On February 26, the American Medical Association and McKesson jointly announced a “licensing relationship to offer the healthcare system a consistent and transparent way to identify and track molecular diagnostic (MDx) tests. Under the agreement, McKesson Z-Code™ Identifiers will be grouped and indexed with corresponding molecular pathology codes in the AMA’s Current Procedural Terminology (CPT®) code set. With identifiers and codes working in tandem to create a comprehensive reference for identifying and tracking MDx tests, the healthcare industry can better understand the growth in this area to support advanced diagnostics innovation.”

The news generated a good deal of interest across the industry. A sampling of news coverage appears below:

Modern Healthcare described the challenges presented by the burgeoning number of tests, quoting AMA CEO and Executive Vice President Dr. James Madara in its story on the agreement: “While there are 3,000 tests available, Madara said, there are some 20,000 human genes and ‘each of the proteins encoded by those genes comes in multiple flavors.’ Madara added that ’3,000 may seem like a small number in the future’ as genetic testing helps move the industry from population-based remedies to individual and unique cures. For now, though, it’s a number that is unwieldy, and the licensing agreement seeks to add clarity and organization.

Healthcare Finance News outlined some potential advantages of a molecular diagnostic test registry in its March 1 coverage, which also appeared in Healthcare Payer News.

Genetic Engineering & Biotechnology News provided a good description of how McKesson’s Z-Code Identifiers will work with McKesson’s CPT codes via Rich Young, associate vice president of lab products and services at McKesson Health Solutions: “When we assign an identifier, we’re taking into account the methodology of a test. We’re taking into account things that make a test unique. It could be the number of alleles …. Anything that does make a test unique, we’re essentially just identifying this with a tag, and then back to AMA, which will then within their process roll that up and map that to their classifications.” Matt Zubiller, vice president of decision management at McKesson Health Solutions, then connected the dots: “The idea is that by being able to use the identifiers and the CPT codes together, a more granular vocabulary will emerge to be able to describe these diagnostic tests …. You can also use those identifier-CPT code combinations to be able to capture the clinical data as well as financial data that come along with the use of these diagnostic tests, which hasn’t been as easy to do before.”

Pharmacogenetics Reporter (subscription required) provides an in-depth analysis of both the history behind the agreement and industry reaction, with Zubiller netting out the continuing role of industry stakeholders: ”Providers, labs, and payors will continue to need to make informed choices to ensure and pay for the right care. This will support them in doing so.”

In American Medical News, Robert Musacchio, PhD, senior vice president of publishing and business services for the AMA, explains why the two organizations came together wiith this agreement: “We had two systems out there doing different things, occupying different niches. That by itself was causing confusion …. Basically, what we tried to do was eliminate some of the confusion out of the market.”

In a Q&A with Clinical Lab Products, Musacchio explains how the mapping process will work: “The AMA will rely on the clinical expertise of authorities in the field to determine appropriate mapping for the CPT codes and Z-Code Identifiers. The AMA recognizes the importance of transparency and will work to accommodate an open process whereby stakeholders can provide input to the new reference map product.” Zubiller answered the question about how this process might impact reimbursement: “The mapping process brings specificity to identification of unique molecular diagnostic tests but it does not provide reimbursement information. Reimbursement information is left to the individual payers and other stakeholders who are responsible for reimbursement systems.”

In Drug Discovery News, Zubiller summarizes: “Getting patients the right care means reducing confusion.”

Matthew Zubiller, Laura Coughlin, RN, and A. Jacqueline Mitus, MD described the application of “content as a service” (CaaS) to healthcare on February 12 in Executive Insights: 

With CaaS, rules are housed in one secured, centralized repository – in “the cloud” – and delivered via technologies based on Web services, so that they can be deployed seamlessly to deliver up-to-date, actionable content into any healthcare workflow for simultaneous use by any stakeholder.

What benefits accrue when healthcare content is centrally maintained, shared as a common language by all stakeholders, and delivered as needed to any point of care? A cohesive ecosystem forms that makes the most intelligent clinical and financial decisions about care, resulting in better quality and more cost-efficient care outcomes.

Read the article here.

In the Winter issue of Biotechnology Healthcare, Bob Carlson interviews Matthew Zubiller, vice president of Decision Management at McKesson Health Solutions, about the importance of helping payers track advanced diagnostics in the age of healthcare reform. Zubiller describes the McKesson Diagnostics Exchange, a system that assigns a unique five-digit alphanumeric Z-Code Identifier to each advanced diagnostic test so that it can be accurately tracked.

Read the article here.

Personalized medicine, specifically the use of molecular and genetic tests to diagnose patients, is a rapidly growing field. However, as the number of these tests increase, healthcare stakeholders face the challenge of determining their clinical and financial impact. 

McKesson’s recently announced licensing agreement with the American Medical Association (AMA) seeks to address this challenge for physicians, payers, clinical laboratories, patients and investors by establishing a consistent and transparent way to identify and track molecular diagnostic (MDx) tests. Under the agreement, McKesson Z-Code™ Identifiers will be grouped and indexed with corresponding molecular pathology codes in the AMA’s Current Procedural Terminology (CPT®) code set. With identifiers and codes working in tandem to create a comprehensive reference for identifying and tracking MDx tests, the healthcare industry can better understand the growth in this area to support advanced diagnostics innovation.

Read more.

McKesson experts Jacqueline Mitus, MD, Steve Silverstein, MD and Matthew Zubiller discuss content as a service, a delivery model for actionable content, in the following excerpt of Actionable Content — A Framework for Better Decision-Making:

In the era of reform, and given the focus on quality metrics as the basis for reimbursement, the ability to tie clinical concepts to business processes is ever more important. To maximize the value of clinical guidance, information must be delivered directly into the workflow at all the points of care or into a “transaction” (e.g., authorization, benefit design, network selection) in a context-specific, on-demand basis. This capability remains a significant challenge today, although newer technologies addressing the challenge in innovative ways.

Content as a service is the delivery method designed to provide actionable, rules-based information to any point of care. The rules are housed in a centralized repository and delivered via technologies based on Web services so that they can be deployed seamlessly into diverse healthcare workflows and across stakeholders. This provides the accessibility and ease of use that not only enables better decisions but also leads to shared accountability between payers, providers and members — and ultimately better quality of care.

Utilization management is another discipline ripe for the application of content as a service. This traditionally paper-based, manual and labor-intensive process can be transformed and automated through the use of clinically credible content delivered in a robust Web-enabled rules engine at the point of care. Proposed interventions (e.g., requests for expensive diagnostic tests) are then automatically screened for appropriateness using data embedded in electronic systems, saving millions of dollars in staff time and provider effort and inconvenience, then shared directly with health plans.

 To learn more, download the full white paper on Actionable Content:  A Framework for Better Decision-Making.