Case Study
Summit Pathology - Achieving Laboratory Profitability Amidst Operational Pressures
December 19, 2024
Clinical labs and pathology groups are facing challenging times. They are under pressure to deliver accurate and speedy diagnostic services even as testing demand has never been higher. Getting full payment for services rendered is harder than ever, the pool of qualified labor has never been smaller, and the cost of labor and supplies continues to rise.
Given all these threats, the odds are stacked against medical labs incapable of adapting to the new realities on the ground and unwilling to embrace new laboratory information system (LIS system) technology that increases productivity and cuts costs.
Key Challenge: Implementing Best Practices and Advanced LIS System Automation to Achieve Profitability
Lab operations must evolve to navigate these complex dynamics and achieve sustainable profitability. Implementing best practices and advanced LIS system automation into lab workflow is a crucial first step. This approach minimizes errors, enhances turnaround times, and significantly reduces dependency on manual labor.
Beyond automation, leveraging lab information system data analytics to gain insights into performance can drive further improvements. By optimizing clinical lab workflow and making data-driven decisions, labs can enhance operational efficiency and lay the foundation for a profitable growth strategy.
Strategic Solution: How Summit Pathology Uses Advanced LIS System Software Technology
Summit Pathology is an independent pathology laboratory with 23 board-certified pathologists who have served hospital systems and physician offices in Colorado, Wyoming, and Nebraska for over 35 years.
The pathology laboratory based in Loveland, Colorado, provides outstanding general surgical pathology plus high-level expertise in additional areas such as breast pathology, cytopathology, hematopathology (including flow cytometry), gastrointestinal pathology, dermatopathology, transfusion medicine, microbiology, and clinical chemistry.
Summit Pathology is CAP (College of American Pathology) accredited and CLIA (Clinical Laboratory Improvement Amendments) registered. It is known for offering world-class expertise, state-of-the-art disease detection, and exceptional customer service.
The forward-thinking pathology group is also widely known for utilizing the latest LIS lab technology to support continued growth and profitability despite the present obstacles facing the laboratory industry.
Here’s a detailed look at how Summit Pathology has leveraged its LIS system, rules, advanced automation, and data analytics to increase efficiency and cut costs.
The Benefits of LigoLab’s Workflow Action Queues and Automation
The Summit Pathology - LigoLab partnership dates back to 2009, with much of that period marked by steady practice growth and agility when needed to adjust to the new realities of an ever-changing lab industry.
“We've had a lot of changes over time to our lab workflows and adapted to them,” said Corey Handlesman, Summit Pathology’s Director of IT. “The flexibility of the LIS system has been a crucial part of accommodating these changes, whether they were changes that were needed for compliance or just to grow successfully.”
In particular, Handlesman credited LigoLab’s real-time workflow action queues and advanced lab workflow automation for replacing checklists, streamlining laboratory revenue cycle management (lab RCM), cutting operational costs, and creating a custom MIPS reporting solution.
Workflow Action Queues - Explained
For those unfamiliar with LigoLab’s workflow action queues and how they work, think of them as helpful and configurable task managers that enhance a lab’s flexibility and help mitigate errors.
Any workflow action a LigoLab user creates requires resolution or follow-up by other designated users or teams downstream. Importantly (and unlike legacy monolithic laboratory information systems) these actions do not halt the specimen’s progress through the lab workflow; allowing it to continue through processing stages like grossing and histology while the flagged issue remains visible in the workflow action queue.
Learn More: Comparing LigoLab Informatics Platform with Legacy Laboratory Information System Software
Therefore, if a field from the patient demographic is missing information, the case can still be processed, and the pathologist can still issue the diagnosis. However, the report will be held until the demographic workflow action issue is resolved. Once corrected, the report can be released and distributed with the updated information. This approach allows continuous lab operations without compromising data accuracy and quality control.
“We rely heavily on building and testing out workflow action queues that allow us to funnel every case where it needs to be and to make sure every action that has to happen does happen before the case is released,” said Handlesman. “This is crucial for quality control, especially when we have new employees or bring on new pathologists before they're credentialed.”
Handlesman also noted Summit Pathology has a workflow queue for lab billing payers who require overreads, making it possible for all submitted claims to go out the door in a reasonable time frame, even those with overread requirements.
Based on these examples, it's easy to see why replacing checklists with workflow action queues created efficiency directly resulting in faster turnaround times.
In-House Laboratory Billing Coder Collaboration
Handelsman also credited the workflow action queues and LIS system automation for Summit’s laboratory billing process, enabling the lab’s in-house coder to collaborate directly with its external lab billing service and save on full-time equivalent (FTE) employment while addressing issues and common rejections.
“This is where we can communicate with the lab’s medical coders to confirm everything is coded appropriately. We have a system in place so no test goes to our lab billing company before it receives diagnosis coding,” he said.
In summary, major highlights of Summit’s lab RCM strategy include improved communication and transparency plus a more streamlined lab billing department.
MIPS Reporting Automation
Summit Pathology has also leveraged the latest LIS system technology to customize its Merit-based Incentive Payment System (MIPS) reporting, turning what was a weeks-long tedious project into one accomplished in a single annual meeting.
Here’s an overview of how it works:
The lab information system simplifies the MIPS reporting process by automating workflow actions based on database logic that recognizes MIPS requirements. The LIS system software works with two main workflow action queues: one for first-time case releases and another for re-releases, addendums, or send-out tests. Coders review cases, add diagnosis codes, and check for specific code combinations to ensure MIPS requirements are met. If certain codes are present, the LIS system automation guides the case through predefined nodes, restricting the entry of non-approved MIPS codes.
Handlesman credited this advanced automation with replacing a manual process, streamlining MIPS reporting to the Centers for Medicare & Medicaid Services (CMS) and CAP, and greatly improving efficiency and accuracy. It’s a “set it and forget it” automated LIS system solution that requires only occasional updates when new codes or combinations arise. Overall it has significantly reduced manual work, maximized CMS reimbursements, and enabled Summit Pathology to achieve top MIPS reporting scores.
“We rely on this functionality day in and day out for multiple processes. We really couldn't function without it,” continued Handlesman.
The Importance of LIS System Flexibility and Customized Reporting
The importance of using lab data continues to grow, and Summit Pathology deserves credit for being an early adopter and realizing the direct correlation between data analytics and enhanced decision-making, operational efficiency, and quality control.
“We're a data-heavy lab and rely on metrics for decision-making that help us determine how we manage compliance reporting, lab revenue cycle management, and grow the business,” said Handlesman.
The Summit IT department regularly utilizes metrics and data from LigoLab’s LIS system database, which allows it to pull quick reports on test results, stats, and other key information. For some cases when the data needs to be broken down further, Handlesman said the department creates customizable dynamic reports featuring calculated fields that generate specific insights, such as efficiency metrics or quality control reports.
He also mentioned Summit Pathology's utilization of data analytics to generate adenoma detection rate reports for GI clients as a standout lab data use case.
“By combining data from the LigoLab platform with additional data provided by our clients, we can accurately calculate and report these rates, aiding clients in their CMS reporting and reimbursements,” he said.
Additionally, Summit Pathology uses statistics and dynamic reports to streamline client lab billing by leveraging LigoLab’s data capabilities and custom scripting.
Here’s a brief overview of that process.
The path lab manages all client lab billing in-house and uses data from the LigoLab platform to track every case released during their RCM cycle. Custom scripts compare new releases with previously billed cases, identifying new CPT codes and preventing duplicate charges. This approach allows them to capture addendums and all changes after the initial case release, ensuring accurate lab billing while avoiding errors and reimbursement delays.
Summit Pathology also bills technical-only and global services directly to clients, with the flexibility to accommodate various billing agreements. It accomplishes this by combining data from the LigoLab platform with custom fee schedules and scripts that have transformed what used to be a time-consuming laboratory billing process into a quick task that can be completed within minutes.
“This has greatly improved efficiency, accuracy, and flexibility in managing our client lab billing, making it a seamless part of our daily operations managed internally rather than having to be outsourced,” said Handlesman.
Handlesman said Summit Pathology frequently collaborates with LigoLab’s support team to build custom data fields and reports tailored to the pathology practice’s needs, ensuring every department can access the specific data required for their workflows. He said this deep integration of data analytics throughout the organization has been a powerful tool in optimizing their operations and client services.
Final Thoughts
Summit Pathology has successfully navigated the challenges faced by today’s pathology groups and clinical labs by embracing advanced laboratory information system technology, automation, and data analytics.
While operating in an environment where diagnostic demand is high, reimbursement is complex, and qualified labor is scarce, Summit Pathology has leveraged LigoLab’s laboratory information system software to streamline operations, reduce manual work, and enhance accuracy.
Summit Pathology’s partnership with LigoLab highlights the benefits of advanced LIS software in modern pathology lab management. While utilizing workflow action queues, dynamic reports, and custom automation, Summit has optimized processes such as lab revenue cycle management, MIPS reporting, and client lab billing. This forward-thinking approach has allowed the lab to maintain high standards of quality and efficiency while supporting continued growth.
Editor’s Note: Corey Handlesman also recently co-hosted a webinar in which these same topics were discussed. CLICK HERE to download the on-demand webinar.
Contact us today to learn more about LigoLab and its advanced pathology lab software solutions (LIS systems, lab RCM, direct-to-consumer lab testing).
