ARUP Laboratories improves quality of care by offering patients and physicians answers to their laboratory test questions. Amanda Barber reports.

Over the past 20 years, ARUP (Associated Regional and University Pathologists) Laboratories, a Utah-based laboratory testing facility, has launched services and technology suites that support its goal—to assist clients by streamlining information flow and enhancing outreach services.

The administration found an opportunity to put that expertise on the Internet with its newest service, ARUP Consult. ARUP previously used its Guide to Clinical Laboratory Testing, an 800-page text available in print and on the Web, for the same purpose. Consult, a free service released in September, was a variation on this theme.

“We redesigned the Web site, reorganized, and reedited the contents to specifically target it to ordering physicians, not only to laboratories,” said Jackson. “Consult answers the questions about when to use a particular laboratory test and how to interpret the results.”

Physicians have access to thousands of laboratory tests, and the science behind those tests changes almost daily. Consult was developed to help keep physicians current. Jackson said before Consult there were few such resources available to physicians.

“There are resources that physicians can purchase from some medical publishers, but in terms of a resource from an academic institution that covers the entire breadth of esoteric lab testing, there hasn’t been anything like that out there,” he said.

Dr. Carl Kjeldsberg, CEO and chairman of ARUP, said the tool will save physicians time, but that isn’t the most vital aspect. “More importantly, they will order the right test the first time.”

Reaching out
A few months before releasing Consult, ARUP released its total outreach service program, ARUP Direct. Nancy Andes, SVP director of marketing for ARUP, said the Direct suite was developed to streamline the outreach process by providing hospitals the necessary tools and education.

“A part of ARUP’s mission is to drive laboratory testing down to the community level and then to support their efforts,” said Andes. “Many of our clients needed assistance with market research, developing business plans and marketing materials to sell their outreach programs, and building sufficient client services. Direct offers solutions to each of those problems.”

Direct’s second tier of services came from a need to keep hospitals connected to physicians. To compete with large reference laboratories, hospitals need to have connectivity to physicians to order and receive results. The company partnered with Atlas Medical, a medical software company, to provide a connectivity solution.

“Atlas Medical provides the engine to help our clients connect and interface with their physicians,” said Andes. “The software also helps with medical records and billing.”

Additionally, Direct teaches ARUP’s clientele how to develop networks and negotiate managed care contracts. Because ARUP provides tests to hospitals and not directly to physicians, the company is not part of the managed care arena. To add this service to Direct, the company partnered with MedNet, a management-consulting firm based in Michigan.

“Our consultative services have been in process for eight or nine years, but the total integrated program was developed and launched right before Consult,” said Andes.

A closer look
Another of ARUP’s services, ARUP ATOP (Analyzing Test Ordering Patterns), was developed in the late ’90s by the company’s chief medical officer, Dr. Edward Ashwood, in response to an increase in questionable laboratory tests ordered by hospitals. “There is evidence in the pathology literature that a substantial minority of laboratory test orders are unnecessary,” said Jackson. “Either the wrong test was ordered or better tests were available.”

ATOP analyzes the total volume of test orders coming from a hospital to identify areas in which physicians could benefit from additional education. Although the circumstances of each hospital are different, Jackson said one of ARUP’s Atlanta-based customers has saved thousands of dollars since completing an ATOP analysis.

“We identified that they were ordering 95% of ARUP’s volume of a whole-blood drug screening test that they could do with urine,” said Jackson. “Their pathologists tracked the root cause to a misunderstanding between the hospital and its transplant service. Since revising the transplant service protocols, our client has saved approximately $50,000 a year in testing.”

Although those test orders would have gone to ARUP, the staff at ARUP does not view the result as a loss. Instead, they view it as a point that strengthens their relationship with their clients. “We knew this meant less business for us, but it was only a portion of the business that client sent to us,” said Jackson. “This was a big win for us because it strengthened our relationship with our client and spread the word to other clients that we are here to support them.”