Changes within the U.S. healthcare system are pressuring laboratory professionals to focus on the broader scope of laboratory stewardship and become cognizant of the value of the laboratory’s overall contribution in addition to quality lab result reporting. Laboratories are encouraged to find new ways to contribute in a value-based, patient-centered healthcare system, broadening their impact, and proving their worth within their organization.
Opportunities for the Lab
The silver lining is that change brings new opportunities. Remarkably, laboratory expenses are a small portion of the overall healthcare spend, yet lab results contribute to nearly every patient’s diagnosis or treatment plan. The high usage of lab testing and its rate of misuse opens a window of opportunity for laboratory professionals to become more involved in decisions about what tests are ordered and how they are interpreted. In this time where it is incumbent upon laboratories to show their value, this opportunity should be taken seriously.
A laboratory stewardship program focuses on making sure the best tests are ordered and properly interpreted, with an eye on patient safety. Historically, laboratories have focused on efficiency; however, the shift to value-based medicine requires laboratory professionals to be aware of downstream healthcare processes related to lab testing. This creates an opportunity for laboratorians to become actively involved with providers in determining best test selection, performance, and interpretation. Laboratory stewardship means the laboratory takes responsibility for, and is active in use of, lab testing, from order through interpretation to analytics.
Population Health Management (PHM)
To address rapidly escalating healthcare costs and improve the quality of care, PHM is being considered an instrumental part of the transition to value-based care. Laboratories must understand and find ways to be involved in PHM to thrive in the evolving healthcare environment.
Point of Care Testing (POCT)
As laboratory budgets shift in response to PAMA and value-based models, laboratory menus will shift as well. Careful consideration should be given to where POCT can be of value. A renewed focus on patient satisfaction and patient-centered care, as well as a more holistic view of the patient’s needs, shines a new light on the potential for POCT. Even though POCT cost per test may be more than the cost of that test in a core lab, if implemented in a scenario where the rapid turnaround time that POCT offers creates significant downstream savings, the cost is well justified.
In addition to POCT, molecular diagnostics is revolutionizing healthcare by paving the way for tailored treatments at the individual level—personalized medicine. Precision medicine and personalized medicine go hand in hand with companion diagnostics, which are genetic and molecular laboratory tests used to determine a patient’s benefits and risks with taking certain medications. Lab testing has steadily moved from a very hands-on process to a more automated process. The role of the laboratorian is expected to become more consultative as providers demand additional support in the interpretation of genetic test results.
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Orchard White Paper, Effective Test Utilization: A Laboratory's First Step in Contributing to the New Healthcare Model