P12158 - Quest WIDESCREEN GRAPHIC 16x9 Template...

Rasaun Robinson Vice President of Sales, CNECT

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CNECT COVID-19 Newsletter

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Dr. Lee Hilborne, MD, MPHSenior Medical Director, Medical Affairs,

Quest Diagnostics

James MoranNational Clinical Informatics Executive,

Quest Diagnostics Information Ventures

Erin MonteverdiExecutive Director,


Karen HamlinExecutive Sales Director,

Southern California & Nevada

Jennifer BarnwellHospital Strategy Advisor,


1 Confidential—For Internal Use Only

QUEST DIAGNOSTICS

COVID-19 TESTINGKaren Hamlin

Executive Sales Director

Southern California & Nevada

UPDATED 9.23.20


COVID-19: Quest Diagnostics key milestones

World Health Organization declares COVID-19 a public health emergency of international concern

JANUARY 30

FEBRUARY 29

FDA announces independent labs can begin COVID-19 testing while pending Emergency Use Authorization (EUA) approval

Quest Diagnostics launches COVID-19 test, begins performing our lab-developed test (LDT) in QDID lab in CA. Scales up test services nationally on March 10 to serve growing demand.

MARCH 9

MARCH 11

World Health Organization (WHO) publicly characterizes COVID-19 as a pandemic

Quest continues to raise testing capacity by expanding locations to perform our lab-developed test (LDT) and releases a high-throughput test (from Roche)

Quest receives EUA for LDT

MARCH 16-20

!!

APRIL 21

Quest releases an IgG antibody test

Test Code

MAY 27

Quest granted EUA for anterior nares nasal swab self collection kits for molecular testing

39504

JULY 18

Quest granted EUA to use specimen pooling for lab developed test


Quest Diagnostics COVID-19 testing figures

0

50,000

100,000

150,000

200,000

250,000

COVID 19 Diagnostic (Molecular) Teststest capacity ramp up3

TEST CAPACITY PER DAY AVERAGE TURN AROUND TIME (IN DAYS)2

200,000Diagnostic (Molecular)

200,000Antibody (Serology)

1priority patients

1 - 2all patients

2all patients

Diagnostic (Molecular) Antibody (Serology)

1. Total performed and reported numbers of tests coincide with the most recent weekly total for a given month, as provided in media statements on newsroom.questdiagnostics.com/CovidTestingUpdates

2. Priority patients include hospitalized patients, individuals in long-term care facilities(such as nursing homes) and pre-surgical patients

3. Total capacity coincides with month-end totals as provided in media statements on newsroom.questdiagnostics.com/CovidTestingUpdates


COVID-19 TESTING

what’s coming next

Pending required approvals

Antigen

testing

COVID/

Respiratory

Virus Panel

COVID

molecular

saliva testing

Serology

IgG + IgM

Serology IgG

semi Quant


Easy online ordering within Quanum® Lab Services Manager or using your own EHR

Supporting telemedicine

Elvi Platform IntegrationSecure provider-to-patient video conferencing platform

PSC hold option lets patients get lab testing at any of our 2200+ Patient Service Centers (PSCs) nationally, without needing to transfer the order manually

September 29, 2020

Improving patient care through

better laboratory utilization

Agenda

Lab Stewardship Case Study / Advisory Services – Jennifer Barnwell

Closing Comments – Erin Monteverdi

Quest Lab Stewardship Overview & Live Demo – James Moran 1


4

3

2

Medical Engagement – Dr. Lee Hilborne

Q&A5


Drivers and potential impact of test overutilizationa

20.6%Overutilization Mean Rate.1

1. Zhi M, Ding EL, Theisen-Toupal J et al. The landscape of inappropriate laboratory testing: a 15-year meta-analysis. Plos One. 2013;8:e78962.


Drivers and potential impact of test overutilizationa

• Ordering tests as groups

• Defensive diagnostics

• Patient pressure

• Repetitive or daily test orders

Drivers Impact

• Incorrect diagnoses,

increased costs,

adverse outcomes,

and patient

dissatisfaction

rate of OVER-utilization1

20.6%

Prevalence

a The term "overutilization" refers to testing ordered for a patient whose symptoms and/or condition may not support the need for the testing under generally accepted

third-party clinical guidelines. Quest's identification of potential overutilization is intended as a guide to assist providers in identifying potentially problematic ordering

patterns and is not intended to replace a treating provider’s medical judgement, based upon evaluation of the patient.

Our approach to

Lab Stewardship

Collaborative solutions that provide

clinical and financial insights that

can lead to laboratory optimization

• Insightful analytics

• Expert, strategic perspective

• Analytic process based on years

of expertise

• Robust, comprehensive data


11

Proven solution

Powerful platform

Extensibility

Working with partners and customers to turn data into value

Medical expertise

Quality lab testing

National scale

“Working with hc1, we've created a solution that overcomes

several of the traditional barriers to delivering real-time

enterprise insights needed to drive and support at-scale

optimization of lab testing.”

Confidential—For Internal Use Only

David Freeman,

General Manager, Information Ventures,Quest Diagnostics

“This strategic collaboration between hc1 and Quest

brings an innovative solution to progressive health systems

that are committed to improving patientcare and

bringingdown costs.”

Brad Bostic,

Chairman and CEO, hc1

12

Lab Stewardship is an opportunity to provide optimal information to clinicians in order to improve the quality of patient care while reducing costs to patients and your organization

Quest Lab Stewardship is an opportunity

Save Money

(Do More with Less)

Control Clinical

Variation

Reduce Unnecessary

Lab Testing

Do the righttest...

Confidential—For Internal Use Only

at the right time… at the right point of care...on the rightpatient... at the right price.

Go beyond basic reports with Quest Lab Stewardship

MonitorHigh-volume and high-cost

testing from every location

Assesstrends that impact the cost

and quality of patient care

Recommendthe most appropriate1 tests

By going beyond basic reports, this solution empowers physicians, lab

administrators and medical leadership with actionable insights to drive targeted

improvements in overall test utilization, clinical care variation and patient

care.

Simplify your labdata

Understand your lab utilization

Bolster high-value care initiatives

Be proactive with real-time monitoring

Apply medical laboratory guidelines

1. The term "appropriate" refers to testing that is consistent w ith applicable third-party guidelines. Quest Diagnostics

identification of potential appropriate testing is intended as a guide to assist providers in identifying ordering patterns

recommended by applicable third-party guidelines and is not intended to replace a treating provider’s medical judgment, based

upon evaluation of the patient.



1. The term "inappropriate" refers to testing that is inconsistent with applicable third-party guidelines. Quest Diagnostics identification of potential inappropriate testing is intended as a guide to assist providers in identifying potentially problematic ordering patterns and is not intended to replace a treating provider’s medical judgment, based upon evaluation of the patient.

Evidence-based medical laboratory guidelines sourced by clinical societies, which can be customized to meet your needs


Demo of Quest Lab Stewardship Reference Platform


Leveraging our expertise through Advisory Services

Medical experts leading the way in Lab Stewardship

Lab stewardship

consultants

600+ MDs, PhDs,

genetic counselors

and Hospital

Strategy Advisors

Lee Hilborne

MD, MPH

Harvey W. Kaufman

MD, MBA, FCAP

Steven B. Keiles

MS, LCGC

Senior Medical

Director, Medical

Affairs

Senior Medical

Director

Medical Informatics

Senior Director

Genetic Counseling

Services

Delivering more impact

Quest Lab Stewardship


Putting Lab Stewardship Into Practice with Signature Health

FQHC customer details

• 160 + Providers

• 3 specialties

• Six locations

• Two independent EMRs

Identified opportunities

• Establish a LS governance

committee

• Improve visibility, utilization,

and standardization around

lab testing

• Eliminate duplicate orders

• Review internal processes for

ordering in two disparate EMRs

• Communication

The approach

• Leverage LS governance

committee to oversee

interventions, changes and

sustain optimizations

• Analyze current data for trends

• Identify alternative

ordering options

• Normalize test codes

• Feedback loop to modify

ordering behavior and reduce

clinical variation

Worked to understand key priorities

Assess and monitor trends Drive continuous improvement

A large Federally Qualified Health Center in Northeast Ohio


Project - Thyroid testing, review of ordering patterns

ASCP, Choosing Wisely: Don’t order multiple tests in the initial evaluation of suspected thyroid disease. Order TSH. If abnormal, follow up with additional evaluation or treatment depending on the finding.

• Reviewed prior year

data

• Patient data review

showed clinical

variation for thyroid

testing

• LS Governance Team

review

• Test Menu update

proposed

• Communication to

providers and sign-off


Thyroid ordering pattern review – the results

Lab Stewardship focused impact to controlling clinical variation

• Updated the Test Menu

• Ensured EMRs were

configured

• Communication was

distributed and posted

by computers

• Continuous review –

Plan, Do, Check, Act

• Clinical variation

reduction ~ 49%!FOCUS-Design PDCA Cycle


“We’ve Learned A Lot From Our Initial Endeavors.

It’s when you are able to share data insights that you get people’s attention.

Understanding the larger scale impact of day-to-day clinical work can empower clinicians to make necessary changes.”

- Dr. Sarah Hoehnen, Medical Director

of Infectious Disease, Signature

Health

Delivery of evidence-based feedback to

physicians to help modify behavior and reduce

clinical variation

A normalized test menu to ensure

standardization of care and more effective

reporting of outcomes

Insights and data that helped Signature Health

meet their clinical objectives and Key

Performance Indicators

Enhanced understanding of their patient

population and the testing needed

Together we can ensure the right test for the

right patient at the right time at the right point

of care – at the right price

Results



Lee Hilborne, MD, MPH

Sr. National Medical Director, Quest Diagnostics

Professor of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA

Chair, ASCP Effective Test Utilization Subcommittee

For the past eight years Dr. Hilborne has been a member of Venice Family Clinic’s Medical Practice committee.

Served as a member of the ASCP Board of Directors for 18 years and was president from 2007-2008.


Erin Monteverdi

Executive Director, Information Ventures

Executive Director, Information Ventures -Analytics Portfolio supporting Health Systems, ACOs, FQHCs, IPAs, and Large Provider Group market segments for Quest Diagnostics

32 years with Quest Diagnostics

More than 20 years of experience driving technology and analytics innovations.


Thank You

(800) 640-1662 [email protected]

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