Within the distributed healthcare delivery model, laboratories hold a unique position in terms of domain expertise, data, and potential influence on patient outcomes. But to better leverage these strengths, they must develop their data analytic capabilities and pair these new skills with the technology and tools needed to act upon the insights gained.
Recently, XiFin Chief Commercial Officer Harley Ross spoke at G2 Lab Institute’s virtual conference on Dealing with a Difficult Economy. During his session, “Adapting to the New Normal: Navigating the Intersection of Healthcare and Economics in a Distributed Healthcare Delivery Model,” he presented a framework that addresses how:
- The latest changes in demand and delivery models create opportunities for labs.
- Extended uses of data can strengthen laboratory financial health.
- Regulatory mandates and reimbursement compression have unexpected consequences for laboratories.
- Strategic partnerships and specialization between laboratory, specialized diagnostics, and pharmacy can benefit laboratories.
One key current trend is the ongoing move toward individualized medicine with healthcare data owned by the consumer. Consumer-driven healthcare relies on convenience, cost, care quality, access, and equity. The pandemic accelerated access to telehealth services, and consumers now expect to have other services available closer to home, providing opportunities for pharmacy and other community-based healthcare services. Certain patient treatments are shifting away from the physician’s office to the pharmacy setting because it is more convenient and less expensive. This trend is being supported by regulatory moves that enable pharmacists to perform more clinical services and directly order, perform, and get reimbursed for testing.
Another trend impacting diagnostics is one toward more personalized medicine and the rapid growth of novel therapies, both of which rely on diagnostic data. There is a growing prevalence of specialty-focused diagnostic providers that offer both imaging and laboratory testing for specialties such as oncology, cardiology, ObGyn, and urology. Understanding the real-world impact of diagnostics on patient treatment decisions is broadly considered critical for advancing personalized medicine initiatives.
“The ability to combine forces to better engage patients and providers drives improved therapy adherence, which benefits patient care and pharmacy and laboratory revenue.” – Harley Ross, Chief Commercial Officer, XiFin, Inc.
These trends create the need for better data exchange and collaboration between laboratories, specialty providers, and pharmacies to power diagnosis, monitoring, and therapy adherence, which in turn creates demand for combined patient/provider engagement tools.
The diagnostics-to-therapy pathway starts with a test result. Clinical labs can assist doctors in managing patient populations by:
- Identifying care gaps
- Supporting early diagnosis
- Tracking patients at risk for acute events
- Flagging patients who are at risk for chronic conditions such as diabetes, kidney disease, and cardiovascular disease
Collaboration between the physician, laboratory, and pharmacy helps ensure better treatment utilization, coverage, and patient/provider experience. One XiFin customer in the substance use disorder space found that having a medically integrated program, including laboratory and pharmacy, increased medication adherence by 52% and reduced emergency department visits by 43%. Integration of services clearly demonstrated a positive impact on cost and the quality of care.
Underpinning these shifts toward individualized and specialized medicine are four key pillars:
1. Consumer-driven. Market leaders are embracing consumer-driven healthcare focused on convenience, expectation, and a digital experience
2. Access and cost-focused. Telehealth, retail pharmacies, and community-based healthcare services provide easier access to care and a better cost model
3. Addresses gaps in care. Distributed healthcare delivery models demand interoperability, strategic partnerships, and the continued expansion of healthcare provider status to pharmacists to close gaps in care
4. Embraces technology advancements. Tech investments and specialized services must support multi-diagnostic disease specialization while enabling appropriate data sharing based on patient preference and control
Laboratories and diagnostic leaders play an important role in this new consumer-driven healthcare environment. Fluid exchange of data and information is critical. Sharing data and allowing the consumer to control whom they share their data with is what is needed for success in today’s marketplace.
Access and cost are primary factors for patients. Telehealth, retail pharmacies, and community-based healthcare services are now the front doors for patient access. Quality is still paramount, and data is the currency that makes the system flow effectively. Laboratories and other diagnostic providers must build new skills in data analytics to fully capitalize on the opportunities presented by these market dynamics.
Moving into value-based care pricing and value-based cost structures with payors, for example, requires a new level of data analytic expertise. Here at XiFin, we are excited about this new landscape and view it as an opportunity for our customers. View the full webinar to learn more about how we are helping our customers and the industry embrace these new opportunities.
Recording courtesy of G2 Intelligence.
Click here to find the complete listing and recordings of G2 Intelligence’s virtual event.