Dominant N.M. lab seeks active role in population health

The largest clinical laboratory in New Mexico is looking to play a larger role in population health management by introducing physician and patient portals to provide community-based longitudinal records that tie together lab data from across health systems.

The strategy, by TriCore Reference Laboratories, Albuquerque, N.M., meshes with the company’s newly launched TriCore Research Institute (TRI), which will mine data to provide real-time analytics to the healthcare providers it serves in New Mexico. “New testing developed by TRI will allow many patients to remain in New Mexico for more specialized care, an option not available in prior years. TRI will focus on assay development and collaborate with local, national, and international biotech companies to create new frontiers in the practice of clinical and diagnostic laboratory medicine,” TriCore explained in a press release.

TriCore will launch its physician portal in the next month or two, then the patient portal will follow a few weeks later. “It’s going to create patient engagement,” President and CEO Khosrow Shotorbani said in an interview with Clinical Innovation + Technology.

Shotorbani believes TriCore is the first in the nation to launch a community-based portal for longitudinal care that works across health systems. “We have to empower patients to know what’s going on with their healthcare,” he said.

The company claims to provide clinical testing and lab services for nearly 70 percent of the state. Shotorbani said TriCore has at least 60 percent of lab data in the New Mexico. That state is in somewhat of a unique position because elsewhere, major lab companies Quest Diagnostics and Laboratory Corp. of America compete with hospitals, whereas TriCore provides the hospital lab services, according to Shotorbani.

TriCore’s portals will be powered by Wave Analytics, the cloud-based analytics platform from customer-relationship management giant Salesforce. “With Wave, TriCore aims to better assist physicians to order the right test, for the right patient, at the right time to achieve three fundamental goals: improve medical outcomes, improve quality of care and help reduce unnecessary procedural and therapeutic costs,” according to the press release.

This is a pilot for Wave technology, testing real-time aggregation of data for “more proactive” population health management, according to Shotorbani.

TriCore has about 18 years’ worth of records on a large number of patients in New Mexico. “You really have to have a longitudinal view of a majority of your patients,” Shotorbani said.

“We are migrating toward population health management,” Shotorbani said. “With it, you can target high-risk populations.”

According to Shotorbani, patients fail to follow up on as many as 60 percent of ambulatory orders, he said. “We want to close the gaps,” he said.

About half of newly diagnosed hepatitis-C patients are unaware they have the disease, the TriCore CEO said. Physicians are overwhelmed, so they often put off follow-up until “escalation” of a disease occurs.

Laboratory services account for less than 3 percent of overall healthcare spending, yet factor into about two-thirds of clinical decisions, Shotorbani said. “It’s a cheap bargain.”

Knowing this, labs can and should play a more active role in communication of results and coordination of care. “The era of throwing the data over the wall and seeing what sticks is over,” Shotorbani said.

He told the story of stopping a physician from working up treatment for the wrong disease. “There was a potential misdiagnosis because the doctor didn’t have all the data,” Shotorbani said.

Before the physician started the patient on an arduous treatment regimen for leukemia, TriCore’s records showed that the patient had visited an urgent care clinic, where he tested positive for clostridium difficile, and the doctor was able to treat the proper condition.

“This is where the puck will be in 3 to 5 years,” Shotorbani said.