Quest and Athenahealth lab interface

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Aamer Hayat

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Sep 19, 2011, 4:58:30 PM9/19/11
to Jonathan Bush, Michael Roy, athenah...@googlegroups.com
Hello Jonathan,
I hope all is well!  I wanted to forward something to you that my practice has been trying to reconcile for about 6 months regarding our lab interface with Quest.  As a brief history:

1) Lab interface between Quest and Athena was set up as a unidirectional interface for our practice (Practice ID 2399);
2) We were under the impression that it was a bidirectional interface;
3) We were telling our patients to go to Quest because they can go to any Quest since we thought our faxes were going to a centralized database (i.e., the outgoing order part of what we thought was a bidirectional interface);
4) Realizing there must be something wrong because too many of our patients would go to a Quest and the Quest wouldn't have their order in their database, I contact Quest and Athena to inquire more.
5) Athena confirmed that it was a result only interface, and not as I had thought a bidirectional interface (I guess the builds and maintains electronic connections with labs...http://www.athenahealth.com/our-services/athenaClinicals.php refers to unidirectional connections);
6) I called Quest and their EMR support group read off a list of vendors it has bidirectional connections (NextGen, ECW) and Athena wasn't on the list. I asked about Athena and they said it was in the "research" phase;
7) My Quest rep learned about this and offered to build an electronic bridge between Quest 360 (their online global lab ordering system/database) and our PMS (Athenahealth) (see the email below);
8) I spoke with Mike Roy, my account manager (doing a great job btw) and when he looked into it, it sounded like Quest wasn't willing to share in the financial risk/responsibility of building the bi-directional part of the interface with Athena.

So from the history above, some things stand out.  It benefits Athena and Quest to have a bidirectional interface (understanding that coordinator just came out for independent labs, but Quest is probably not considered an independent lab) because:
    1. Quest is one of the largest providers of lab services in the country (approx 2000 patient service sites);
    2. Athena's major competitors have bidirectional interfaces with Quest;
    3. Athena is growing and with its partnership with EHS and Synermed out here in Fresno, CA, is creating relationships with providers who interact with Quest a lot; The Athenahealth Sales people who built that relationship also thought there should be a bidirectional interface with Quest and were going to look into it for me;
    4. It would significantly reduce paper output and increase workflow efficiency if we could tell our patients, "just go to any Quest, our EHR automatically sends your lab order to their global database" instead of what we do now which is first help the patient find their nearest Quest, then fax the request and print out an order for the patient so they remember which Quest they selected (a Communicator improvement opportunity- have lab/consult orders be part of the patient summary in the portal or have them publishable to the portal);
    5. It sounds like Quest has a way to connect to our PMS with an electronic bridge (see email below);
    6. It's what is good for Athenahealth (you meet your competition on basics and surpass them on other areas- I shouldn't have to choose between apples and oranges, I should choose what is better;  increases client satisfaction, retention, referrals), Quest (drives more patients to Quest because of the ease of use in sending patients there) and Athena's clients (streamlines workflow, patient satisfaction).
I thought I should bring this to your attention because it makes sense to have a bidirectional interface and the reasons there isn't one don't make sense. My other ideas about communicator and workflow I've talked to Mike about and have asked various CSC operators to  send to the client upgrade request list.  I've included Mike on this email and other members of the Athenahealth California User Group that we created out here in California (who I'm sure would benefit from and be interested in a bidirectional interface with Quest).
Thanks for taking the time to read this.  If you have any questions, I can be reached at 559-450-7295 or my cell at 312-498-2066.

Regards,
Aamer Hayat
COO
avecinia wellness center
your partner in optimal well-being


---------- Forwarded message ----------
From: Baro, Enola G <Enola....@questdiagnostics.com>
Date: Thu, Sep 1, 2011 at 8:18 PM
Subject: RE: clarification about where labs are sent
To: Aamer Hayat <aamer...@gmail.com>


Aamer,
I was at your office this morning and Lee asked a question in regards to your interfaces orders. She indicated that when they place orders in Athena they have to choose a Quest location and wondered if that order be available to all Quest locations. I told her you had emailed me a question on your orders last week, however, upon her description of the process it sounded to me as though your orders were not actually being submitted to us electronically, but rather, the vendor was dropping the order to the chosen location via fax. I stepped outside to place a call into one of our interface analyst to discuss your vendors set up. Per our conversation, Athena is a results only interface. The orders you create and submit are not sent electronically, but actually faxed.
 
If you would be interested in performing electronic orders, that would have your orders going to a central hub at Quest and available to all NorCal locations let me know. This could be achieved by utilizing our Care 360 with an electronic bridge to your PMS at no cost to your practice.
 
Thanks,
Enola
 
 From: Aamer Hayat [mailto:aamer...@gmail.com]    
Sent: Tuesday, August 23, 2011 1:46 PM
To: Baro, Enola G
Subject: Re: clarification about where labs are sent

Thanks, I called and asked too. My providers and staff didn't know, so i thought that was the case and wanted to confirm. hope all is well!

On Tue, Aug 23, 2011 at 1:30 PM, Baro, Enola G <Enola....@questdiagnostics.com> wrote:
Aamer,
When you send your electronic order to Quest Diagnostics that order is held in an area that is accessible by all Quest locations within the Sacramento Business unit (Oregon border down to Porterville). Is there some order that brought on this inquiry that needs to be looked at? Let me know.
Enola Baro, ASR
Sent via my Blackberry

From: Aamer Hayat <aamer...@gmail.com>
To: Baro, Enola G; Dr. Unaiza Hayat <uhay...@yahoo.com>
Sent: Tue Aug 23 16:01:41 2011
Subject: clarification about where labs are sent



Hi Enola,
I wanted to clarify something- So if we have a lab request electronically sent to a quest (say quest lab A) and the person accidentally goes to quest lab B, would quest Lab B be able to pull that request through a central database or such? 
Thanks,
--
Regards,
Aamer Hayat
COO
avecinia wellness center



avecinia wellness center is Fresno's premier integrated medical clinic and wellness center. Our mission is to partner with our patients to help them attain their optimal well-being. We do this by integrating the practice of internal medicine/primary care with different, proven health modalities such as health/weight management, acupuncture, massage therapy, aesthetic services and state of the art technology such as our patient portal and electronic health record. To learn more or to make an appointment, visit www.avecinia.com or call us at (559) 450-7299. You can also read our blog: avecinia.blogspot.com, become our fan and/or sign up for our monthly e-newsletter on our facebook page: www.facebook.com/avecinia and follow us on twitter at www.twitter.com/avecinia4health.

------------------------------------------ The contents of this message, together with any attachments, are intended only for the use of the person(s) to which they are addressed and may contain confidential and/or privileged information. Further, any medical information herein is confidential and protected by law. It is unlawful for unauthorized persons to use, review, copy, disclose, or disseminate confidential medical information. If you are not the intended recipient, immediately advise the sender and delete this message and any attachments. Any distribution, or copying of this message, or any attachment, is prohibited.



--
Regards,
Aamer Hayat
COO
avecinia wellness center



avecinia wellness center is Fresno's premier integrated medical clinic and wellness center. Our mission is to partner with our patients to help them attain their optimal well-being. We do this by integrating the practice of internal medicine/primary care with different, proven health modalities such as health/weight management, acupuncture, massage therapy, aesthetic services and state of the art technology such as our patient portal and electronic health record. To learn more or to make an appointment, visit www.avecinia.com or call us at (559) 450-7299. You can also read our blog: avecinia.blogspot.com, become our fan and/or sign up for our monthly e-newsletter on our facebook page: www.facebook.com/avecinia and follow us on twitter at www.twitter.com/avecinia4health.


------------------------------------------
The contents of this message, together with any attachments, are intended only for the use of the person(s) to which they are addressed and may contain confidential and/or privileged information. Further, any medical information herein is confidential and protected by law. It is unlawful for unauthorized persons to use, review, copy, disclose, or disseminate confidential medical information. If you are not the intended recipient, immediately advise the sender and delete this message and any attachments. Any distribution, or copying of this message, or any attachment, is prohibited.



--
Regards,
Aamer Hayat
COO
avecinia wellness center



avecinia wellness center is Fresno's premier integrated medical clinic and wellness center. Our mission is to partner with our patients to help them attain their optimal well-being. We do this by integrating the practice of internal medicine/primary care with different, proven health modalities such as health/weight management, acupuncture, massage therapy, aesthetic services and state of the art technology such as our patient portal and electronic health record. To learn more or to make an appointment, visit www.avecinia.com or call us at (559) 450-7299. You can also read our blog: avecinia.blogspot.com, become our fan and/or sign up for our monthly e-newsletter on our facebook page: www.facebook.com/avecinia and follow us on twitter at www.twitter.com/avecinia4health.

Aamer Hayat

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Sep 22, 2011, 7:09:19 PM9/22/11
to Jonathan Bush, Michael Roy, athenah...@googlegroups.com, VPCD
Hi Jonathan,
Thanks for getting back to me. It's the first clear indication of what is happening.  It also helps us as providers understand the relationships we are involved in. 

To me, it sounds like providers may be able to band together to help Quest understand that it is in their greater good to cover the cost of the interface. Perhaps I can put together a letter showing Quest why it make sense for them (i.e., how many providers are using Athena, are sending or could potentially send lab orders to Quest, etc) to do what it takes to do business with us. From my rep's email, it sounds like they are willing to cover the cost of building an electronic bridge, so why not a true interface?

If I can get the following information, maybe even just for California, then I can create a letter, ask the other Athena users in CA to sign on since it will benefit them as well, and we can send it to them.  
  • Number of California Athena providers
  • Average number of lab orders being sent out by providers
  • Average number being sent to or received back from Quest (do you guys keep track of volume on the uni-directional interface?)

I may not be able to collude with my peers to negotiate better insurance rates, but I should be able to do so with non-insurance providers and hopefully get them to see why it would make economic sense for them to work with us.  

Jonathan, I don't want to keep you tied up in this, I can correspond with Mike or anyone else who may be better suited for this going forward.

Regards,
Aamer

On Wed, Sep 21, 2011 at 5:57 PM, Jonathan Bush <jb...@athenahealth.com> wrote:

We are in a real struggle with Quest right now.

 

We want them to pay for the interface and they want us to charge you.

 

Someone has to pay.

 

Our goal for next year is to cut the cost of clinical to our clients in half by getting interchange fees from entities like quest that benefit tremendously more than you from a bi-directional interface.  They essentially save $8 PER ACESSION!

They have no business not paying so we can cut your rate.

 

If they haven’t agreed by year end, we will simply either a) not cut your rate or b) cut your rate but charge you $1 per accession when you use them but NOT charge you when the hospital lab or others who are more than happy to pay that $1

 

Hope that helps

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