Health IT Summit Beverly Hills 2014 – Case Study “Agile Partnerships to Achieve Common Goals in Lab Information Systems” with Pat Cooke, Chief Information Officer, CellNetrix Pathology and Laboratories

1. AGILE PARTNERSHIPS TO ACHIEVE COMMON GOALS IN
LAB INFORMATION SYSTEMS
PAT COOKE CELLNETIX CIO
JOHN COLE SUNQUEST REGIONAL VP OF SALES
11/04/2014
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2. A STRONGER SYSTEM
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3. A STRONGER SYSTEM
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4. A STRONGER SYSTEM
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5. HEALTHCARE
IS AN
ECOSYSTEM
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6. THE ECOSYSTEM IS CHANGING
Dramatic shifts in delivery models
Huge increase in healthcare lives
Profound downward pressure on reimbursement
Consolidation at every level
CELLNETIX.COM
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7. 2007: CELLNETIX FORMATION
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8. PATHOLOGY IN 2007
70% of pathology groups are 7 Pathologists or less
Little inter-group competition (but growing competition from national labs)
Lack of subspecialization. Outdated IT tools
Size and economies of scale required to:
• Improve quality
• Reduce costs
• Subspecialize
• Expand testing technologies and IT
• Compete
CELLNETIX.COM
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9. WHAT WE WERE
CELLNETIX.COM
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SMALL GROUPS
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LABS
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I.T. SYSTEMS
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10. WHAT WE HAVE BECOME
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LARGE GROUP
1
I.T. SYSTEM
1
CENTRAL LAB
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11. STRONGER TOGETHER
53 pathologists
300 total employees
Serving 15 hospital systems
Extensive molecular program including NGS
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12. “CellNetix is an IT company that
happens to be in the lab
business…”
Dr. Don Howard - CellNetix CEO & Chairman of the Board
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13. PATHOLOGY LAB INFORMATION SYSTEMS IN 2007
Historically designed around dictation/transcription workflow
Often based on Microsoft Word with SQL server
Weak or non-existent specimen tracking capabilities
Workflows often involved paper, hand-writing or preprinted labels
CELLNETIX.COM
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14. NEW PATHOLOGY IT REQUIREMENTS
Barcoding to prevent specimen loss & patient misidentification
Paperless workflow
Workflows to support subspecialty case assignment
Rules engine to manage multi-client/multi-casetype complexity
Telepathology for virtual expertise pools
Integrated QA
Structured data entry and reporting
CELLNETIX.COM
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15. Preference would have been to buy
Software vendors were starting to respond to new needs (slowly…)
We needed these tools “yesterday”…
We had no choice but to build
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Buy
Build

16. PROJECT: PAPERLESS WORKFLOW
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Scanned
Documents visible
at appropriate
stages
• All documents batch-scanned
on receipt
• Barcoded labels attached to
each document &
automatically pulled into case
Touchscreen with
“Quick Buttons”

17. PROJECT: SPECIMEN TRACKING
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From Pickup In Lab: at 10+ points
Stage Specific
Touchscreen apps
throughout lab
Android courier app
with bar-code
reader
Unique bar-codes
on all specimens,
blocks and slides

18. RESULTS: ELIMINATED SPECIMEN LOSS
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0
Lost or missing
specimens

19. PROJECT: SUBSPECIALTY ALLOCATION
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• Automates subspecialty case
assignment
• Rules based
• Balances workload per site and between
sites
• Allows for:
• Case mix
• Thresholds
• Conference coverage
• Pre-vacation workload…

20. RESULTS: INCREASED SUBSPECIALIZATION
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21. PROJECT: INTEGRATED LAB QA
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Default errors for
each stage in the
process

22. RESULTS: REDUCED ERRORS
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23. PROJECT: WEB PORTAL
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View
associated
images
Contact
Diagnostician
PPDDFF RReeppoorrttss

24. PROJECT: DIGITAL PATHOLOGY
Telepathology
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• Virtual expertise pools
• Subspecialized pathology
regardless of location
Whole Slide Imaging
• Same Day IHC for remote
pathologists
• Her2 & KI67 image analysis
• Conferences

25. 7 YEARS LATER
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26. WHERE WERE WE NOW?
Specimen tracking
Paperless workflow
Automated subspecialty case assignment
Telepathology and Whole Slide Imaging
Speech recognition
System wide rules engine
Structured data entry and reporting
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27. PATHOLOGY IN PERSONALIZED MEDICINE
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Prevention Therapy Management
Risk Markers
Prognostic and
Therapeutic Tests
Response
Measurement
Family History and
Cancer Genetics
•Genetic (germline)
testing (traditional,
array, and NGS)
•Some tissue testing
Major technologies
•Morphology
•Flow Cytometry
•IHC
•Cytogenetics
•FISH
•PCR
•CGH arrays
•NGS
Diagnosis
Diagnostic
Tests
Integration of Data
and Communication
with Clinical Team

28. WHY DISCRETE DATA?
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Discrete
Pathology
Data
Cancer
Registries
Healthcare
Data
Warehouses
Translational
Research
Systems
ACO
Population
management
Standards &
efficiencies =
better product at
lower cost
Clients
Pathology Group

29. CELLNETIX.COM
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Buy
Build
A
B C
OR
PARTNER

30. DUE DILIGENCE
Issued RFP in 2013
Reviewed 10 LIS Providers in detail
Found no solution that could replace current technology entirely
Cost of change was significant
Risk of change in 24x7x365 operation was even more significant
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31. SUNQUEST AT A GLANCE
• Founded in 1979
• 30+ years experience focused on
© 2014 Sunquest Information Systems, Inc. | Confidential and Proprietary 31
AP and CP market
• 1,700 hospitals
• 4,000 physician offices
• 300,000+ users
• Headquartered in Tucson, AZ
• Development Centers in the
U.S., India, and the U.K.
Number ONE Provider for:
• 400+ bed hospitals
- 30% AP LIS share
- 32% CP LIS
• UK NHS Trust hospitals
- 65% share
• Acquired PowerPath in 2011
• Over 700 employees
worldwide
• Average employee tenure
is 7 years
• 8% of employees with
Sunquest for 20+ years
Experience Growth
Global Dedication

32. CELLNETIX STRATEGIC COLLABORATION
One of the leading, most innovative collaborations in anatomic pathology
© 2014 Sunquest Information Systems, Inc. | Confidential and Proprietary 32

33. STRATEGIC COLLABORATION
Win-Win
• Shared Risks
• CellNetix, giving up development capabilities
• Sunquest, ROI based on commercializing quickly
• Shared Rewards
• Sunquest, better product = increased sales & market share
• CellNetix, better product = efficiencies & improved quality
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QUALITY
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34. SUNQUEST COMMITMENT
Purchase CellNetix IP & commercialize products
Significantly enhance discrete data capabilities
Integrate molecular pathology solution that supports NGS
Integrate rules engine
Improved reporting
Hire our dev team and build development center at our lab
Move towards more agile development methodology
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35. CELLNETIX COMMITMENT
Sell IP to Sunquest & focus on partnership rather than development
Provide space for development center at core lab
Allow open access to pathologists and lab staff
Take on beta software on accelerated schedule
Contribute ideas and innovation
Support Sunquest marketing initiatives
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36. SHARED PRODUCT VISION
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Discrete
Reporting
For
Consistency
& Mineability
End-to-end
Specimen
Tracking
& Paperless
Workflow
LEAN efficiencies reducing costs
Voice
Recognition
&
Touchscreen
Enabled
Integrated
“Stage
Specific” QA
Rules Engine
&
Configurable
workflows
Improved patient
outcomes & safety

37. BROADER RELEVANCE
Healthcare providers and software vendors need to partner
Great software can’t be built in a vacuum
Agile development is key in a fast market
Partnerships are built on trust and shared risks/rewards
Both sides need to think creatively and be prepared to go out on a limb…
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38. QUESTIONS?
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