CHICAGO (GenomeWeb) – KolGene is branching out from its roots as a marketplace for matching clinicians to genetic testing laboratories.
In October, the Israeli bioinformatics startup released the second iteration of its eponymous product, a system to automate the tracking of genetic tests that physicians and hospitals send to outside laboratories.
"Everybody is sending out tests in growing numbers," said Dan Faszczyk, CEO of Herzliya, Israel-based KolGene. "There is almost no scenario where there is one lab that's supplying all of their customers' and clinicians' needs in one place."
Yet, management of these send-outs has been largely manual to this point. "This operation is still being managed with Excel spreadsheets or paper," even Post-It notes, Faszczyk said.
"Using those methods to manage 10, 20 samples a month, that's OK. But when you're sending out thousands of tests annually from different clinicians from different sites sometimes, you need a tool to keep track." That is what KolGene has put into in its second release, but the company continues to develop the product.
"Our plan is to offer, eventually, a complete solution, a complete management tool, for all aspects of the process of ordering genetic tests, from the point where a clinician meets a patient," Faszczyk said. This includes handling logistics of ordering and following up, as well as integrating test results into clinician workflows. "That's the bigger vision."
To achieve this vision, KolGene executives and users know the technology must be matched with electronic health records and laboratory information management systems. "Eventually, this will have to be integrated with the EHR on one end and on the other end with the LIMS, to offer a complete workflow," Faszczyk acknowledged.
"We're starting with offering a tool to replace Excel. We're actually adding new features all the time to improve the workflow and also to provide the users with more value with regard to the logistics and the clinical aspects of the process," he continued.
KolGene also helps facilitate data sharing within organizations to prevent order duplication and make it easier for clinicians to cover for other practitioners. "If someone is away and is managing their send-out on an Excel spreadsheet that's stored in their computer, no one has access to that. What do you do when the report comes back to the patient or when the report is late?" Faszczyk said.
"Also, by centralizing it, you make sure that you are bringing down the number of misorders," Faszczyk said. "If they're sharing information and if someone is monitoring the operation, then the chance for a misorder is reduced."
Faszczyk pointed to a passage in the 2015 second edition of the text, Clinical Genomics.
"Patient sample tracking can be one of the most difficult components of clinical genomic sequencing because the process requires many steps that occur over a period of several days, among several people, and the process must protect the patient's privacy," that book said.
He also cited a 2016 study in which Stanford University Medical Center was able to halve the number of inappropriate test genetic orders and save $250,000 in a year by taking a more active role in test management.
"What we're doing is corresponding directly with these needs," Faszczyk said.
Ehud Banne, a pediatrician and medical geneticist at the Clinical Genetics Institute Kaplan Medical Center in Rehovot, Israel, started using the KolGene system in late December.
"It's mainly used to address the issue of how to follow up on tests that are being sent outside of the genetic institute," Banne said. "This part of KolGene is more interesting to me than other parts of KolGene. For me, it was a great solution," Banne said.
The institute — part of Clalit Health Services, one of four main integrated delivery networks in Israel — primarily sends out sequencing tests, and occasionally tests for point mutations, he said.
Banne previously managed tests with a handwritten notebook. "I found that very bothersome," he said.
The hospital suggested that he try Excel spreadsheets. "It's manual," he noted. "Probably, there's a way to program Excel to follow up on things and do all sorts of pull-ups and remind you if a test didn't come back, but I don't know this kind of programming." He had to check on test statuses by himself.
"It's not very well presented in Excel, so I found KolGene's solution to be more presentable and easier to manage. It gives you very good notice of what's going on and how's your budget spent and what test did you send and which company did you send those to," Banne said.
In a live demonstration via Skype, Banne showed how the KolGene dashboard displayed the average price for each test from each testing lab. It listed the status of each test, including which were in process and which had been completed. Clicking on "orders" showed exactly which tests have been requested, when the order went in, and which lab got the test.
Banne customized the system by choosing not to list patient names on his dashboard in the name of privacy, just a code. He keeps a listing of patients and their corresponding codes elsewhere.
There are some shortfalls, though. "I need to process the data by myself," Banne said. "It's kind of manual in that manner, but I think it's still worth it." He does not order tests through KolGene yet, but expects to do so in the future.
Banne said he has asked KolGene for a module showing how long has passed since he placed an order and how long the lab has to return the test, based on the clinician's request. "It would make it even easier to follow up on tests," he said.
For its part, KolGene is trying to respond to such customer inquiries.
Since the release of the second full product iteration three months ago, the company has added the ability for clinicians to tag reports they get back from labs. Results can show up in the system, but it does currently involve a bit of work. Without direct integration, clinicians must upload reports to the KolGene platform, though the tagging feature allows users to classify and index these reports.
Tagging can help people see if different labs are consistent in reporting specific variants, Faszczyk suggested. With a couple of clicks, ordering clinicians also can glean the rate of variants of uncertain significance for a particular lab.
"You can do a lot of clinical analytics just by using this feature," Faszczyk said.
KolGene continues to integrate its technology, via application programming interfaces, with other companies involved in the send-out process. Coming soon is the ability to track specimens sent by courier. "Clinicians, if they want to know in real time where the sample is, this is something that we are adding shortly." Faszczyk said.