Editors: Raymond D. Aller, MD, & Dennis Winsten
Sonora Quest initiative turns ideas into innovations
November 2023—“The best way to have a good idea is to have a lot of ideas,” according to Linus Pauling, a chemist and chemical engineer who, among other accomplishments, helped create a form of synthetic plasma. But when there is no structure in place to nurture those ideas, the result can be “a lot of people focused in a lot of different directions,” says Sky Soom, innovation analyst with Sonora Quest Laboratories.
Hence, the creation of Sonora Quest’s Innovation Center of Excellence, an initiative aimed at capturing, vetting, and supporting innovative ideas that may benefit the pathology laboratory—and its patients, providers, and payers. The center, launched last year, uses an ideation funnel to channel worthwhile ideas into a centralized process where they can be evaluated, researched, and, if they are potentially viable, assigned project owners who will manage them.
Sonora Quest encourages employees to submit ideas to the ICOE through its ServiceNow platform, which serves as an electronic ticketing system for tracking ideas submitted from throughout the company.
(Employees were already familiar with ServiceNow because the information technology department uses it to collect and manage service requests.)
“If employees are shy about bringing up something in their team meetings, this is the place where they can bring forward those ideas, and it is our job to pay attention to them,” Soom says.
The ServiceNow innovation center submission page looks like a Web page and contains fields that ask for basic information, such as employees’ names and to whom they report, and some elements of employees’ ideas.
Creating the optimal submission page was a balancing act between keeping the questions succinct enough to motivate employees to submit their innovative ideas while deterring suggestions that could be easily and quickly addressed within a department, Soom explains. For example, the innovation center team determined that requesting such information as long-term project costs could deter employees from submitting ideas and that simple suggestions, such as moving gloves to a different location, are better handled via a conversation between an employee and his or her supervisor.
Sonora Quest has advertised the ICOE to employees via laboratory signage and messages flashed across large-screen televisions. The center has also undertaken internal marketing campaigns, including challenges that encourage employees to help the ICOE reach goals of having set numbers of ideas in the pipeline at once, Soom says.
The center is tasked with tracking how much Sonora Quest invests in innovation and ensuring that such projects meet predetermined criteria. The company requires that innovation projects be novel and unproven, drive growth, and foster partner engagement that benefits not only Sonora Quest but its joint venture owners, Banner Health and Quest Diagnostics, Soom says. Therefore, Soom communicates regularly with innovation-focused counterparts at Banner and Quest to ensure the companies’ interests are aligned.
The ICOE also vets projects based on whether they make one aspect of a process easier while inadvertently making another part of it more difficult. For example, an innovation designed to improve a patient’s blood draw experience won’t work if it puts extra burden on phlebotomists, Soom says.
Among the projects that have made it to fruition are programs for distributing at-home testing kits to monitor blood glucose levels and screen for colorectal cancer and an outreach system to text reminders to patients who may have forgotten to schedule tests ordered by their physicians. Many of the projects have focused on improving patients’ experiences, Soom adds.
The ICOE is intended to be a two-person department in which staff do not have daily operational responsibilities.
What the center lacks in dedicated manpower, it makes up for through collaboration, says Soom, who works closely with Tom Leggett, senior director of business development at Sonora Quest, whose department generates a large portion of the innovation ideas. Soom and Leggett gave a joint presentation about the ICOE at the 2023 Executive War College, earlier this year.
“We can do investigations around requirements, costs, return on investment, and future needs within the industry, and we can study whether we are evolving to support patients, clinicians, and the overall health of the system,” Soom says. This means vetting a project through such measures as researching regulatory issues, gathering medical research, and evaluating Medicare reimbursement rates.
Soom presents ideas that make it through such analysis to a steering committee. The committee includes Sonora Quest’s chief information officer and representatives from the enterprise project management office, business development, and the operational excellence team, which is a Six Sigma type of process-improvement team. Sometimes representatives of other departments or other specialists within the company also participate, depending on the nature of the project being evaluated. The steering committee makes final decisions about which projects to prioritize.
“We provide the structure,” Soom explains. “If we present a good business case, other departments become involved.”
Often, when a smaller innovative idea that has merit but may not meet all the criteria of an ICOE project is presented, a department volunteers to take ownership of the project and manage it. “For example, the enterprise project management office might say, ‘I’ve got capacity, and I’m going to pick that up and push it forward,’” Soom says.
All projects, regardless of size, must be assigned an owner, but the larger projects often require collaboration among several departments, as well as budgets, additional personnel, or other resources. The ICOE team helps develop the business plan for these larger projects and coordinate the efforts of the departments involved.
Since its launch, ICOE has refined its processes, particularly with regard to leveraging ServiceNow’s capabilities.
“Now, as something moves out of ‘idea’ and into ‘demand,’” Soom says, “you can create a story for the IT team from ‘demand’; you can create a project plan for the enterprise project management office; and we can fold it into finances so we can see what we are spending and what kind of revenue is coming in.”
The ICOE also uses the ServiceNow platform to track and store ideas that it is shelving in the event that the team wants to revisit them at a later date. Soom contacts employees who submit such ideas to explain why the center is not moving forward with their suggestions. He also asks employees if there are other aspects of the project that were not in the original submission but should be considered. Soom views such follow-up as critical to developing and sustaining a culture that encourages innovation and creativity.
“I hate to use an old cliché,” he says, “but no idea is a bad idea. We have to be respectful of people who are coming forward and putting themselves out there and trying to help the company and advance medicine.”
—Renee Caruthers
Regenstrief and SNOMED kick off terminology initiative
The Regenstrief Institute and SNOMED International have commenced their initiative under which they will generate the LOINC Ontology, standardized terminology to drive broader health data interoperability globally.
The ontology is intended to support providers and other users who implement different combinations of Systematized Nomenclature of Medicine Clinical Terms and Logical Observation Identifiers Names and Codes in health information systems by allowing them to meet clinical and regulatory requirements in a single solution. “Linked together in a complementary way, SNOMED CT provides the computable framework and LOINC provides laboratory and pathology content in an [understandable] format to countries who do not currently use LOINC,” according to a Regenstrief press release.
The LOINC Ontology, which is owned by Regenstrief, will be made available without charge under the current royalty-free LOINC license. SNOMED International members and users will be able to work with LOINC in the same format they use for SNOMED CT.
Each organization retains editorial control of its respective standard.
At CAP TODAY press time, more than 24,000 terms had been included in the LOINC Ontology preview, which was slated to be published for review and feedback by the end of 2023.
MTuitive releases solution for aggregating oncology data
MTuitive has introduced mTuitive Insight, a database that consolidates structured oncology data from any integrated lab information system or EHR.
The solution can be used to accrue, share, present, and analyze standardized data of value to pathology, oncology, surgery, research, and quality control.
MTuitive Insight uses structured data captured via synoptic reporting. The system also employs standard, purpose-built reports to measure performance against standard quality metrics.
MTuitive can build custom query functionality and custom dashboards for the solution that are centered on patient information, tissue, images, and other data useful to research and patient care.
“MTuitive Insight exports data to all major business intelligence platforms, complements existing enterprise data warehouse strategies, extends the use of current solutions, and is intuitive to use, even for nontechnical users,” according to a company press release.
mTuitive, 508-771-5800
Microsoft introduces health care AI tools
Microsoft has launched a series of analytics and artificial intelligence offerings as part of its Microsoft Fabric data analytics platform and Azure AI services.
The company has developed health care data and analytics tools, available in preview capacity within the Microsoft Fabric platform, that allow health care entities to combine data from previously siloed sources across their organization, including laboratory information systems, EHRs, picture archiving and communication systems, claims systems, and medical devices.
“The [Fabric] solution brings structured, unstructured, imaging, and medical device data into the Fabric data lake with open data standards using FHIR [Fast Healthcare Interoperability Resources], DICOM [Digital Imaging and Communications in Medicine], and MedTech services, providing customers with one common architecture,” according to a Microsoft blog post.
A new service for the Fabric platform will also allow organizations to de-identify patient data using machine-learning models that extract, redact, or surrogate identifiers before extracting information from unstructured data, such as doctors’ notes.
Among the new tools for Microsoft’s Azure AI services are Azure AI Health Insights, Azure AI Health Bot, and Text Analytics for health.
Azure AI Health Insights provides prebuilt models for performing analyses and providing inferences that can be used by clinicians and researchers to facilitate patient care. The models, being launched in preview, are patient timeline, which extracts information from unstructured data to create a chronological overview of a patient’s medical history; clinical report simplification, which converts medical jargon into simplified text while preserving the essence of the clinical information; and radiology insights, which provides quality checks through feedback on errors and inconsistencies across reports and identifies follow-up recommendations and findings within clinical documentation.
The generative AI-based Azure AI Health Bot can pull data from within a health organization and external sources, such as the FDA and National Institutes of Health, to provide users with information on treating disease and handling protocols and processes.
Text Analytics for health uses machine-learning intelligence to label medical information and extract it from a variety of unstructured data sources, such as clinical documents and notes. Microsoft plans to offer the tool not only in English but also Spanish, French, Italian, German, Portuguese, and Hebrew.
Dr. Aller practices clinical informatics in Southern California. He can be reached at rayaller@gmail.com. Dennis Winsten is founder of Dennis Winsten & Associates, Healthcare Systems Consultants. He can be reached at dennis.winsten@gmail.com.