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1
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2
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3
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4
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- 1987 Thomas O. Tiffany, PhD,
DABCC hired as CEO
- of PAML; Revenues at
that time = $5 M
- 1989 NetLab is deployed to PAML clients
- - Accessioning & results now available remotely
- Dr. Tom Tiffany develops and
gains approval of growth through acquisition
- 1992 PAML net revenues grow to $22 M
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5
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- Largest independent lab in the Northwest
- Serves physicians, clinics, hospitals, long-term
- care facilities, government and private industry
- The Northwest’s most comprehensive esoteric testing center, over 98% of
all tests ordered are performed in-house
- The only SAMSHA toxicology lab in the NW
- Internationally recognized staff of Ph.D & M.D. scientists
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6
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- Serves about 95 hospitals throughout the West
- Employs >1,000 people in NW
- Performs more than 2.0 M Tests/yr in Spokane
- Sends out > 1 M bills / year for PAML and Partners
- Bills > $110 M annually (18 billing services)
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7
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- Healthcare is a local issue – not national.
- A well positioned regional lab system can compete effectively with the
national laboratories.
- Clinical integration of healthcare services
- will occur.
- Lab systems that are integrated with other healthcare services will have
a competitive advantage over independent outpatient labs.
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8
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- Inpatient and outpatient lab testing can be combined effectively, with
improved quality & service to physicians.
- Physicians prefer combined inpatient & outpatient clinical
information when available.
- Clinical technology is rapidly changing (cytogenetics and genomics).
Large laboratory systems will be well positioned to leverage the new technologies.
- Market share matters!
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9
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- PARTNERSHIPS: PACLAB-WESTERN WASHINGTON, TVL-BOISE,TCL-TRI CITIES
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10
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11
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12
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13
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14
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- Three Palousse Hospitals
- - 1st hospital venture
- Yakima, WA
- PacLab Network Laboratories, Seattle WA
- Tri Cities Laboratory,
- Tri-Cities, WA
- Alpha Medical Laboratories, Coeur d'Alene, ID
- Treasure Valley Laboratory; Boise, ID; Southern Idaho Regional Lab
(SIRL)
- BioLabs, Salt Lake City, UT
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15
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- The World Series was canceled due to a players strike.
- Super Bowl - Dallas Cowboys beat the Buffalo Bills
- PAML continues its growth strategy purchasing a small lab in Yakima, WA
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16
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17
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18
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19
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- Super Bowl:
- San Francisco beat San
Diego (49-26)
- O.J. Simpson is acquitted
- Forrest Gump wins Academy Awards for
Best Picture, Best Director and Best Actor
- PAML purchases labs in 2 cities
- - Olympia
Medical Laboratory (OML)
- - Columbia
Biomedical Medical Laboratory (CBML)
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20
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- Three major Healthcare organizations finalize plans to form a regional
outreach program in western Washington
- Of key importance was to keep $$$ and jobs within PACLAB hospitals , and
control high quality testing standards.
- PACLAB LLC formed November 1, 1996.
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21
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- “ …to help create local laboratory outreach programs by providing
comprehensive laboratory services with the highest quality of testing
and customer service standards.
PACLAB fosters relationships between local hospitals &
clinics and their community physicians, allowing local decision-making
with the same resources available to reference labs.”
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22
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23
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- Providence Everett Medical Center
- Colby Campus
- Pacific Campus
- Mill Creek Campus
- Providence Health System
- Providence Centralia
- St. Peter’s Hospital
- Overlake Hospital & Medical Center
- Franciscan Health System
- St. Joseph’s Hospital
- St. Francis Hospital
- St. Clare’s Hospital
- Evergreen Healthcare
- Pathology Associates Medical Laboratories (PAML)
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24
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25
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26
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- ‘Limited Liability Company’ chosen as the legal form.
- PACLAB LLC acts as agent for members in contracting laboratory services.
- Manager (PAML) provides Billing, Marketing, Finance, Information
Services and Management Support under contract.
- Manager (PAML) provides Esoteric Testing.
- Members provide Routine Testing/Infrastructure Services.
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27
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28
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29
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30
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31
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- Y2K Scare
- Billions of dollars are spent
world-wide preparing computer software for Y2K
- Entertainment:
- Star Wars Episode I opens;
grossing $103 M
- its first 5 days
- Quest completes the acquisition of SKBCL
- PAML forms the next step in partnering …..
- Tri-Cities Laboratory LLC is
formed
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32
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- Three area hospitals & Tri-cities Lab (PAML)
- Kadlec Medical Center
- Lourdes Medical Center
- Kennewick Medical Center
- Combines inpatient and outpatient testing
- Core Laboratory concept
- Rapid response laboratories at hospitals
- Esoteric testing to PAML
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33
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- Inpatient & Outpatient testing STANDARDIZED in the community
regardless of where performed.
- Single source for laboratory information.
- L.I.S. - Misys Flexilab System
- Inpatient / Outpatient Orders and results thru hospitals’ H.I.S.
- Kadlec Medical Center - McKesson
- Lourdes Medical Center - Meditech
- Kennewick Medical Center - McKesson
- Combined Inpatient and Outpatient access
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34
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35
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36
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37
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38
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39
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- The world survived Y2K!
- The closest presidential election in
decades
- is determined by ‘pregnant’ and ‘bulging’ chad’s
- Subway Series in New York
- - Yankees beat Mets (4-1)
- PAML buys Treasure Valley
Laboratory in Boise, ID
- Southern Idaho Regional Lab
(SIRL) is formed
- in conjunction with St
Alphonsus Regional Med Ctr in a
- “CO-TENANCY Model”
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40
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- After acquisition, Boise-based
testing was
- diverted to:
- - St. Alphonsus
- - PAML
- Marketshare:
- - YR 2000 – 50%
- - YR 2001 – 45%
- - YR 2003 – 60%
- Information System – Mysis Flexilab
- - Order entry – Hospital based system
- - Results - Hospital based system
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41
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42
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43
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- PAML purchases lab in Salt Lake
City
- Testing –
- - Local testing performed
on site
- - Reference work sent to
PAML
- Information Systems
- - Order entry Flexilab
- - Results reporting
Flexilab
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44
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45
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- Virtual laboratory...Consolidated operations - separate locations
- History of partnerships with hospitals - developed into a corporate
strategy.
- Serves as managing partner & esoteric reference lab for joint
ventures
- Integrated Information Systems with Unique Information Technology
products
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46
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- All PAML partnerships are
profitable, & offer tangible benefits to PAML & their Hospital
partners.
- Profit margins range from 10%
to 15%.
- All partnerships enhance
laboratory testing
- services in the community.
- Future growth will be through
new markets,
- and/or new partnerships.
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47
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48
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- Owners control testing, costs and service quality
- Increased testing volumes result in lower inpatient and outpatient lab
testing costs
- Revenues fund investments in equipment and personnel
- Combined inpatient / outpatient lab data provides enhanced physician and
patient experience
- An enhanced test menu supports referring specialists
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49
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- Common Goals / Trust / Executive Level commitment
- “…we must work together to survive”
- Collective commitment to legal and
business ethical practices
- Strong disincentives to dissolve membership
- Equitable partnership agreements that provide fair distribution of
profits
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50
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51
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52
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- 100% accurate results (error
free)
- 100% reliable service
- 100% on-time results or
services
- No added work or disruptions
- Effective communication with a
live person when needed
- Understand what they need, why
and when they need it ….
- From a recent Patient Safety Conference:
- Matthew B. Weinger, MD
- Director Anesthesiology, U.C. San Diego
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53
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54
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- 13 Different LIS’s
- - Meditech
- - Cerner
- - Triple G
- - Misys
- - McKesson
- - Antrim
- and the list goes
on….
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55
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56
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57
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58
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59
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- Automated resources accessed via
the Internet.
- Web services are
software-powered resources or
- functional components whose
capabilities can be
- accessed at an internet URL.
- Standards-based web services use
XML to interact
- with each other, which allows
them to link up on
- demand using loose coupling.
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60
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- Interoperability
- Platform independent
and work outside of private networks.
- Usability
- Expose the business logic of
many different systems over the Web.
- Reusability
- Component-based and the
closest thing possible to zero-coding deployment.
- Deployability
- Even over firewalls and
security is built right it.
- Control
- You decide who sees what.
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61
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62
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63
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Notes