by
Gus Iversen, Editor in Chief | February 27, 2015
From the January/February 2015 issue of HealthCare Business News magazine
Meanwhile, pathology services are emerging that focus on gastroenterology practices. “Big lab players like Quest, Sonic Healthcare, the big national laboratories; they do everything from blood samples, urine samples, hair samples, dermatology samples, and so on,” says Ladd. “As a gastroenterologist, do you want someone evaluating your GI specimen who just reviewed a scalp sample? Or do you want that being looked at by an expert pathologist who has spent the entire day looking at gastro slides?” says Ladd. Lewis credits new quality-assurance databases and information technology advancements with establishing more thorough and effective care standards.
He says a doctor should spend at least six minutes conducting a colon exam because shorter exams are proven to yield fewer polyps and adenomas, and those detection rates are part of the data being collected. Lower polyp detection rates are shown to lead to a high interval colon cancer rate.
“In New York, the Department of Health sends out quarterly reports benchmarking where you stand,” says Lewis. They are evaluating doctors on a number of things: “Ten-year recall numbers, adenoma detection rates, examination time, completeness of exam, and quality of exam,” he says. “Screening every ten years helps wipe out 80 percent of colon cancer deaths,” says Lewis, but over-screening can lead to unnecessary expenses. It has been shown that many doctors do not follow national guidelines and that excessive screening can be a costly problem in its own right.
“The only exceptions are if you find polyps or there is high risk, or colon cancer in the family,” says Lewis, which would indicate the need for more frequent screenings. There are also new quality measures that make doctors responsible for their patient’s prep, which in previous years had not been the case. If a patient shows up for a colonscopy but they haven’t been properly prepped, (usually with a liquid diet or something to clear the bowel) then time and money are wasted.
“The cleansing of the bowel before the procedure is important because if it’s not effective then it’s hard to see lesions in the colon,” says Philip Doyle, director of marketing, gastroenterology at Olympus, who anticipates preparation becoming an increasingly important topic in coming years.
According to Lewis, this emphasis on prep has opened the door to a new kind of third-party business that helps patients along that process. “They call, text, or e-mail the patient several times leading up to the exam to make sure they’re following directions,” he says.
