Often, the most challenging part of running a clinical toxicology lab has nothing to do with testing itself. Between daily operations, client management, changing reimbursements, and the constant threat of inspection, many toxicology labs are finding the logistics of day-to-day lab management difficult to keep up with. Though a lab and its staff might be well-prepared to run accurate tests, it’s impossible to run a successful lab without also being able to manage internal processes and customer relations, as well as understand changing industry regulations.
If your lab struggles to manage operations, it’s important to identify specific problems you’re facing and choose solutions that address them directly. Though there are plenty of creative ways to tackle any of these problems without help from lab software, implementing a laboratory information management system (LIMS, or LIS) could resolve a significant number of them. It’s important to weigh the cost of any solution, both in terms of the hard cost and staff hours, and consider what will work best for your team.
Walk yourself through the process of completing an order from start to finish, and see where your lab’s common roadblocks are. How much time does your staff spend per week calling clients who placed an incomplete order, or one with missing insurance or sample label information? How much time is spent collecting the info needed to bill clients?
It’s important to define processes at your lab for taking orders, handling missing information, and delivering results to clients. Clinical lab software makes an enormous difference how likely it is that staff will adhere to these processes. LimitLIS Toxicology includes a client portal that lets customers order tests automatically, as well as review results immediately upon release. Lab personnel can directly message clients through the portal when information is missing, and the software stores the message history, which reduces the potential for further errors in communication.
Identifying your lab’s client communication roadblocks can also help reduce overall turnaround time. It may not be possible to reduce the time required to run a test without sacrificing accuracy, but streamlining the administrative processes of receiving orders and reporting results can make a huge difference.
Again, a defined process of manual checks can make it easier to deliver faster results. But this is another situation in which a LIMS with automated ordering and results delivery is extraordinarily helpful. Some features of the LimitLIS client portal help streamline things on the client’s side as well – for example, clinicians only see positive results on each LCMS data import, which saves them time.
The ASAM’s guidelines for toxicology testing have made it harder to get reimbursed without documenting the medical necessity of the test. Combine this with a national decrease in diagnostic lab fees, and many labs are seeing lower overall reimbursements. If you’re running your lab without a LIS/LIMS, make sure that you’re documenting the reason for the test with every order you take. Get staff in the habit of checking the order at key stages in the workflow (after ordering, before delivery of results, etc) to make sure that medical necessity is never missed. But switching to a LIMS can help reduce the potential for human error. With LimitLIS Toxicology, physicians submitting orders via the client portal are required to provide the medical necessity of each test in order to submit.
It’s incredibly challenging for lab staff to find the time to create daily quality control (QC) reports and Levey-Jennings (LJ) charts manually. Despite the effort required, it’s important to stay on top of this task. Consider delegating the task of generating QC or LJ reports to one person, and setting aside time as needed for them to work exclusively on this. (Or if it’s in your budget, hiring a quality assurance specialist.) But a more cost-effective option might be to use a LIMS with automated QC and LJ charts. LimitLIS important QC data automatically with sample results, which eliminates the need for QC orders to be placed separately. Results can be annotated with comments, and signed directly in the system by the lab director.
In 2016, CMS implemented four new HCPCS G codes for definitive drug testing in 2016, which made Medicare reimbursement both A) connected to the number of drug classes tested, and B) heavily limited by CMS’ clinical laboratory fee schedule. It’s now incredibly important for labs to track the number of drug classes tested per sample, as well as using the correct G-codes and CPT codes. If you’re not using lab software, make sure at least one person on your staff is well-versed in these guidelines and can implement checks on all orders subject to Medicare reimbursement. LimitLIS Toxicology counts the number of all drug classes tested per sample and generates the correct CPT codes and G codes for each procedure automatically, reducing the potential for human error.
Reducing overhead and taking on more clients will increase your revenue, but careful optimizations can also make your business more profitable. In the absence of a business development consultant, it’s hard for lab staff to know where to start with a business analysis like this. LimitLIS Toxicology includes comprehensive data mining and analytics capability, which helps lab personnel identify the best-performing tests, most profitable clients, physician ordering and prescription trends, and more. Identifying what your lab does best both helps you prioritize work, and helps you find new potential revenue sources without the stress of reducing overhead.
Before implementing any solution, it’s important to start with a clear definition of what your lab’s specific weak points are. Knowing exactly what’s causing the problems you’re having will help make sure that you’re able to choose a solution that will actually be effective. Though there are ways to streamline your administrative processes and workflows manually, the potential for human error is greater when only humans are involved. Using lab software can make managing a lab of any size, as well as increasing its profitability, much less time-consuming and more effective.