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Case Study: Multi-Specialty Clinic

Oregon-based Multi-Specialty Clinic Implements LIS to Manage EMRs More Efficiently


Transitioning from manual workflows to digital patient test management eased by intuitive, flexible, feature-rich Polytech LIS

“We’re small but we do a lot of work,” said the lab manager for the Clinic, a 23 multi-specialty provider group in Oregon. “Of the tests we perform, about 95 percent are done on site.” Unlike most small operations around the U.S., this laboratory is unusual, in that it does not outsource significant testing volumes to one of the large reference labs.

Recently, the lab manager completed deployment of a new clinical lab information system (LIS), Polytech™ LIS, purchased from Comp Pro Med, Inc., a 25-year-old company based in Santa Rosa, California. Comp Pro Med’s longevity and stability, as well as their product’s resilient, flexible features, made them the perfect fit for her needs. Above all, the lab manager benefited from Comp Pro Med’s service ethic and the high degree of responsiveness that they gave to her throughout their installation and deployment.

The lab manager holds herself accountable for any purchasing decisions she makes and is passionately committed to the best interests of her organization. Like many medical groups throughout the U.S., the Clinic has wrestled with computerization issues. “Our physicians wanted to make the right choice for our organization so this has been a decision made over an extended period of time. The national mandate for electronic medical records (EMRs) helped move us in this direction.”

Two key events propelled the LIS purchase. The Clinic moved into a new building two years ago after experiencing significant growth and, they had to find a replacement for their aging practice management system (PMS). That replacement decision gave the lab manager the green light – and the budget – to find an LIS endowed with the multiple, robust interfaces that were called for by integration with a new PMS.

The Growth Factor: Clinic Outgrows Facilities and Regulations Drive Change

“When we moved into this building and the culture started to change, we could see those changes within our own practice,” observed the lab manager. “There were flow issues that encompassed the new building. You wouldn’t think going from one story to two would bring such a significant change. But it’s had a huge impact on our paper flow.” The previous system was nearly all manual. “We had a little system that was hooked to our chemistry. It took the information from the chemistry analyzer and spit it out in a useable format for us. We were able to monitor our QC [quality control] on it as well but it was an old DOS-based system that was archaic. It served its purpose until we could get here. But trying to get those reports upstairs – and getting them to the right place – has been a challenge.”

Lab Manager Sought a Stable Company with a Flexible LIS

For five years, the lab manager’s diligence in seeking the best LIS brought her through various stops and starts. There were a few experiences that made her skeptical and cautious. “I trusted someone, thinking they would make things happen for us. Then, their company went bankrupt.” As she renewed her search for a system, her initial criteria had to include assurance that the vendor would be around after the system was installed.

“Comp Pro Med’s 25-year track record meant a lot to me,” stated the lab manager. When she spoke with her CEO about the final vendor candidates, she spelled out the pros and cons. “I wasn’t sure at the time on what side of the balance sheet to place their small size. But for us, their small size has turned out to be a big asset. Comp Pro Med is a vendor that takes my needs to heart,” she said. “And they have proven business longevity. I had to know my new vendor would be here to support me down the road.”

But she also found their product, the Polytech Clinical Laboratory Information System, to be easy to use, flexible and feature rich. She appreciated the fact that she and her staff could perform 95 percent of their work on a single screen for patient entry, test orders, standing orders and results review.

The lab manager was impressed by the fact that Comp Pro Med’s software engineers had written hundreds of interfaces for lab analyzers, EMR systems, hospital information systems (HIS) and practice management systems (PMS), as well as billing and accounting systems – and they had written them entirely in house. “I liked the fact that, when I call for support, the person who wrote the software is the one who answers the phone,” she observed.

She was reassured by the fact that Polytech has multiple redundant databases so that her data wouldn’t be lost, there would be no down time and maintenance of her LIS would be simplified. Data mining and automatic QC trending, outlier processing and reporting, analysis and flagging per expected values were also important to her. “I like the fact that their background is from the laboratory too,” she said. “Comp Pro Med was born out of reality. Their CEO, Jeff Fisher, was a laboratorian. He saw the need for this and it grew from there.”

Tangible Evidence of LIS System Flexibility Required

The lab manager had to see a tangible product before committing to any vendor. She was determined to be cautious and was supported by her CEO to perform optimal due diligence. “I wanted to look back and know I’d given everything very careful consideration.” In making her purchase decision, she encountered vendors that would claim they could do something the way she wanted but were unable to give a tangible example. “They assured me they could do what I asked but I kept hearing ‘the programmers will take care of that as a part of your set-up’ and that wasn’t good enough. Because of my learning process during the past five years, I’m not as gullible as I used to be!” she stated with a laugh. “I want to see it. I want to have my hands on your example before we cut you a check.”

Comp Pro Med offered tangible evidence and they impressed her with their rapid response. “I shot my questions off and said ‘this is what I’m after.’ Then Jeff Fisher shot back answers and a trial within two hours! I was astonished. I realized that if he could do that, then they must truly have a system that was flexible.”

Interfacing with the EMR and Upgrades Included

Since the lab manager would be interfacing with an EMR within a few years, a large part of her working criteria included interfaces for that system. Her LIS had to be adaptable and flexible, as did the company she bought it from. “I wanted a system that allowed me to go in and change something, a system I could tweak,” she stated. “When I asked other companies, ‘what if I need something changed?’ the answer I got was, ‘Well, if it’s a little change, we’ll ask the engineers and we’ll see. Otherwise, you’ll have to pay each time you ask for a change.’ So basically what we would get from most vendors was a hard, fast product with no versatility in it. It’s canned. You don’t have any input. You can’t say, ‘You know, what if you did this … or how about if you did this?’”

“Comp Pro Med is not that way. Regular, free upgrades are a part of their service agreement and it’s proven out. They’ve tweaked my system and made upgrades at my request. I’ll come up with something and they work to figure out how to make it work for us.” Versatility of the reporting was also key. “It wasn’t everything but I knew I was going to have this two to three-year gap before we were plugging it into an EMR,” she continued. “I had to factor in a migration but also duplicate what we were currently doing to a certain degree. You know labs are all different and the flow’s different in each one, and the way this system is set up, there are so many different ways to do things that it’s going to be practically customized to our particular lab.” Among the many applications she values are the unlimited user-definable rules and the thousands of configuration items or switches that are automatically available in the system.

She points to one example of how they helped her hook into the previous manual system so it really works well for the physicians. “It actually keeps chart size down as they build an accumulative record over time. It was just very important to our providers to keep that formatting – and it was very important to me to satisfy their needs.”

She observed physician response to the single sheet reports sent with patients who had been hospitalized or treated in other locations. “Our providers didn’t like these. They were just used to this shingle-style, colored-coded system. With a printed-out accumulative, they would have to change out reports in the chart. They don’t want to do that because they can miss something and this impacts the quality of care they’re committed to providing.” Comp Pro Med fulfilled this request and, at the very outset, provided her with mock-ups of the shingle-style format so that, once again, she would have her tangible evidence of a promise fulfilled.

The Value of Direct, Timely Access to a Small Vendor’s Team

“The willingness on Comp Pro Med’s end has just been fantastic,” she declared, “and their support has been incredible.” She observes many companies who are focused on a constant new business search. “Maybe the reason they stay small is this: What they care about more than anything is taking care of the customers they have.”

As a small company, Comp Pro Med’s size and service ethic became an advantage for the Clinic. “They are willing to do what you ask them to do. They have a connection with you,” stated the manager. She saw vivid contrast to this connection when she worked with larger companies. “The frustration of trying to get in touch with a particular person and get the attention you need was exasperating. “To me it was a matter of our needing to address an issue sooner rather than later because so many other critical steps were depending on that one step in the sequence. Well it sometimes took two days to get a response.”

She believes the level of service at Comp Pro Med is what sets them apart. “I would say it’s one of several things that set them apart.” From Comp Pro Med’s perspective, this collaborative partnership owes a lot to the lab manager. “She is the ideal customer,” stated Fisher. “I would say she’s in the top five percent of the hundreds of clients we work with throughout the U.S. She’s an educated, intelligent user and a true partner. We’ve found her to be very resourceful with ideas for new applications and new ways to solve a problem. We value her insights and we’re particularly pleased that our work together has solved her problem, improved her operations and answered her needs.”

The Oregon-based Clinic is a multi-specialty medical group of twenty-three providers, including physicians and nurse practitioners, founded in 1949. Along with internal medicine, a broad range of other specialties includes obstetrics, family practice, podiatry, acute care, and pediatrics. The lab manager is a medical technician who received her degree from Oregon Institute of Technology (OIT). She has served the Clinic since 1986 after completing her internship at St. Vincent’s Medical Center in Portland.