Quest Diagnostics' CIO Drives Business ValueBy Peter High
Quest Diagnostics' CIO Drives Business Value
Quest Diagnostics is a $7.5 billion company with 43,000 employees providing diagnostic information services. It focuses on a wide menu of medical testing and diagnostics on a national scale. CIO Lidia Fonseca is responsible not only for typical IT functions, but also for creating and developing many of the company's client-facing systems, connectivity products, and analytics and informatics solutions in partnership with Quest's strategy, Information Ventures and other internal teams. This includes bioinformatics—the clinical annotation and reporting service for next-generation sequencing and advanced diagnostics. She is also executive sponsor for Quest's business transformation program. She recently spoke with CIO Insight contributor Peter High about these issues.
Peter High: You are responsible for traditional IT, along with client-facing solutions and business transformation. What about you and your team lent itself well to the expansion of responsibilities into these nontraditional areas?
Lidia Fonseca: Part of the reason I joined Quest was to drive standardization. The company traditionally had more of a regional model for processes and technology. Healthcare IT has been a growing enabler for our customers, giving us an opportunity to provide solutions and interact directly.
We showed an interest in partnering with operations, our clinical franchises and our commercial team, and set up a structure enabling us to do that. We forged partnerships and collaborated closely with strategy, operations, commercial, medical teams and clinical franchises. This collaboration across the enterprise is critical, so that a CIO or IT organization can transcend being considered back-office and start to enable the front end, which is where the growth and client-facing pieces are.
High: The company has strategic imperatives, which you define as accelerating growth and driving operational excellence. Traditional IT departments might be more focused on the latter. What are some examples of how you and your team engage in each.
Fonseca: I start with driving operational excellence, a strategy we support in a number of ways. One is standardization. We’re moving all of our sites toward standard platforms for laboratory and billing, common instruments in our laboratories and a common test directory.
For example, in 2014 we started a multiyear effort standardizing our platform, Q Suite. We completed four sites in 2015 and three in 2016, increasing the test orders flowing through the platform from 65 to 80 percent in two years. We can now set up new customers faster, speed up specimen processing in our laboratories and move work around our laboratory network. We plan to complete all of our sites. This standardization both drives efficiencies and benefits our customers.
The customer experience is also enhanced by the digital enablement of our operational and billing processes. In 2016, we launched electronic check-in capability, whereby patients check in using an iPad kiosk. If they don’t have an appointment, they see where they are in the queue. The phlebotomist can see how many patients are waiting, how many have appointments or are walk-ins.
Monitors in the patient service center provide information about our services, present marketing or digital messages and allow patients to see if there is a shorter wait time at a nearby facility. Making this process digital creates a better experience for our patients and employees. We perform testing for one in three American adults each year, so a tremendous number of people benefit from these enhancements.
Another area in digital enablement is real-time payment adjudication. We collect payments for patients across our network and instead of saying, “We’d like to collect your credit card information, but we do not know exactly how much you owe,” we can ping the payer’s system directly so there is certainty about the patient’s responsibility. For the three payers for whom we have enabled this capability, collections have risen by double digits. We’ll continue to roll this out.
This year we’ll introduce a patient preregistration service. Typically, when a patient comes to a patient service center, it is a 15-minute interaction. Preregistration translates to significant savings because we’ve collected what we need, informed patients of their responsibility and saved them time.
Another example is our partnership with Safeway. In 2016 we opened 50 clinics in Safeway stores, with new equipment and technology. Patients have easier access, easier parking, can multitask by shopping, and can get something to eat or drink if they’ve been fasting. The reviews from patients, phlebotomists and Safeway have all been very positive.
High: What is IT doing to support Quest's accelerated growth strategy?
Fonseca: We focus on numerous strategic areas. One is recognizing the importance of creative strategic acquisitions and supporting the integration process. The merger and acquisition team is in the lead, but the functional groups—operations, commercial, technology and data teams—are involved in due diligence and in developing strategies before the acquisition and later integrating that acquisition as quickly as possible so we can deliver on the goals.
Quest Diagnostics' CIO Drives Business Value
Another facet is partnering with big hospital health systems and other risk-bearing entities in various business combinations. In many cases, hospitals need us to conduct advanced tests that require special technology and expertise. They leverage our technology through connectivity, our test directory, and our analytics and reporting capabilities to help them deliver appropriate, cost-effective testing.
The third strategy is offering broad access to diagnostic innovation, such as in our partnership with Memorial Sloan Kettering and IBM. We help oncologists identify potential treatments and clinical trials for patients based on sequencing of a tumor's genomic profile.
Another example is bioinformatics—the intersection of molecular biology, software engineering and informatics. The pattern is first to capture information—such as sequencing the genome or identifying a patient's condition or stage of a disease—then use the bioinformatics and clinical annotations to help physicians decide the best steps to take in patient care.
The fourth area in our growth strategy is to be recognized as a consumer-friendly provider of diagnostic information services. Consumers are becoming more actively involved in managing their health, and some states now allow patient-initiated testing.
We currently have four million consumers interacting with us through the MyQuest application portal and mobile app to access results online, make appointments, pay bills, access a historical report of all their encounters with Quest, and engage in patient-initiated testing. We’re also working with consumer-focused companies, such as Ancestry, to be their behind-the-scenes provider of testing.
We also work with franchise partners and external innovative companies to design products and services that help organizations maximize insights from lab and other health data. For example, we offer Quanum Data Diagnostics, an analytics solution, jointly with Inovalon. Doctors can access real-time analysis that shows things such as gaps in care relative to performance measures and how to align coding the patient's care with value-based models on which reimbursement is increasingly based.
Because of Quest's IT connectivity with nearly 600 electronic health records platforms, physicians can likely access the solution in their existing EHR platforms and workflows—a huge advantage. Another example is Quanum Population Health, which gives a large client the ability to benchmark the performance of their sites, as well as the individual providers. Other services include integrating the payer's preauthorization guidelines at the point of ordering to ensure that testing is in line with clinical guidelines and medical necessity. We will continue to provide the analytics that incorporate decision support in the areas of clinical, operations, and reimbursement.
High: How do you think about talent management from an IT perspective?
Fonseca: When we launched our Quest Quanum portfolio, we considered all our offerings as being in one of three buckets. One, helping customers analyze information. Two, helping our clients (patients, providers, health systems, payers) interact and connect with us. And three, engagement, which differs depending on whether we’re presenting information to patients, a payer, a hospital or health system.
Looking at these buckets aligns the talent we are looking for. Roles in analytics—such as data storage, data scientists and data architects—have expanded, but also narrowed as we look for more specialized expertise.
We also develop software flexible enough to be applied across different channels. Through interacting with customers, we realize that what people do on their tablet differs from what they do on their mobile device or laptop.
The developers and architects we hire take a more agile approach and are comfortable with not knowing all the requirements from the get-go. But they can put an experience in front of a client, user, consumer or provider, get feedback, and then iterate that design or experience. That talent base has evolved as we realized what the user is actually doing with us.
Another area that continues to develop is security. The developers not only conduct unit testing, but also use new technologies that enable them to do some security testing up front. When we look for talent, we look for developers who have a mindset to develop and test the code before they hand it down the software lifecycle development process.