Bringing advanced diagnostic care to underserved rural areas

Case Study

Situated in a sprawling geographic region in mid-Missouri, Boone Health expanded its reach to improve access to high-quality holistic care throughout the area, improving the health of community members and increasing net revenue along the way.

Their challenge

Boone Health has provided coordinated healthcare to residents living in a 14,000-square-mile area in central Missouri for more than 100 years. Known for putting patients first and delivering full-spectrum services, Boone Health — a county-owned, regional referral center — struggled to extend the same caliber of care to all residents in the communities served.

“Boone is in a unique location,” says Drew Wilkinson, director of laboratory, ambulance, and emergency services at Boone Health, which is located in Columbia. “We are in the heart of Missouri, so we serve 26 counties around Boone County. A lot of that is rural Missouri — that is a challenge in and of itself.”

The population has steadily increased over the past few decades in the areas Boone Health serves. Many patients seeking care can travel to Boone’s main campus, which is a healthcare oasis in the rural state, says Wilkinson.

But not everyone in the surrounding communities had the same access to care, and the population growth was not reflected in Boone’s daily hospital census or laboratory volumes and profitability.

“Previously we did not have a wide footprint,” says Wilkinson, adding that when he became the director of laboratory services in 2016, Boone had a singular laboratory draw site for outpatients located within the main hospital building. “We made the 26 counties come to Boone, but we know that’s not the way. We wanted to take that care to the 26 counties.”  

Their solution

In 2017, Boone Health capitalized on an opening to extend its reach and capture new patients in need of quality diagnostic care when the independent pathology lab that had served the area for 30 years was purchased by a national lab.

“We knew at that point that we had an opportunity to serve our patients locally,” Wilkinson says. “We tapped into every Mayo resource we had at that time to get our strategic plan going forward. And we’ve not let up on that since.”

The relationship between Boone Health and Mayo Clinic Laboratories extends back to the late 1990s, when Boone began sending reference testing to Mayo Clinic. In addition to providing rare tests, Mayo Clinic offered education and support for improving laboratory operations to better serve patients.

“We really tapped into their resources to say, ‘How can we do this better?’” Wilkinson says. “It was truly just taking the resources available on the website and some email correspondence to get us going, but we took that and ran with it.”

As part of Boone’s strategic growth plan, it expanded its primary care and specialty care networks. From 2017 to 2022, six new clinics and even more laboratory draw sites opened their doors.

“We went from having just one main hospital draw site to opening up nine additional outpatient draw sites around those primary care centers because we wanted to attract the patients that were coming for those,” Wilkinson says. “We ran faster than we thought we knew how to run, but we knew we had to do that for patients in our area.”

At present, more than 500 patients each day receive services at Boone’s outpatient draw sites. “We know that we are truly impacting mid-Missourians with the high-quality healthcare we provide. We see it year after year and it doesn't look to be letting up,” Wilkinson says.

The increase in patient and laboratory volumes made an impact on Boone leadership. Having seen the initial growth, they looked to their lab to understand how they could continue expanding.

“One thing that we really piggybacked off of with (Mayo) was helping to explore our outreach opportunities,” Wilkinson says. “Several years ago, I think the (laboratory) was looked at as a cost center versus a revenue center. When I came into this role and we started growing the outpatient work, that’s where we really started communicating with our senior executive team to show the value in outpatient lab services.”

With Mayo’s guidance, Boone discerned which tests made financial sense to keep in house and expanded their testing repertoire.

Wilkinson says on-site visits from Mayo Clinic outreach specialists were instrumental in demonstrating the value of the laboratory to Boone leadership. “Our lab is at the forefront of their minds and continues to be a huge growth strategy for our health system as we look at the years to come.”

Their results

What’s next?

As Boone Health has grown, the laboratory has evaluated its ability to take on reference testing and has begun partnering with smaller hospitals within its 26-county service area, Wilkinson says.

“We’ve actually become their reference lab. The testing we don’t do, we send on to Mayo Clinic. Where we see the next phase going is to these larger clients, other rural hospitals that want to partner with us because of the Mayo name and connection.”

Wilkinson adds that his team routinely passes along the information and education provided by Mayo Clinic to their clients, equipping those organizations with testing and laboratory-related resources.

“Truly having this two-way partnership where (Mayo) is encouraging us to bring testing in house and giving us the resources to do that, I can’t think of another vendor or partner we use at Boone that does that within the laboratory setting. We don’t feel like they are competing against us, and they truly want to see us do better, grow, and become more efficient. It’s very unique and we’re taking full advantage of it.”

Learn more about partnering with Mayo Clinic Laboratories

“With the high-quality service that Mayo provides, we're able to pick up a phone, get either the physician an answer or the patient an answer, and then close that loop the same day with our patients, which obviously elevates the level of service we can provide and ensures confidence in the result they are receiving.”

Drew Wilkinson, director of laboratory, ambulance and emergency services at Boone Health


Robin Huiras-Carlson

Robin Huiras-Carlson is a senior marketing specialist at Mayo Clinic Laboratories and a Mayo Clinic employee since 2015. Her writing focuses on specialty testing, innovation, and patient-focused initiatives.