Last month, I shared evidence of an unsustainable “spend trend” in health care and the role that laboratory medicine, advanced diagnostics, and pathology play—as a contributor or remedy to—the rising cost of patient care. Starting this month, I’ll walk through a series of learnings that helped our laboratories build a sound utilization management program aimed at reducing total cost of care.
There’s an apropos saying that I’ll borrow from a Mayo Clinic colleague who succinctly sums up this month’s lesson:
“All thrust, no vector.”
The phrase points to the need for good research and planning as the first step in any major change.
As motivated health care leaders, when confronted with a problem—utilization management in this case—our first instinct is often to “do.” But, a successful practice transformation is built upon cooperative understanding, championing, and action from across the hospital or system. Practitioners, administrators, operations teams, and analysts need a shared vision to drive aligned change.
They need vector.
Under the advisement of the Mayo Clinic Clinical Practice Committee, we approached our utilization charge with a scientific mindset. We engaged in an analytic “baselining” of critical utilization capabilities and surveying of key staff to guide our early efforts and investments. Key capabilities we measured included:
- Subject matter expertise
- Clinical content
- Leadership support
- Staff commitment
- IT infrastructure
- Analytic tools
- Operational capacity
- Diffusion capabilities
Don Flott, our Director of Utilization and Integration Services, co-led this early introspective effort and was responsible for driving the administrative framework of a programmatic utilization model. He shared, “The surveying showed us two important items: 1. It offered a quantified degree of understanding, and 2. It surfaced definitive areas of strengths and weaknesses across the must-have capabilities. It showed us exactly where we were starting and where our efforts were best prioritized.”
If this is striking a familiar nerve or piquing your interest, that’s good.
We recognized early that our colleagues across the country were likely wrestling with the same challenges as us, and we could quicken their progress by sharing our learnings and templates. To that end, we created the Utilization Management Assessment as part of the services we avail to clients.
In the words of Ms. Tammy Fletcher, a leading manager on our Utilization and Integration Services Team, “The Utilization Management Assessment queries are based on the same nine essential capabilities our practice identified as critical for advancing sound utilization management. These capabilities serve as the cornerstone upon which a utilization management committee can build sustainable change in laboratory-ordering practices and total cost of care models.” That means, it’s a pretty cool tool.
I won’t sugarcoat it, it’s a demanding endeavor. But it’s one that can have a profound impact on improved care and reduced costs—not just in the laboratory, but across the hospital.
We’ve created the assessment for you as a proven scientific first step to guide your efforts and set a foundation with both thrust and vector.
This post is co-authored by Tammy Fletcher, Administrator of Value-Based Services at Mayo Mayo Medical Laboratories. Tammy came to Mayo Medical Laboratories in 2000. She brought with her extensive experience in the health care business arena working with growth oriented medical companies. Tammy has a BA in Business Administration and a Master’s Degree in Organizational Leadership from St. Catherine University. She is a member of the American College of Healthcare Executives.