How ECPC is Leveraging LigoLab’s LIS System to Streamline Pathology Lab Workflow and Expand Laboratory Operations

Dr. Elizabeth Rinehart and Dr. Michael Hitchcock are young, talented pathologists who represent a bright future for Eastern Connecticut Pathology Consultants (ECPC), a fast-growing practice that provides pathology services, physician office laboratory management, and advanced diagnostic testing for hospitals, cancer centers, physician office laboratories, and patients throughout southern New England.

Recently, both doctors, along with Kristen Conley, Chief Information Officer at ECPC, shared their experiences from 2020 and 2021: a challenging time that included an aggressive timeline to implement LigoLab's all-in-one laboratory information system (LIS) platform during a global pandemic, while establishing their new normal.

Drawing on insights from Rinehart, Hitchcock, and Conley, this two-part case study illustrates how a team of motivated physicians and laboratory professionals successfully executed a growth strategy and scaled operations with the support of a responsive, business-focused LIS company.

Recap of Part One

In part one of this lab information system case study, we highlighted how ECPC's partnership with LigoLab began quickly after a phone conversation between one of the practice's pathologists and a colleague working at another practice in Colorado. Conley explained that the call couldn't have come at a better time; ECPC was underwhelmed by the usability, flexibility, and responsiveness of other pathology lab management systems offered by leading laboratory information system vendors.

"Before becoming familiar with LigoLab, it felt like whatever decision we were going to make, we would be settling," said Conley, who jumped at the opportunity to learn more about LigoLab’s all-in-one laboratory information system (with the latest laboratory billing solutions embedded within the platform) and began to have discussions with LigoLab’s CEO, Suren Avunjian, in late December of 2019. 

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To read part one of the study, we invite you to click on the link below. You’ll learn how both modern laboratory information system functions and cost alignment positioned LigoLab as the best LIS software for ECPC. You’ll also learn more about ECPC’s LIS system implementation experience and how LigoLab’s innovative and future-ready anatomical pathology software solution helped fuel the expansion plans for this dynamic group of pathologists.

ECPC Case Study, Part 1: Learn How LigoLab’s LIS System Became the Centerpiece of Change for ECPC, a Thriving New England Pathology Practice

Meet Dr. Elizabeth Rinehart and Dr. Michael Hitchcock 

Dr. Elizabeth Rinehart

Dr. Rinehart joined ECPC in the summer of 2017. She earned her medical degree from the University of Kansas School of Medicine. She concluded her residency and fellowship at Harvard's Brigham and Women's Hospital, serving as Chief Resident in Anatomic Pathology during the 2014 academic year. She is board-certified in Anatomic and Clinical Pathology and specializes in gastrointestinal, liver, and pancreaticobiliary pathology.

Dr. Michael Hitchcock

Like Dr. Rinehart, ECPC is also Dr. Hitchcock's first professional home. He is board-certified in Hematopathology and in Anatomic and Clinical Pathology. Dr. Hitchcock received his medical degree from the University of Texas Southwestern Medical Center and completed his residency at Baylor University Medical Center, where he served as Chief Resident. He completed fellowship training at Baylor University Medical School and joined ECPC in July 2017.

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Adapting to COVID-19 in Real Time

During the interview, both doctors reflected on the moment when they fully understood how COVID-19 would affect their personal and professional lives.

"First, there was the anxiety of having a new transmissible infection that was likely to be widespread in a very short amount of time," recalled Hitchcock. "About work, it was a huge shift. First, we all stabilized and tried to individually stay at one site, rather than provide cross-coverage at multiple sites and multiple hospitals."

"We tried to limit ourselves to only one site so that the pathologists weren't potentially cross-contaminating each other," said Rinehart. "By limiting our in-person interactions, we also limited the potential fallout should somebody contract the coronavirus or have to provide care to somebody who had."

Lower Volumes, Higher Learning

As one might expect, anatomic pathology case volumes fell toward the end of March and remained below normal throughout April 2020, but rebounded quickly in the months that followed. For Hitchcock, the brief slowdown created an opportunity for deeper learning.

"I spent an enormous amount of time online going through medical journals, webinars, and other literature searches to learn as much information as possible to help us make informed decisions about testing. At that moment, anatomic pathology was somewhat of an afterthought as clinical pathology went into overdrive," he said.

Thankfully, the pathologists gradually transitioned back to more normal operations, a welcome change for Rinehart, who emphasized that daily interactions with pathologists are critical to providing the best patient care.

"Those interactions are routine, and not just between Mike and me, but with several of our organization's pathologists throughout the day. Our communication often extends beyond patient cases to conversations about scheduling and related topics. Being able to communicate is paramount for our practice, especially with all the different sites and levels of care that we offer."

Getting Up to Speed on LigoLab's Anatomic Pathology LIS Software

In addition to learning about the virus and its implications, both doctors used the period with lower-than-normal volumes to become familiar with LigoLab's anatomic pathology LIS software module, which is embedded within the new laboratory information system ECPC had recently implemented after partnering with the LIS company.

"I started covering Harrington Hospital in March of 2020, right around the time we implemented LigoLab," said Rinehart. "Dr. Aneta Rafalowski had already been trained on the LIS software platform and knew the basics of how to sign out cases. I spent an afternoon with her for training and then worked from home the next two days, gradually learning the nuances of LigoLab and its many applications."

Working from home, Rinehart logged into both LigoLab's training and production environments.

"That allowed me to toy around with creating macros, taking pictures, and creating synoptic tables. I also learned basic keystrokes for creating an addendum, corrections, amendments, and worklists. In terms of being able to sign out cases and utilize my report templates, macros, and things of that nature, I felt pretty comfortable within about a week."

Hitchcock credited Rinehart for helping him get up to speed quickly once volumes recovered.

"It was nice to have a superuser like her," he said. "When I started with LigoLab, our volumes were already picking back up, so it was important for me to get up to speed and sign out cases in a short amount of time."

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How the Laboratory Information System Helped Streamline ECPC’s Lab Workflow

Both doctors agreed that LigoLab's anatomic pathology module and laboratory information system software significantly streamlined their workflows.

Quick Text and Linked Diagnoses Accelerate Sign-Out

"My favorite thing about LigoLab is that I can put in a final diagnosis and it links everything together," said Hitchcock. "It brings in the microscopic description and the comment, and I can do things very quickly. About 40 to 50 percent of my sign-outs are GI cases, and those are very fast, text-heavy, and highly repetitive for me."

"I would agree with Mike in terms of quick texts being very helpful. I, too, like being able to link the quick text from the microscopic description to the report comments," added Rinehart.

Rebounding From the Pandemic With a Clear Plan

As noted, the dip in volumes didn't last long. Hitchcock credited strong laboratory leadership with developing and executing a plan of action.

"We had to decide quickly how we were going to try to get testing back up again, how we were going to triage materials, and how we were going to isolate patients,” he explained. “Once you have a plan and everyone is on board, you can start getting patients back into your facilities. In terms of patient trepidation, there wasn't as much as we would have thought."

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The Future of Anatomic Pathology Software and LIS Systems

Both doctors welcomed the opportunity to look ahead to the future of anatomic pathology, a future that is increasingly molecular-based.

A Molecular Future With Growing Biomarker Demands

"The trends of the last 10 years continue; we get smaller and smaller pieces of tissue, and we try to do more and more," said Hitchcock. "It seems like each month, a new biomarker comes out, and we need to decide whether or not it has clinical implications. Is it useful? How expensive is it to test for? How much tissue will we need to perform that testing? Of course, cancer is the biggest domain where we concentrate the most effort, and that's driving the decisions we make."

Digital Pathology and AI on the Horizon

Hitchcock also pointed to the FDA's emergency use authorization for remote pathology services during COVID-19 as a development worth watching.

"This has allowed us to reimagine how we provide diagnostic services. It has opened the door for a lot of new technology, new workflows, and the potential benefits of digital pathology," he said, while also noting that the use of artificial intelligence to aid pathologists with diagnoses continues to accelerate at a massive rate.

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What’s Great About ECPC

Community-Based With Subspecialty Depth

When asked what they like best about ECPC, both doctors mentioned diversity and important ties to the community.

"We have the private practice aspect while still being community hospital-based, which means we don't feel like we're being siloed off in our lab doing our own thing. We offer a broad array of subspecialty expertise, enabling us to provide quality diagnostic services to our patients. We also work with various physicians' office labs, and by having those relationships with individual physicians and hospital clinicians, we're able to tie everything together," stated Rinehart.

Agility as a Competitive Advantage

"ECPC has had a lot of success and has been going through growth that at times feels exponential, and part of that success comes from being very nimble," continued Hitchcock. "We are not a behemoth in terms of providing pathology services, but we have a strong outreach program with physicians. We can speak with them, find out what they need from us, and adapt accordingly.

"That was a big push for why we wanted LigoLab. Having a modern in-house laboratory information system allows us to respond very quickly to the needs of our clinical colleagues and, in turn, the patients we serve. It also gives the practice an advantage when the hospitals' LIS systems are sunsetting or being replaced due to a lack of future support," he said.

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Continuing ECPC’s Growth and Commitment to Quality

As covered in part one of this series, ECPC has used strong laboratory leadership and its partnership with LigoLab to expand operations and better serve southern New England, all while staying true to its core values. The practice remains committed to a collaborative culture and the delivery of comprehensive, accurate, and timely diagnostic results, while maintaining an unwavering focus on patient care and 24/7 accessibility. 

To learn more about ECPC, visit ecpclab.com.

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Frequently Asked Questions About ECPC's Laboratory Information System Experience and Anatomic Pathology LIS Workflow

How did ECPC manage LIS system implementation during the COVID-19 pandemic?

ECPC went live with LigoLab's laboratory information system at Harrington Hospital in March 2020, just as COVID-19 restrictions were taking effect. The team adapted by shifting to remote support during the pandemic and used the period of lower case volumes to train pathologists on LigoLab's anatomic pathology LIS software. Both Dr. Rinehart and Dr. Hitchcock reached comfortable proficiency within weeks by logging into LigoLab's training and production environments from home.

How did LigoLab's anatomic pathology software improve sign-out efficiency for ECPC's pathologists?

LigoLab's quick text functionality allows pathologists to enter a final diagnosis and automatically link the microscopic description and report comments, significantly reducing repetitive typing. For high-volume, text-heavy specialties such as GI pathology, which accounts for 40 to 50 percent of Dr. Hitchcock's sign-outs, this feature dramatically accelerates throughput without sacrificing accuracy.

What features did Dr. Rinehart use during her initial training on LigoLab?

Dr. Rinehart used LigoLab's training and production environments to practice creating macros, photomicrographs, and synoptic tables, as well as keystrokes for addenda, corrections, amendments, and worklists. She reported feeling comfortable with core sign-out functions, report templates, and macros within approximately one week of training.

What role does daily pathologist communication play at ECPC?

Dr. Rinehart emphasized that daily communication among ECPC's pathologists is essential to providing the best patient care, covering not only case consultations but also logistical coordination across multiple facilities. LigoLab's unified medical LIS platform supports this by giving all users access to the same real-time case data across sites, reducing the communication gaps that can arise in fragmented multi-location environments.

How does LigoLab give ECPC a competitive advantage when hospital LIS systems sunset?

Dr. Hitchcock noted that having a modern in-house laboratory information system allows ECPC to respond quickly to the needs of clinical colleagues and patients, and gives the practice a strategic advantage when hospitals' LIS systems are being replaced due to a lack of future support. ECPC can step in as a capable, technology-forward partner with a reliable, fully integrated platform already in place.

What does the future of anatomic pathology look like according to ECPC's pathologists?

Both Dr. Rinehart and Dr. Hitchcock envision a future for anatomic pathology that is increasingly shaped by molecular testing, driven by smaller tissue specimens, a growing number of clinically relevant biomarkers, and the expanding adoption of digital pathology and AI-enabled diagnostic tools. They also believe the FDA's emergency use authorization for remote pathology during the COVID-19 pandemic helped accelerate innovation by creating new opportunities to rethink how diagnostic services are delivered and how pathologists can leverage AI to enhance clinical decision-making. 

What makes ECPC's culture and practice model distinctive?

ECPC combines the flexibility and accessibility of a private practice with the community hospital relationships and subspecialty depth of a larger group. Its pathologists are known for being nimble, responsive to clinical colleagues, and committed to delivering accurate, timely results across a wide range of diagnostic disciplines. The practice's ability to listen to clients and adapt quickly has been a key driver of its exponential growth in southern New England.