title: Exploring New Ways to Deliver Value to Healthcare Organizations: Algorithmic Testing, Data Integration, and Diagnostic E-consult Service.
abstract: As the USA Health Care System undergoes transformation and transitions to value-based models it is critical for laboratory medicine/clinical pathology physicians to explore opportunities and find new ways to deliver value, become an integral part of the healthcare team. This is also essential for ensuring financial health and stability of the profession when the payment paradigm changes from fee-for-service to fee-for-performance. About 5 years ago we started searching for ways to achieve this goal. Among other approaches, the search included addressing the laboratory work-ups for specialists' referrals in the HarrisHealth System, a major safety net health care organization serving mostly indigent and underserved population of Harris County, TX. We present here our experience in improving the efficiency of laboratory testing for the referral process and in building a prototype of a diagnostic e-consult service using rheumatologic diseases as a starting point. The service incorporates algorithmic testing, integration of clinical, laboratory and imaging data, issuing structured comprehensive consultation reports, incorporating all the relevant information, and maintaining personal contacts and an e-line of communications with the primary providers and referral center personnel. Ongoing survey of providers affords testimony of service value in terms of facilitating their work and increasing productivity. Analysis of the cost effectiveness and of other value indicators is currently underway. We also discuss our pioneering experience in building pathology residents and fellows training in integrated diagnostic consulting service.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA semyon.a.risin@uth.tmc.edu.
authors.forename: Semyon A
authors.initials: SA
authors.lastname: Risin
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Brian N
authors.initials: BN
authors.lastname: Chang
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Welsh
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Kidd
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Moreno
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Tholpady
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Amer
authors.initials: A
authors.lastname: Wahed
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Nghia
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Marylee
authors.initials: M
authors.lastname: Kott
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas - Houston Medical School, Houston, TX, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Hunter
mesh_terms: D000465:Algorithms; D003695:Delivery of Health Care / Q000458:organization & administration*; D006282:Health Personnel; D006801:Humans; D012017:Referral and Consultation; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D017216:Telemedicine