Case Study
How ECPC is Leveraging LigoLab LIS to Streamline Pathology Workflows and Expand Laboratory Operations
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May 13, 2021
Dr. Elizabeth Rinehart and Dr. Michael Hitchcock are young, talented pathologists and they represent a bright future for Eastern Connecticut Pathology Consultants (ECPC), a diverse and 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, Director of IT and Business Development at ECPC, shared what they’ve experienced over the last year -- a challenging year that included an aggressive timeline to implement LigoLab’s LIS platform during a global pandemic and while establishing their “new normal.”
We’ve compiled what we learned from Dr. Rinehart, Dr. Hitchcock, and Conley into a two-part case study that demonstrates how to effectively execute a business plan and scale laboratory operations with a group of highly motivated physicians and laboratory professionals with the support of a responsive and business-savvy software vendor – LigoLab.
Last month, in part one of the study, we highlighted how ECPC’s partnership with LigoLab quickly commenced thanks to a phone conversation between one of the practice’s pathologists and a colleague working at another practice in Colorado. In part one, Conley explained how the call couldn’t have come at a better time. ECPC was underwhelmed by the usability, flexibility, and responsiveness of other LIS systems in the marketplace.
“Prior to 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 and began to have discussions with LigoLab’s CEO Suren Avunjian in late December of 2019.
To read part one of the study, please click on the link below. There you’ll learn how functionality and cost made LigoLab the right choice for ECPC. You’ll also learn more about their implementation experience, and how LigoLab’s innovative and future-ready solutions have helped fuel expansion plans for this dynamic group of pathologists.
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In part two of the study, we’ll focus on the shared experiences of Dr. Rinehart and Dr. Hitchcock as they transitioned to the LigoLab platform and adjusted to a new and uncertain work environment due to COVID-19. We’ll also learn about their first impressions of the software and what elements of LigoLab’s platform are helping them provide superior diagnostic patient care in a more streamlined manner with improved turnaround times. Lastly, we’ll get their thoughts on the future of Anatomic Pathology and what makes them proud to call ECPC their work home.
Dr. Rinehart began her career at ECPC in the summer of 2017. She received her medical degree from the University of Kansas School of Medicine and completed her residency and fellowship training at Harvard’s Brigham and Women’s Hospital, where she was Chief Resident in Anatomic Pathology during the 2014 academic year. She is board-certified in Anatomic and Clinical Pathology with subspecialty expertise in gastrointestinal, liver, and pancreaticobiliary pathology.
Like Dr. Rinehart, ECPC is the first professional practice for Dr. Hitchcock. Dr. Hitchcock is board-certified in Hematopathology as well as Anatomic and Clinical Pathology. He received his medical degree from the University of Texas Southwestern Medical Center and completed his residency at Baylor University Medical Center, where he also served as Chief Resident. After his fellowship training at Baylor University Medical School, Dr. Hitchcock joined ECPC in July of 2017.
During our recent interview, both doctors reflected on the past year, particularly when they first realized the effects COVID-19 was potentially going to have on 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 Dr. Hitchcock. “In relation to 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 Dr. 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.”
As one might expect, AP volumes fell toward the end of March and stayed below normal for all of April 2020 but the numbers rebounded quickly in the months that followed. For Dr. Hitchcock, this allowed him to educate himself about the virus.
“As all this was happening, questions arose rapidly because everybody was trying to get as much information as they could about the new virus,” he said. “I, for one, 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.”
Recently, the pathologists have moved toward more normal operations, enabling Dr. Rinehart and her colleagues to once again cover multiple sites.
“Today as we speak, I'm in a private physician office lab with three other pathologists. We’re still using the same precautions like masking, distancing, and not gathering in the hallways, but for the most part, we’re pretty much back to normal,” she said.
More normal operations are a welcome change for Dr. Rinehart, who said that daily interactions among pathologists are critical to providing the best patient care.
“Those interactions are routine, and not just between Mike and myself, but with several of our organization’s pathologists throughout the day. Our communication often goes beyond patient cases into logistical conversations about scheduling and things of that nature,” said Rinehart. “Being able to communicate is paramount for our practice, especially with all the different sites and all the different levels of care that we offer. The degree of communication between doctors is quite broad and it occurs every day.”
In addition to learning more about the virus and its implications related to testing, both doctors also utilized the brief period with lower than normal volumes to become familiar with LigoLab LIS, a new laboratory information system that ECPC had recently implemented.
“I started covering Harrington Hospital in March of 2020 right around the time we implemented LigoLab,” said Dr. Rinehart. “Dr. Aneta Rafalowski had already been trained on the 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 the many applications of the software.”
While working from home, Dr. Rinehart was able to log in to LigoLab’s training and production environments.
“That allowed me to toy around with creating macros, taking pictures, and creating synoptic tables. I also was able to learn basic keystrokes for creating an addendum as well as many other tasks (e.g. corrections, amendments, creating worklists). I spent those days learning while also trying to stay current with the coronavirus and CDC guidelines and recommendations,” she said. “There is still some degree of learning that’s taking place, but 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.”
Dr. Hitchcock said it didn’t take him long to develop a comfort level with the elements of the software he relies on daily, and he thanked Dr. Rinehart for making that possible.
“It was nice to have a superuser like Dr. Rinehart,” 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.”
Dr. Hitchcock also acknowledged that the LigoLab platform is feature-rich and that there is still more for him to learn. He referenced better quick text organization and using the worklists more powerfully as areas where he would like to become more proficient.
Both doctors agreed that the platform has helped to streamline their workflows.
“My favorite thing about LigoLab is that I can put in a final diagnosis and it links everything together,” said Dr. Hitchcock. “It brings in the microscopic description and the comment, and I can do things very quickly. Roughly 40-to-50 percent of my sign-outs are GI (gastrointestinal) cases, and for me, that is very quick text-driven with a lot of repetition.”
“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,” said Dr. Rinehart.
As noted earlier, the dip in volumes didn’t last long. Dr. Hitchcock credited strong laboratory leadership with developing a plan of action and then executing the plan.
“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 said. “Once you have a plan and everyone is on board, then you can start to get patients back into your facilities. In terms of patient trepidation, there wasn’t as much as we would have thought.”
Now, with vaccines readily available and COVID-19 cases declining within their region, both doctors welcomed the opportunity to look into the future of AP, a future that’s progressively becoming molecular-based.
“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 Dr. 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 are we going to 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.”
Dr. Hitchcock also mentioned the FDA response to COVID-19, with the agency greenlighting emergency use authorization for providing pathology services remotely, as something to keep an eye on.
“This has allowed us to reimagine how we provide diagnostic services and has opened the door for a lot of new technology, new workflows, and the potential for digital pathology,” said Dr. Hitchcock, who also noted that the use of artificial intelligence to aid pathologists with their diagnoses continues to accelerate at a massive rate.
When asked about 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 have a broad array of subspecialty expertise which allows us to provide quality diagnostic services to our patients. We also work with various physician office labs and by having those relationships with individual physicians and hospital clinicians, we’re able to tie everything together,” said Dr. Rinehart.
“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 Dr. Hitchcock. “We are not a behemoth in terms of providing pathology services, but we have a strong outreach program with physicians. We're able to talk with them, find out what they need from us, and then adapt to their needs.”
“That was a big push for why we wanted LigoLab. Having our own laboratory information system (LIS) allows us to respond very quickly to the needs of our clinical colleagues, and thus the patients we serve,” he said. “It also gives the practice an advantage when the hospitals’ AP LISs’ are being sunsetted or replaced due to lack of future support.”
As we documented in part one of this series, ECPC has leveraged its laboratory leadership and its partnership with LigoLab to expand operations and better serve southern New England while still adhering to the core values of the practice – a collaborative approach to providing comprehensive, understandable, accurate, and rapid results with an absolute dedication to patient care and 24/7 accessibility. To learn more about ECPC, visit ecpclab.com or contactus@ecpclab.com.
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