Copyright © 2018 Albuquerque Journal
The past few months were a time of transition for TriCore Reference Laboratories, an Albuquerque-based organization that provides laboratory and related services throughout the state.
At the end of last year, Khosrow Shotorbani, the company’s chief executive officer and a high-profile figure in the New Mexico health care industry, quietly left the company. In March, TriCore’s chief financial officer, Kent Gordon, departed the organization and was replaced by Renee Ennis of Presbyterian Healthcare Services.
But TriCore’s new CEO, Dr. Michael Crossey, dismisses any notion of turmoil within the company.
“We had an exceptional team then, and we have an exception team now,” said Crossey, who served as chief medical officer before Shotobani’s departure and was named the long-term head of the organization in March. “It would be odd for an organization of our size to not see some transition as we look toward the future.”
At the same time TriCore is evaluating its future, it is also honoring its past: The company’s 20th anniversary is later this summer. A TriCore spokeswoman said the organization is still deciding exactly what to do to celebrate the anniversary, though it will definitely include recognition of TriCore’s 1,300 employees, a head count that has more than doubled since 1998.
In anticipation of its coming milestone, Crossey led the Journal on a tour of TriCore’s core lab and discussed the company’s current operations and plans going forward.
Automation hits lab
TriCore is a not-for-profit organization co-sponsored by Presbyterian Healthcare Services and the University of New Mexico Health Sciences Center. According to its Form 990 filings with the Internal Revenue Service, the company earned about $84 million in revenue in 2016, the most recent year for which such information is publicly available.
TriCore has 30 patient care sites throughout the state, and in addition to Presbyterian and UNM, it processes thousands of lab tests for Lovelace and the New Mexico Cancer Center, among others. The company’s core labs perform about 10.5 million clinical tests a year, everything from the esoteric (like complex genetic tests) to the routine (including complete blood counts and urine tests).
It’s those routine tests that account for the bulk of the 10.5 million tests, and Crossey said that handling them efficiently has been one of the keys to TriCore’s success. For one thing, by handling routine tests, hospitals are able to focus on testing for patients in the emergency department and intensive care unit. For another, the company is able to process a much higher volume of incoming work. There are benefits for the staff, too, Crossey said.
“Automation has hit the clinical lab,” said Crossey. “When routine tests are increasingly automated, it’s the problem specimens that become a focus for technicians, which are more intellectually challenging.”
Among the tests that TriCore processes primarily through automation: Pap smears and urine samples. Implementing that technology has not led to job losses, according to Crossey, but rather a shift to having staff handle tests that are flagged as abnormal and those that require more complicated analysis.
When the Journal visited the core lab in May, urine samples were being fed through a $2 million machine from Italian company Copan Diagnostics Inc. TriCore was the first lab in the U.S. to install the system and have it fully integrated into its operations, according to Crossey.
Automation and other technological advances have also allowed the company to keep more of its work within New Mexico, because the company has the capacity to handle a greater volume of routine tests and has been able to invest in resources to handle more complicated services. Crossey said that in the early days, TriCore sent about 30 percent of its tests out of state for processing; that number is now 1.5 percent.
“It’s so important to shift the load to in-state,” he said. “You can send something to Denver, Dallas, or Phoenix, but those results are going to take at least three days. And when you’re a patient waiting to hear about cancer treatment, those are three very long days.”
Not all of the company’s expansion over the past two decades can be attributed to organizational planning, Crossey acknowledges. TriCore’s toxicology operations – those that deal with detecting the presence of substances with adverse effects – have been in high demand in recent years for reasons outside the company’s control.
“Unfortunately, there’s been a lot of growth,” he said. “There’s a one-to-one correlation with the opioid crisis.”
He says he is hopeful that TriCore’s services can provide useful support to patients and physicians as the state tackles the epidemic.
As for the future, Crossey said the company will explore the digital imaging of slides and means of sharing those images, much the way medical professionals handle X-ray images. There’s also the lab’s partnership with health care company Roche, through which TriCore staff tests devices for the multinational corporation.
“It’s part of our strategy to diversify, and culturally it’s a great fit, too, because our staff loves to try new things,” Crossey said.
Perhaps the greatest question for the company in the coming years will be the extent to which it is able to live up to an initiative highly publicized by Crossey’s predecessor, Shotorbani: finding ways to harness the massive amounts of data being processed through TriCore and using them to help physicians better understand the populations they serve. Crossey, who said that labs produce about 70 percent of the data found in any given patient’s chart, said exploring the world of data analytics is still a priority for the company.
One thing likely to stay constant is the company’s focus on keeping operations close to home. Crossey said there is no strategy in place to turn TriCore into a national lab two decades after it was founded, and he has no desire to do so.
“I just want to be the best regional lab,” he said.