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Best Practices: Passing the Test

Novis D. Best Practices: Passing the Test. Health Executive. 4; April 20,2008; 14-17

Most hospitals contract with pathologists for professional services and laboratory oversight, and in many cases, these contracts were arranged with parties long retired or gone. Because laboratory margins have thinned considerably in recent years, it’s important for hospital administrators to refresh their understanding of the value their pathologists provide.

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Past Projects and Deliverables

Summary of Projects

CONSULTING
Dr. Novis assists clients directly, and as a subcontractor for other consulting companies with providing laboratory and pathology services. Dr. Novis has:

For hospital administrators:

  • Evaluated the adequacy and quality of pathology services,
  • Designed models for delivery of pathology service and pathologist reimbursement
  • Conducted recruitment searches for a laboratory medical director and sub specialty pathologists.
  • Conducted billing, utilization, and compliance audits

For private laboratories

  • Secured CLIA certification and CAP accreditation
  • Evaluated delivery of pathology services
  • Addressed sales teams of customer preferences
  • Presented webinars on applying lean production techniques to reduce errors 
  • Implementing lean techniques resulting in a 20% reduction in billing audit completion times.

For pathology organizations and support vendors:

  • Performed national and international accreditation inspections
  • Provided governance functions
  • Advised defense attorneys on matters relating to laboratory quality, CLIA and CAP compliance, and laboratory oversight
  • Authored articles on pathology and laboratory service delivery
  • Authored manual on launching tissue laboratories

For physicians

  • Advised community hospital pathologists on practice organization, service delivery, quality assessment
  • Wrote pathology service proposal
  • Analyzed scientific literature.

MEDICAL PRACTICE, MANAGEMENT, ADMINISTRATION
Courtagen Life Sciences, Woburn, MA.
Since 2011, Dr. Novis has been the CLIA Laboratory Director of Courtagen Life Sciences a privately held clinical laboratory that performs next generation sequencing (NGS) technology to diagnose mitochondrial disease in children and adults
. Dr. Novis

  • Assisted Courtagen in receiving CLIA certification and state licensures.
  • Authored laboratory procedures
  • Developed quality control and quality assurance systems.
  • Advised management in all aspects of laboratory management and service 

Oxford Diagnostic Laboratories (ODL), Marlborough, MA
Since 2008, Dr. Novis has been the Medical Director of ODL. ODL is a privately held clinical laboratory that performs TSpot-TB test, a cutting edge blood test for the diagnosis of Tuberculosis that is replacing the antiquated TB skin test., Dr. Novis has

  • Assisted ODL in receiving CLIA certification, CAP accreditation, and state licensures.
  • Authored laboratory procedures
  • Developed quality control and quality assurance systems.
  • Advised management in all aspects of laboratory management and service
  • Served as a resource and troubleshooter for ODL clients.

Young Novis PA (YNPA)
For 25 years, YNPA provided anatomic and clinical pathology services to two community hospitals, the University of New Hampshire Student Heath Center laboratory, and Path Lab Inc, a regional private laboratory. As managing partner of YNPA, Dr. Novis :

  • Introduced practice innovations including:
  • Computerized anatomic pathology and cytology records (1981)
  • Non-physician assistants (1982)
  • Template diagnostic reporting (1983)
  • Computer generated graphics (1992)
  • Internet-based reporting (2002).
  • Delivered 8% revenue growth/year over 25 years, 31% revenue growth in last 4 years of practice with greater than 50% of pre-collection gross revenues realized to net income.
  • Demonstrated consistently high rate of customer satisfaction.
  • Demonstrated consistently high metrics of quality; recognized by hospital Performance Improvement Committee as a high quality provider.

Northeast New England Pathology Associates (NENEPA)
For 10 years, NENEPA, a consortium of four pathology practices provided anatomic and clinical pathology services to regional and national laboratories in the Seacoast region on New Hampshire and Southern Maine. As founding partner and President, Dr. Novis

  • Organized four competing practices to work cooperatively and embrace concepts of partnering and value generation.
  • Ensured profitability: during its last 3 years of operation (2001-2005), third party reimbursement revenues increased  over 150%, realizing revenues of 4.6 million.

Physicians Professional Management Company. (PPMC) www.ppmcbilling.com
PPMC is a physicians billing and practice management company serving office-based and hospital practices in Massachusetts, Maine, and New Hampshire. As Founding Partner and Director, Dr. Novis participated in:

  • Strategic planning resulting in conversion of the company from a co-operative consortium to a private for-profit entity, targeting of markets, developing new product lines, and fostering growth.
  • Realization of 31% growth in last four years with revenues exceeding 5 million dollars annually.

QUALITY
College of American Pathologists (CAP) www.cap.org
The CAP is the professional organization of pathologists. Dr. Novis has served as Vice Chair of the Quality Practices Committee and is a laboratory inspector for the CAP s Laboratory Accreditation Program

  • Designed, planned, and monitored approximately 100 national studies of quality outcomes, benchmarking and best practices in Pathology and Laboratory medicine.
  • Studies purchased by over 1000 institutions worldwide generating 1 million dollars of revenue annually.
  • Wrote quality outcome summary reports and analyses for customer distribution.
  • Published articles in peer reviewed journals.
  • Presented data at national society meetings.
  • Reviewed manuscripts dealing with quality practices for several medical journals.
  • Provided data by which the College of American Pathologists Laboratory Accreditation Program established standards of performance.

Wentworth Douglass Hospital (WDH) www.wdhospital.com
WDH is the largest of five acute care community hospital, serving a population of 100,000 people residing in the Seacoast region of New Hampshire and Southern Maine.

Advised hospital Performance Improvement Committee; work cited for excellence by the JCAHO.

HOSPITAL GOVERNANCE AND PLANNING
Wentworth Douglass Hospital  (WDH) www.wdhospital.com
WDH is the largest of five acute care community hospitals serving a population of 100,000 people residing in the Seacoast region of New Hampshire and Southern Maine. WDH maintains a full service cancer diagnostic and treatment facility and owns The Works Family Health and Fitness Center,  one of the largest health and fitness centers in New Hampshire. For 10 years, Dr. Novis was a Hospital Trustee, serving on the Strategic Planning and Community Benefits Committees. He was Chairman of the Board of The Works.

  • Sole or major contributor to projects including:
  • Development of outcome-based dashboards for strategic planning and governance.
  • Designing a system for educating and orienting Trustees.
  • Implementing a system that provided financial assistance to under served citizens: 4.2 million dollars worth of assistance distributed yearly to over 3700 citizens while maintaining levels of operating margin, operating cash, and days cash on hand that exceeded national benchmarks.
  • Establishing a dental clinic providing care to 2500 under served citizens within first  6 months of operation.
  • Providing medication assistance of 2.5 million dollars annually to under served citizens.
  • Developed strategic and master plan for hospital-owned health and fitness center.  The design included a 7.5 million dollar, 40,000 sq. ft. facility expansion which allowed the creation of a community family program. In the first 2 years of operation, revenues increased from 3 to 4.5 million, membership increased from 5,000 to 9,000, and health system utilization was increased through health screenings which referred members into other hospital services—all done while maintaining a net operation margin of 22%.
  • Contributor to projects:
    • Cancer Center expansion
    • Extension of primary care services into secondary markets
    • Hospitalist and Intensivist programs
    • Physician succession plan
    • Expansion of physical plant
    • Joint ventures with staff physicians (MRI, Sleep Lab)
    • Design and development of system of to assess implementation of burgeoning technology.

PROFESSIONAL ACTIVITIES
College of American Pathologists (CAP) www.cap.org; Clinical Laboratory Management Association (CLMA) www.CLMA.org); American Society of Cytopathology  (ASC) www.cytopathology.org; Northeast Medical Association (NEMA) www.nemaonline.com

Dr. Novis has served on the CAP’s Quality Practices, Education and Cancer Committees and is the New Hampshire Representative to the House of Delegates.

The ASC is the is the professional organization of pathologists and technologists sub-specializing in the field of Cytopathology. Dr. Novis headed the ASC s task force on membership, and was a member of their Strategic Planning Committee.

NEMA is a multi-specialty medical society devoted to studying advance in outdoor medicine and sports-related injuries. Dr. Novis has served as NEMA’s Secretary-Treasurer and President.

As a member of these organizations, Dr. Novis has:

  • Designed and conducted membership preference surveys and produced a plan for increasing the ASC’s membership.
  • Authored the ASC mission statement and strategic plan, including outcome metrics.
  • Designed a concept for CAP Internet-based learning and professional consultation. .
  • Authored CAP cancer diagnostic protocols.
  • Provided performance criteria for CAP Laboratory Accreditation Program.
  • Designed planned and conducted 10 NEMA’s national and international scientific symposia.
  • Evaluated best practice studies (CLMA).