Changing prenatal care with data
Headquartered in Albuquerque, New Mexico, TriCore Reference Laboratories (TriCore) decided to take lab results further by integrating artificial intelligence algorithms into its processes. Rick VanNess, Director of Product Management at TriCore, explains, “What we’re doing by taking laboratory data and translating it into actionable information for someone is completely innovative and different.”
TriCore’s first area of innovation centers on prenatal care in New Mexico. Over 30 percent of New Mexico’s births are to women who receive either intermediate or inadequate prenatal care. Inadequate prenatal care can lead to further complications like preterm birth, which can then develop into additional medical problems for both mother and infant. “Laboratory tests allow us to monitor a patient’s health throughout their care and enable us to inform patients that they might be at risk for preterm delivery because of an abnormal result before and/or during their care,” says VanNess. “We can then inform a care provider in an effort to avoid a negative outcome.”
Guidelines developed by the American College of Obstetricians and Gynecologists (ACOG) and the US Preventative Services Task Force (USPSTF) influenced the algorithm. It relies on real-time and longitudinal laboratory results, selected health information, and published treatment guidelines to risk-stratify expectant mothers according to gaps in care and/or increased risk of complications. When TriCore implemented the algorithm, it had specific goals in mind: to stratify risk for expectant mothers and convey needs in near real time; to improve timeliness of prenatal care; to measure the closure of gaps in care; to diagnose births in real time for postpartum care; and to identify risk of maternal complications.
Although the primary motivation to build the algorithm was patient health, budget cuts also played a role. Medicare cut reimbursements on the national clinical laboratory fee schedule by 10 percent per year for the next three years and up to 15 percent per year for the following three years. In response to these budgetary pressures, TriCore’s Chief Scientific Officer, Dr. David Grenache, says, “We had to think of a way to diversify our line of business to demonstrate the value of the laboratory.”