Abhinav Shah: Innovating Outpatient Lab Testing and Lab Spend Reduction

Abhinav Shah: Innovating Outpatient Lab Testing and Lab Spend Reduction

In the ever-evolving landscape of healthcare, optimizing efficiency and reducing costs without compromising quality are critical objectives. Outpatient lab testing, a vital component of medical diagnosis and treatment, often contributes to a significant portion of healthcare expenditure. The need to streamline this process and minimize lab spend has led to the development of innovative solutions. One such visionary in this field is Abhinav Shah, a highly accomplished principal software engineer.

Abhinav Shah possesses a wealth of experience and expertise in software development, spanning an impressive 17 years. Throughout his career, he has demonstrated a versatile skill set, working across a broad range of systems, including server, web, mobile, and embedded technologies. This diverse background has contributed to his deep understanding of the intricacies involved in developing comprehensive software solutions.

However, it is Abhinav Shah’s remarkable achievements and contributions to the healthcare industry that set him apart. Notably, he spearheaded the creation of a groundbreaking technology platform for Beacon Laboratory Benefits Solutions. This platform, built under his leadership, has emerged as a game-changer, enabling healthcare providers to drive quality improvement while significantly reducing lab spend by up to 20% in outpatient lab testing.

Abhinav Shah’s ability to conceive and develop such innovative solutions showcases his exceptional talent for addressing real-world challenges. The technology platform for Beacon Laboratory Benefits Solutions has revolutionized how laboratory testing is managed, creating a transformative impact on the healthcare landscape. By leveraging advanced technologies and meticulous design, Abhinav has empowered healthcare organizations to optimize their operations, resulting in improved patient care and substantial cost savings.

The significance of Abhinav’s work is further amplified by the practical implications of Beacon Laboratory Benefits Solutions. With the platform in place, healthcare providers gain access to a comprehensive suite of tools that effectively drive quality and reduce lab spend. This remarkable achievement has earned Abhinav recognition as a visionary leader in the field, as his technology platform continues to empower healthcare organizations worldwide.

To delve deeper into Abhinav Shah’s innovative creation, we have the privilege of interviewing him. Our aim is to gain invaluable insights into the technological intricacies behind Beacon Laboratory Benefits Solutions, uncover the challenges encountered during its development, and understand the future trajectory of this groundbreaking platform. By exploring the mindset and expertise of Abhinav Shah, we can further appreciate the profound impact his work has made on the healthcare industry.

Hello, Abhinav! Can you walk us through the process of how you developed the technology platform for Beacon Laboratory Benefits Solutions? What challenges did you face and how did you overcome them?

The initial step was to develop the technology for a decision support system. In collaboration with scientists, we compiled a catalogue of health conditions and symptoms, and linked these to lab tests that could potentially diagnose those conditions. I then designed a system capable of deducing, through a series of questions and answers, which lab tests would be most effective in diagnosing a patient’s health condition.

The most significant challenge was accurately predicting the lab tests that would be most beneficial for diagnosis. We resolved this issue through a combination of AI and a vast dataset that we amassed by working closely with scientists.

The subsequent step involved constructing a prior authorization system that integrated a patient’s insurance with outpatient labs to secure prior authorization for lab tests. The main hurdle here was the fact that each outpatient lab operates its own bespoke system. As a result, we had to invest many weeks and days to address integration issues in order to reliably obtain prior authorization from an array of providers.

How did you identify the need for a solution like Beacon Laboratory Benefits Solutions? What was the driving force behind its development?

Effective management of lab benefits is crucial for payers, hospitals, and health systems in today’s healthcare industry. Even though lab testing makes up less than 3% of total healthcare spending in the US, it accounts for the highest volume of medical care activities. According to estimates, around 4-5 billion lab tests were conducted in 2017, and their total cost was approximately $113 billion.

Healthcare payers and providers are facing various challenges related to lab testing, such as increasing lab expenses, incorporating lab data into pay-for-performance approaches, and monitoring quality metrics. The outcomes of these tests affect around 70% of a patient’s diagnosis and treatment decisions. Therefore, it’s crucial to utilize lab testing appropriately to enhance patient outcomes and control expenses.

The rapid increase in lab test utilization has led to concerns about inappropriate testing, including both over-testing and under-testing. Although it’s commonly believed that repeat and redundant tests contribute to this issue, a recent study found that almost 44% of initial tests are inappropriate. This could result in more expensive and inaccurate downstream care.

Clearly, there was a demand for a product that would not only minimize inappropriate lab tests but also reduce costs for both patients and providers.

What metrics did you use to measure the success of Beacon laboratory benefits solutions? Were you able to achieve the desired results in reducing lab spend and improving quality?

Between 2014 and 2018, a platform was used in the Florida market for 79 specific tests to improve the use of evidence-based guidelines for test utilization. The tests were selected based on a review of claims data and were correlated with professional or governmental recommendations or guidelines. The goal was to enhance the use of point-of-care decision support.

BeaconLBS’ national clinical advisory board has reviewed and approved the suggested point-of-care education, messaging, steerage, and question sets. The platform has been utilized by over 85,000 physicians to treat almost 550,000 patients. The platform’s use led to a 46% increase in physician compliance with evidence-based test ordering and a 19% decrease in patient out-of-pocket expenses. Output Language Code: EN

Can you discuss any feedback or testimonials you received from customers using Beacon laboratory benefits solutions? How did you incorporate this feedback into future versions of the platform?

One piece of feedback we received from a customer concerned how we could assist them in reducing inappropriate lab tests. In response, we made some modifications to our decision support system, leading to a further decrease in the number of inappropriate lab tests.

What role did innovation play in the development of Beacon laboratory benefits solutions? How did you ensure that the platform was both innovative and practical?

This was an industry-first achievement and we built the technology from scratch. We had to develop AI for our decision support system to accurately suggest appropriate lab tests. At every stage of development, we collaborated with physicians, clinicians, scientists, and labs to ensure our product was user-friendly, reliable, and efficient.

How did you go about testing and iterating on the technology platform for Beacon laboratory benefits solutions? Did you encounter any unexpected results or challenges during the testing phase?

We collaborated with physicians, clinicians, scientists, and labs to test our product technology. The greatest challenge resided in constructing the prior authorization technology, which required us to integrate with over 30 unique lab systems. Frequently, we discovered that an approach effective with one lab system did not necessarily function with another.

What steps did you take to ensure that Beacon laboratory benefits solutions was scalable and could handle large volumes of data and users?

We established a scalable and elastic fleet of servers to manage large volumes of data. Furthermore, we implemented rigorous guardrails, including extensive testing and robust change controls, to guarantee the product maintained its high quality.

Can you discuss any future plans or updates for Beacon laboratory benefits solutions? How do you see the platform evolving over time?

We plan to invest more in the following:

  • Digitizing cases
  • Expanding the coverage of test identification and mapping

I foresee the platform evolving to reduce costs for prescription drugs and healthcare in general.