectivity” will have a distinct advantage over those who hope the customer never asks … and who continue to ignore the changes all around them.
Risk vs. reward
Why does this seemingly harmless connectivity and reporting tool create such anxiety, and why do so many polished professionals do their best not to engage customers in conversation about it?
Often, it is a concern that the solution will not meet customer needs, and will frustrate the customer, putting the rest of the business at risk. From time to time, I hear “Yeah, I had a customer get a LIS from me about 5 years ago — or I know someone who did.” Fill in the blanks with a long and unsuccessful implementation, lack of features the customer expected, higher cost than hoped and jeopardy to the business.
Sound familiar? It only takes one difficult or unsuccessful customer experience with unfamiliar products to scare off even the most seasoned veteran. Why put your business and customer relationships at risk, right? And besides, there are plenty of direct LIS companies. Let them do the work and get the headaches. There is no on-going reagent trail to LIS anyway.
However, it doesn’t have to be that way. An LIS system provides key features and advantages for the physician office lab performing moderate complexity testing. For example:
- Test orders placed in the EMR can go directly to the LIS to create test orders seamlessly for the instruments the lab uses – that’s efficient.
- Quality control packages make it easy to review and understand performance of every test the lab performs – confidence in results.
- An LIS system captures all patient results, and sends them to EMR and patient records. This assures patient records are complete and enables billing for all tests performed.
- An LIS system provides a variety of management reports about which tests were performed, by whom for which patients and when. This allows efficient oversight of the lab and careful attention to patient test results. It simplifies lab administration.
- LIS implementation helps enable the physician practice to comply with two of the four MACRA performance categories: Improvement Activities and Advancing Care Information, which together comprise 40 percent of the needed MACRA performance metrics.
- It automates record keeping for the lab, leading to better preparation for an inspection. Good organization simplifies the inspection experience.
Successful implementation
So, if that’s all true, what does it take to develop a successful LIS solution, and how does the account manager avoid the pitfalls mentioned earlier?
Attention to the basics. It takes a comprehensive understanding of customer needs and requirements, selection of the right LIS solution, a well-detailed implementation plan agreed by the customer, LIS company and instrument manufacturers, and follow up during the implementation phase and post implementation.
Understanding of customer requirements
You need to know the following:
- Which lab instrument systems they want to interface
- What EMR(s) they use
- Whether they want bi-directional or unidirectional connectivity
- Are they replacing a current LIS, or is this a first LIS?
- If replacing a current LIS, why do they want to change?
- What do they THINK the benefits of the LIS will be? How realistic is their viewpoint?
Developing a solution
Share what you learned with your most trusted LIS supplier (or ask your lab specialist or other colleagues who they recommend). Set time with your LIS supplier to meet with the client to establish or confirm the detailed customer needs. Have your LIS supplier work with the instrument manufacturers and EMR company to assure needs are clearly understood, time frames and costs are established and each company has a lead person involved and an overall plan is established. Be present and participate actively.
Share the implementation plan and proposal with the customer; close for agreement on costs, timing, and customer responsibility for training and implementation.
Implementation
Make sure your LIS supplier takes the lead on implementation, because they are the experts. Hold a kickoff meeting with the implementation team and customer to begin the process. Hold milestone meetings on a fixed schedule with all involved. Uncover and immediately report and resolve implementation issues with the team involving the customer in the process. Make sure customer training is carefully planned and customers are fully engaged. Maintain active customer communication every step of the way until they sign off on final implementation.
Post implementation
Following implementation, hold a team meeting, without the customer, post customer sign off to assess how the implementation went and any learnings that could make the next implementation smoother. Meet with the customer 30 days or so post implementation with the LIS supplier (and key instrument manufacturers if needed) to review progress, assess any further training needs or customer questions regarding use of the system. Continue to hold progress report meetings at appropriate intervals.
A well thought out LIS system solution helps your customers in many ways and adds to your credibility as a key resource and consultant. LIS systems will have increasing importance as MACRA is implemented.
Things to remember
Remember, you are the quarterback; use the expertise of the entire team. Good customer expectations and diligence in uncovering needs are critical to a good result.
EMR connectivity (how long it takes to get the EMR to respond and help with their end) is always the rate limiting factor on implementation speed. The EMR company will change an interface fee; make sure the customer understands this in advance.
You can do this, and your customers need LIS and EMR connectivity to maximize their MACRA performance in Improvement Activities and Advancing Care Information.