Laboratorians provide critical clinical information that contributes to improving healthcare service delivery in the ever-changing healthcare system. Laboratory testing is essential in making diagnostic or therapeutic decisions and disease monitoring, allowing physicians to adopt appropriate evidence-based approaches to treating patients. In essence, laboratory services significantly impact many aspects of the healthcare system, including waiting time, length of stay, resource utilization, and patient safety. This feasibility study assesses the effectiveness of an online check-in laboratory model and its effectiveness in mitigating access, quality, and efficiency of laboratory services. As technological advances continue to streamline the healthcare industry, patients still face challenges accessing their lab results. A study by Ramsay et al. (2017) on the completion of lab testing by diabetes patients revealed that turnover time, poor health, lack of education, and forgetfulness are some of the problem’s patients face in accessing laboratory services. The online check-in laboratory model is geared towards solving the challenges of quality, turnover time, and access to laboratory services.
Evaluating Feasibility
In the past, clinical laboratories lacked the potential to provide diagnostic information and their ability to act as a revenue source for most healthcare facilities was not realized. With time, these laboratories have become an integral part of the healthcare system, with more physicians acknowledging the need for quality and timely laboratory services. Despite significant advances in technology and the introduction of electronic health records, waiting time remains a major concern for patients and health professionals. A study by Zhang et al. (2016) on improving laboratory services in the low-resource area showed the progress several international initiatives have taken to scale up laboratory services in these regions. Moreover, these programs have shown significant improvements in disease monitoring and rapid diagnostic testing in situations where results are needed urgently.
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Effective laboratory management is essential to improving service delivery and revenue generation. An increase in revenue mandates that expenses be reduced and time is taken to access these laboratory services. Seeking appointments, ample collection, and picking test results can be hectic. Despite integrating technology in laboratories and other health facilities, patients still experience delays in seeking these laboratory services. Developing an online check-in laboratory system that will allow patients and physicians to access health services will significantly reduce operational costs, increase the return of investment, and improve patient satisfaction. According to McCall et al. (2016), ensuring quality laboratory services encompasses prioritizing customer satisfaction in the areas of accuracy, precision, economic benefit, and turnover time. Technology is at the center of this proposed model, with additional resources of an online portal, access to the internet, and a central database also needed to run the service.
Strategic Effect
Pathology and laboratory practices in the U.S. are one of the most regulated practices. In conjunction with the College of American Pathologists and Joint Commission, the Clinical Laboratory Improvement Amendments accredit most American laboratories, ensuring that they enforce health-related policies that govern their operations (Wilson, 2016). In addition to the universal policies, laboratories must incorporate healthcare guidelines and practice standards applied across many hospitals. A common misconception in quality provision is that no result is better than poor-quality work (Wilson, 2016). In clinical laboratories, quality is mandatory, but it cannot be achieved without imposing strict regulations that govern the practice. With technology integration in clinical laboratories becoming a norm in most states, the need to regulate technology use in healthcare continues to gain momentum.
Creating an effective online check-in laboratory model will follow the adherence of many policies and regulations that control quality, access, and technology use in laboratory services. As the scope of clinical laboratories has increased over the years to serve individual patients, screen, and survey diseases that inform public health, extensive laboratory networks have been developed to promote communication and coordination among health professionals, facilities, and regions. However, quality management in this field has elicited mixed reactions from relevant authorities in recent years, especially in the standardization of laboratory services and the creation of rapid diagnostic tools. The local, federal, and international health communities continuously address these issues by improving the current policies and adding new regulations in conjunction with technical experts.
Informatics will play a significant role in managing the online check-in laboratory program. Emerging technologies can be incorporated into laboratory information systems. A measure of their accuracy, automation, and speed in ordering, interpreting, and dispatching test results will be pivotal to determining the program's effectiveness and quality of care management. Moreover, how the program will capture critical patient data, retrieve, and analyze the data will determine the program's suitability to operate in an information-driven environment. Given the significance of laboratory services to all patients, the online check-in laboratory program will target all patients and physicians. The program will also ensure that wait times are mitigated by improving accessibility, availability, and efficiency of laboratory services. Both patients and physicians will have an easy time accessing all the information they need from the central location.
Market Analysis
Understanding the market structure and target demographics, patient data on laboratory access is vital. Since the program will serve all patients, priority should be placed on accessibility and timely results. With an estimated population of over 109,000
(“U.S. Census Bureau QuickFacts,” n.d.), Ventura city still experiences disparities in health provision. While there are several other clinical laboratories within the area, more data is necessary to analyze market competitiveness and identify competitors. With a wide range of patients visiting the health facility, laboratory services are overstretched. Simultaneously, other facilities and private practitioners within the city who lack the required laboratory facilities also seek services in the facility. By implementing the online check-in laboratory program, these facilities and practitioners will easily be notified of their results once they are out.
Assuming that the laboratory accepts all major health insurance providers, the program will not be convenient for the 7.8% of people without health insurance. However, for the rest who have insurance health coverage, the program will automatically process their payments and notify them of any changes or issues. This advantage will rival other laboratories within the area, adding to its effectiveness in scheduling orders, request results, and book additional services at any time. Moreover, the proposed program will automatically generate financial reports at the closure of business, giving the management the power to measure its effectiveness to streamline laboratory service delivery. While negative reviews deter people from seeking laboratory services, the online check-in service will improve patient satisfaction and foster increased service delivery.
Financial Analysis
The expansion of the laboratory service and capacity will require a high initial capital investment of approximately $200.000. A large part of the investment will be devoted to developing the online system and setting up the required network resources to store and access the data. An additional $10,000 will be used to train the pathologists on how to use the proposed system. Management training will also fall under this category as the new system will incorporate management tasks on financial reporting. As challenges are expected to impact the new system's implementation, net incomes and revenues are estimated to be minimal, with the management approximating a net income of around $450,000. However, the proposed system is expected to bring in more revenue in subsequent years. The net income will allow for the expansion of the online laboratory service and cater to its maintenance.
Funding the project will require a partnership between the private and public sectors. The company will welcome private investors' participation and collaboration with the local government to see the project through. Equity, debt, and the government grant will constitute funding sources to support the project, with the health facility contributing a small amount to provide the extra support to develop and implement the system. Equity will come from interested sponsors who want to be part of the project. The company will appreciate local sponsors who share in its vision to improve care services in the community. While equity is a viable option to raise enough investment capital, finding a good investor is challenging. Moreover, some sponsors will have other vested interests, stipulating tougher terms and conditions before offering the capital. The health facility can secure debt capital from a local bank to support its project. The debt will incur a fixed tax rate over a specified period. Government grants, on the other hand, are hard to secure. However, through the government's partnership and financial support, the laboratory facility can receive sufficient funds to push on with the program.
SWOT Analysis
The main strength of the proposed online check-in laboratory program is its low start-up cost due to the existing IT infrastructure present within the facility. While training is mandatory for all staff members, most of them are already familiar with similar systems and their operations. Additionally, they support the new system acknowledging its significance in streamlining care services, reducing turnover times, and fostering patient satisfaction. The human resource is well equipped to handle an influx of patients once the system becomes fully integrated. Another strength is that most patients have access to smartphones and the internet. Accessing the system's portal will be made simpler, and patients and other physicians can register, sign in, schedule orders, view, and request test results wherever they are. Computer literacy among many patients further makes it easier for the company to educate patients, cutting down on excessive expenditure during the implementation phase.
Despite the above strengths, the proposed program has its weaknesses. Operations at the facility are still young, and it is facing stiff competition from other well-established laboratories with online check-in services. There is much to learn in the healthcare business, and the management is optimistic that incorporating technology into its core business operations will significantly give it a competitive edge over its rivals. Another weakness of the proposed system is the breach of data. With a limited operational budget, the company cannot invest in top-notch data security systems to safeguard patient data. Breaches within the system will significantly impact the company's reputation, driving away potential customers.
Opportunities for the proposed system is promoting online check-in laboratory services to patients through health promotion and education. The facility can conduct campaigns to educate patients and other customers on the online system's benefits while spreading different messages related to promoting public health. Such initiatives can attract more donors and bring the local government on board, securing additional funding to expand its services. However, a significant threat to the program is economic instability, especially when healthcare costs have risen tremendously. At the same time, people without affordable health insurance covers will be unable to access our services due to economic challenges. These threats could limit the facility and its proposed system from generating the expected revenues. In the end, it could place the company in a bad position with accruing debts.
Operations Performance
As earlier noted, the proposed online check-in laboratory system targets to improve efficiency, quality, and access to laboratory services. At the initial stage, the proposed system is expected to reduce the turnover time, and a backload of services was limiting the lab's ability to serve a large population within the shortest time. While it is too early to collect any meaningful statistical information, predictions indicate incremental progress over the next several years. Given the positive predictions, the proposed system will streamline the lab's internal operations and report generation to guide public health decision-making. With continued reporting and evaluation of the system use and financial records, the management will have a clear understanding of its operational performance in mitigating laboratory services' challenges. Moreover, the reports will allow for recommendations on ways of improving the system's performance. Overall, turnover time, quality, and access to healthcare services, challenges that impact the larger healthcare system, will be managed by implementing the system, opening doors for improving other healthcare sectors.
Outpatient
The current trend in healthcare is that healthcare organizations are moving towards a patient-centered approach, allowing patients to take an active role in matters of their health. According to Bokhour et al. (2018), a culture change and the implementation of patient-driven frameworks are critical to realizing evidence-based practices that ensure patient needs, preferences, and experiences are satisfied. Featherall et al. (2019) also share the same view in that leadership change is vital to instilling a culture of a patient-centered approach and empowering frontline health workers by creating achievable goals. Away from incentives of culture change, the proposed system's vision aligns with the Affordable Care Act goals in promoting health education and primary care in outpatient care settings. Moreover, the proposed system also embraces a patient-centered paradigm
Outlook
Turnover time and access to quality healthcare services continue to impact the U.S healthcare system and health organizations. Inequalities within the sector have a significant impact on the vulnerable population, and the lack of health insurance covers further worsens the situation. Those patients diagnosed with chronic diseases, such as diabetes, need constant laboratory services to monitor their progress and assess their treatment plan. Given the implication of delayed lab results by such patients, this feasibility study is critical to assessing an online check-in laboratory process's practicality and effectiveness to mitigate such concerns. Moreover, the proposed system supports the continued collaboration and coordination of different health agencies in promoting public health. The system fosters the evaluation and use of evidence-based practices in defining interventions that mitigate healthcare challenges. From a broader perspective, barriers to quality care services, including financial challenges, insufficient healthcare workforce, and ineffective treatment interventions require proper policing and the introduction of nursing best practices. Therefore, the proposed system will play a central role in providing quality care services to all patients, fostering health education and promotion, and improving overall public health.
References
Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N., Solomon, J. L., & Lukas, C. V. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC Health Services Research , 18 (1). https://doi.org/10.1186/s12913-018-2949-5
Featherall, J., Chaitoff, A., Simonetti, A., Bena, J., Kubiak, D., Rothberg, M., Roumina, K., Hurle, N., Henricks, W., & Yerian, L. (2019). Creating a culture of continuous improvement in outpatient laboratories: Effects on wait times, employee engagement, and efficiency. American Journal of Medical Quality, 34 (4), 389–397. https://doi-org.proxy-library.ashford.edu/10.1177/1062860618808383
McCall, S. J., Souers, R. J., Blond, B., & Massie, L. (2016). Physician satisfaction with clinical laboratory services: A college of American pathologists Q-probes study of 81 institutions. Archives of Pathology & Laboratory Medicine , 140 (10), 1098-1103. https://doi.org/10.5858/arpa.2015-0486-cp
Ramsay, N., Johnson, T., & Badrick, T. (2017). Diabetic patient adherence to pathology request completion in primary care. Australian Health Review, 41 (3), 277–282. https://doi-org.proxy-library.ashford.edu/10.1071/AH16012
“U.S. Census Bureau QuickFacts: San Buenaventura (Ventura) city, California.” (n.d.). Census Bureau QuickFacts. https://www.census.gov/quickfacts/sanbuenaventuraventuracitycalifornia
Wilson, M. L. (2016). Regulations, standards, guidelines, and benchmarks. American Journal of Clinical Pathology , 145 (6), 742-743. https://doi.org/10.1093/ajcp/aqw108
Zhang, H. L., Omondi, M. W., Musyoka, A. M., Afwamba, I. A., Swai, R. P., Karia, F. P., Muiruri, C., Reddy, E. A., Crump, J. A., & Rubach, M. P. (2016). Challenges of maintaining good clinical laboratory practices in low-resource settings. American Journal of Clinical Pathology , 146 (2), 199-206. https://doi.org/10.1093/ajcp/aqw083
