Leveraging lab data to combat diabetes and chronic kidney disease

27 August 2024

Three things that matter in healthcare: Location, location, location

Social determinants of health significantly impact wellness. An estimated 80%-90% of patient outcomes are influenced by those factors, obstacles and inequities.

Particularly, where a person is born and raised or lives and works will have significant impact on their health. Expectedly, payers, hospitals, health systems and providers are consistently working toward mitigating risk factors and achieving the quintuple aim of:

1. Improving the patient experience

2. Creating better outcomes

3. Lowering overall costs

4. Enhancing clinician well-being

5. Achieving health equity

To help reach these aims, lab data can be used in innovative ways to help identify and manage the most at-risk populations since lab results impact more than 70% of clinical decisions. Lab results are also used to screen, diagnose and monitor a majority of patients with HCC-coded conditions.

Patients with conditions like diabetes, cardiovascular concerns and chronic kidney disease (CKD) likely form a major focus for your organization. This is due to their significant impact on the cost of care since these patients often have increased emergency room visits and hospitalizations if their conditions aren’t well-managed.

How lab data narrows your focus on socially vulnerable communities

Lab data allows you to support socially vulnerable populations to enable health equity planning and location-based interventions. However, for lab data to be at its most effective, it needs to be standardized to provide for data integrity and support scalability.

Labcorp has recognized that and operates the only laboratory netowork with a nationally standardized footprint across the United States. Our integrated network allows national quality control, a standardized patient experience and the ability to produce clean, comparable laboratory data.

To illustrate the power of leveraging lab data, below are some real-life examples of how Labcorp has worked with health leaders across the country to highlight location-specific issues and allow for more successful, targeted preventive programs.

Diabetes in Chicago: where and why?

One of the challenges in chronic disease surveillance is that national studies, like the National Health and Nutrition Examination Survey, can tell you what's happening in America but can’t narrow down to what’s happening in Chicago or in the south side of Chicago, in particular.

While a spreadsheet with abundant data provides insights, it doesn't tell a story. In contrast, spatial visualizations help people understand what’s happening at the community level, which assists with prevention and disease mitigation.

It's imperative to know what risk and disease factors currently impact pockets of your local community so you can address them in near real-time and help prevent them from getting worse with targeted intervention. Lab data can help you monitor population health trends, like watching radar on a weather map to determine if you’re in a storm’s path.

Looking at Chicago from this perspective, we can see significant variations across the city regarding poorly controlled diabetes.

The power of lab data can support other discoveries

Labcorp partnered with the CDC CKD Surveillance Project to gain a better understanding of factors contributing to diabetes in Chicago. In a recent analysis, we were able to connect current health challenges with a historically discriminatory housing policy called redlining.

By spatially overlaying patient addresses with maps that represented the previously redlined areas of the city from the 1930’s, we’re able to assess the impact on diabetes for individuals residing in those areas. Findings indicated that people who currently live in previously redlined areas of Chicago are three times more likely to have diabetes than people who live in areas that weren’t redlined. The need for care has run consistently in these areas over generations.

Prediabetes and diabetes in Florida: what if the zip code was the patient?

In public health, it’s also important to identify hot spots and clusters to see what, if anything, is related. This can help you understand what's happening in your area, enabling you to treat zip codes in need with your targeted programs.

In the following graphic, you can see the average A1C in the state of Florida compared to the medical guidelines for prediabetes and diabetes.

This level and type of visual data quickly and easily displays the A1C by zip code, differences between Miami and Fort Lauderdale, and shows increased A1Cs the further inland you move.

Findings like these may not necessarily surprise local officials. Still, too often, when you're working on community measures or interventions, you can’t quantify the problem to justify funding and resources dedicated to those measures. Lab data could potentially help provide your justification.

Locating hotspots of diabetes and kidney disease in South Carolina

In South Carolina, we collaborated with a Medicare Quality Improvement Organization (QIO) to explore use of lab data for identifying communities with diabetes and CKD. Labcorp analyzed average A1C and eGFR lab tests at the zip code level to identify areas of greater disease severity across the state.

Using spatial visualization, we looked at a cluster and outlier analysis and pinpointed a significant hot spot on the state's eastern side for both diseases, overlaying areas of concern. We further refined the analysis using a zip code to locate the highest instances.

This detailed information allows for collaboration with community leaders to validate the hot spot analysis. For instance, a leader from one of the QIOs noted that the large pink spot around Interstate-95 is locally known as the “Stroke Belt”.

Quantifiable data highlighting specific health challenges makes it easier to secure resources for addressing these issues. Insightful uses of lab data enables improved understanding of the effectiveness of specific community interventions and guides future efforts.

Collaborating on kidney disease

Labcorp partnered with the National Kidney Foundation to provide support of their state-level leadership summits across the country. Kidney disease is diagnosed and managed predominantly by lab values, and population-level lab data is exceptionally helpful to identify areas with patients most at-risk for having or developing kidney disease.

For example, when analyzing lab data for socially vulnerable patient populations, we’ve uncovered multiple concerns. First, patients with decreased kidney function aren’t receiving the necessary testing to accurately stage their condition, with over 50% of early-stage kidney disease patients lacking a urine test to assess the amount of protein in their urine.

Second, there were concerns with ICD coding for kidney disease. Many patients were either incorrectly coded or not coded at all. We examined recent eGFR results and the corresponding ICD10 code to determine the percentage of undiagnosed cases.

Our analysis revealed that only 17% of patients with eGFR results indicating Stages 3 to 5 kidney disease had any coding for the condition. This underscored the critical need for accurate coding to enable proper diagnosis and treatment.

Through collaborations like these, Labcorp is helping set the stage for addressing chronic health conditions in communities by providing essential data insights. This enables healthcare providers to identify, quantify and address health challenges more effectively, helping to deliver better outcomes for patients.