A Conversation With LIS System Administrator Kristie Becerra

Learning to share is an important part of growing up. It’s a concept that teaches the values of compromise, fairness, and cooperation. In this context, sharing is universally accepted as a good thing because it strengthens social ties and a person’s well-being. 

So sharing, in general, is good and should be encouraged, but what about sharing mission-critical laboratory information system software with another healthcare organization? 

As one might expect, this type of arrangement comes fraught with issues, especially when sharing access and control. 

That was the case for Pathology Consultants, a multiple subspecialty independent pathology practice that has served western Oregon’s medical community since opening in 1932. Before November 2021, the group with nine pathologists had been providing diagnostic pathology services to patients and providers in the region while sharing a laboratory information system with a group affiliated with the same health system.

What follows is a recent discussion with LIS System Administrator Kristie Becerra. Here she describes what lab life was like before partnering with LigoLab, an LIS company specializing in software development of modern medical laboratory solutions for independent clinical laboratories and pathology groups. 

During our conversation, Becerra, whose career with Pathology Consultants spans 20-plus years, shares in detail how implementing LigoLab’s pathology lab management system has turned a challenging situation for the pathology practice into an opportunity to venture out independently, gain the desired control of the business, and improve both lab workflow and productivity. 

What key factors prompted a move away from a shared LIS System and toward the LigoLab platform?

We were intrigued with the idea because we were sharing a laboratory information system with another pathology group affiliated with PeaceHealth, which was hosting a lot of the backend of the LIS system, including our servers and our IT group. We were challenged with this arrangement, primarily because of a lack of full authority and LIS control.

Eventually, we learned that PeaceHealth was planning to replace the LIS system with another one. At that point, we either had to go along with them or off on our own. That’s when the final decision was made to venture out independently. 

Why LigoLab - why was it the right laboratory information system for your group?

We chose LigoLab because we wanted the ability to do everything we wanted to in one flexible laboratory information system. 

The old LIS system was solely an anatomic pathology LIS, but even with that limitation, we were still running some clinical tests. We saw bringing in more clinical tests as a growth opportunity and needed a laboratory information system that could support that desired growth.

What was the implementation experience like for you and other staffers?

There was a bit of a divide at first, as you would expect with such a significant operational change. Some of us thought it was very exciting, and others were more resistant. 

I liked the fact that we were adding advanced pathology lab software technology, providing us with a chance to learn something new and to improve processes and quality. 

We're in a much better place now than we were before the implementation of LigoLab. Our staff has learned to vocalize any issues that come up because we now are capable of fixing them. In addition to having a new LIS system, we’ve also learned how to communicate better with each other. 

What are some examples of business growth since going live with LigoLab’s informatics platform in 2021?

We brought in three different PCR tests with a whole new platform and reporting style, and we were able to custom-develop that with the help of LigoLab’s support team. 

The tests support our anatomic pathology department. As an example, when we diagnose cancer, sometimes there's additional testing that needs to be done to determine the course of treatment.

Before LigoLab, we were sending out these tests, but we monitored the volume and determined that it was more financially feasible for us to bring these tests in-house. By doing so, we also get quicker turnaround time facilitating treatment decisions and we’re able to better utilize the tiny pieces of tumors used for all the different tests that need to be run. 

We work with a large oncology group (Willamette Valley Cancer Center) that serves the whole state of Oregon. They get a lot of patients that travel from far away to come to their group. 

They're a big part of our business, and we want to fully support them and that line of business, and those are two additional reasons for bringing on more clinical testing. 

How else has your business improved since partnering with LigoLab?

We do a large volume of dermatopathology and before LigoLab, our two dermatopathologists who take turns covering that service were putting in long days. 

When we switched to LigoLab, those two were pretty ripe for any kind of efficiency improvements.  The switch to LigoLab allowed a significant improvement in dermatopathology efficiency.

We utilized the ability of the LigoLab platform to connect the micro diagnosis to the final diagnosis and automatically attach the CPT and ICD 10 codes. We also created a ton of templates for them. There was a little bit of a learning curve, but as we got them going, they started to see the value in it.

They were the first of our pathologists who felt the benefit of the new LIS system, and they openly say they would not be able to get through our volume of derms without this system. They now finish their work at a decent time, working regular hours even when a day’s volume is higher than normal. 

On the coding side, before LigoLab we were looking at every single case and every test that we ran. We were looking at documentation for the results. We were looking at codes, and manually applying them for every single case. 

Now we’ve significantly streamlined the audit review process for coding. Instead of touching every single case, we're able to go over and just audit some areas to make sure the coding is populated and matches the diagnosis.

We've also utilized the flexible reporting options in LigoLab that allow us to offer clients very customized reports. We’re now able to pull information out of the LIS system and create dynamic reports that we can distribute to them. 

This has significantly helped our Health Information Management (HIM) department because, before LigoLab, they were doing all the searching for those reports manually. Now it’s just a couple of clicks and the LigoLab platform generates the reports for them. 

Can you share more details about the templates created to assist the pathologists?

Derm path can be very repetitive work. For example, basal cell carcinoma, our dermatopathologists might see 60 or more of these cases daily. The pattern on the slide is very similar, so the description and the diagnosis are the same and only the margin sizes change. 

We've created templates so the pathologists have the verbiage they want in there, allowing them to quickly click through those areas and then fill in the information that's specific to that biopsy. 

They put in a final diagnosis, and then we have the microscopic attached to that, meaning every time they populate the final diagnosis, their microscopic description automatically populates for them, too. If they need to change anything, they just pop into that section and edit.

This workflow makes things a lot quicker than if they were to review the slide, dictate out the microscopic diagnosis, and then spell check to make sure the voice recognition software correctly entered the speech diagnosis. 

All of those little enhancements have added up to some significant time savings for them.

Early on, the LigoLab support team assisted me with the creation of these templates, but I feel like I’m proficient now and both I and members of our HIM team can create them without assistance. 

Note: Before her current role as LIS System Administrator, Becerra served as the lab’s HIM Manager. 

How else does your pathology group use the LigoLab platform to improve lab efficiency?

We also utilize LigoLab’s synoptic reporting feature for other anatomic pathology cases. That’s worked out very well for similar reasons because a template is used to remove repetitive steps and speed up the process. The feature also helps us hone in on the specimens that qualify for MIPS reporting, allowing us to maximize revenue for those cases. 

Now that we’re reaping the rewards with our dermpaths, our next focus is going to be on GI (gastrointestinal). It’s another high-volume area for us that we’d like to improve with templates because we’ve truly seen the benefit of them. 

Our eventual goal is to standardize diagnostic reporting as much as we can because this has advantages for clients, pulling data becomes much easier, and it makes meeting compliance and quality standards less challenging.

What’s the biggest difference between the LigoLab platform and the previous LIS system that you were using?

For me, it’s the opportunity to customize and have the product work for us. LigoLab makes that happen. 

Has LigoLab’s support team been helpful and can it quickly assist whenever needed?

Anytime I've communicated that I have an urgent issue, they've responded appropriately. 

Going from implementation with daily contact to a handoff to the support team was a bit of a transition for us, but LigoLab was very accommodating during the transition period. The support team responded and met our needs.

Now I'm perfectly comfortable with submitting a support ticket. I get a response usually right away, saying at the very least that they’ve received the ticket and will be working on the issue. I've been pretty satisfied with the support.

How long did it take for you to become fully aware of Ligolab’s laboratory information system functions?

 I still come across things every once in a while that surprise me in a good way. I often refer to the Confluence manual that accompanies the LIS software. I find that very helpful. 

Note: The Confluence manual mentioned by Becerra is embedded within the LigoLab platform, offering users easy-to-access workflow guides, reference manuals, frequently asked questions, and more. 

Do you have any final thoughts that you’d like to add about LigoLab and how it’s helped to enhance your business?

We’ve seen increased volumes and we’ve grown our test menu, and that's always good for business. We're very happy with the product. We've had a few little things here and there but I don't think there's anything else on the market that would satisfy us to the extent that the LigoLab platform has.

Pathology Consultants: Nine Decades of Providing Clinical and Anatomic Pathology Services to Western Oregon

Pathology Consultants is a thriving pathology practice based out of Springfield, Oregon. For 90-plus years the group has provided evidence-based diagnostic pathology services to patients and providers in the region 

PC’s pathologists have expertise in multiple subspecialty areas of pathology and routinely partner with oncologists, surgeons, and radiologists to deliver up-to-date multidisciplinary cancer care to patients from all over Oregon.

LigoLab’s All-in-One LIS & RCM Laboratory Informatics Platform

LigoLab Informatics Platform is an all-in-one laboratory information system and laboratory revenue cycle management solution designed to help pathology groups and clinical labs digitally transform into modern and efficient organizations that are more productive and more profitable. 

The enterprise-grade software platform features modules for anatomic pathology, clinical pathology, and molecular diagnostics workflow, plus laboratory billing and direct-to-consumer lab testing functionality, all embedded within an integrated database and software infrastructure that eliminates data silos and efficiently manages all departments and operations with maximum interoperability. 

The LigoLab platform also features powerful rule and automation engines that enable users to build custom rules that automate complex processes and improve turnaround times.