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Novel markers, a payer's perspective: commissioning a new service
Christopher P Price1, Les Martin
1Department of Clinical Biochemistry, University of Oxford, John Radcliffe Hospital, Headington, UK. cpprice1@googlemail.com
Summary
Implementing evidence-based laboratory medicine is challenging due to difficulties in demonstrating test effectiveness and tracking outcomes. Proper commissioning ensures diagnostic services meet clinical needs and fiscal requirements for optimal patient care.
Area of Science:
- Laboratory medicine
- Clinical diagnostics
- Health services research
Background:
- Evidence-based practice is challenging in laboratory medicine.
- New diagnostic tests often lack formal effectiveness requirements.
- Test effectiveness relies on correct clinical decisions and actions post-result.
Purpose of the Study:
- To address challenges in evidence-based laboratory medicine.
- To outline a framework for commissioning diagnostic services.
- To ensure diagnostic services meet clinical needs and fiscal governance.
Main Methods:
- Reviewing principles of evidence-based laboratory medicine.
- Describing the process of commissioning new diagnostic services.
- Highlighting the importance of outcome evaluation.
Main Results:
- Diagnostic tests offer broad clinical benefits but outcomes are often outside the lab.
- Commissioning involves needs assessment, service specification, securing services, and monitoring.
- Effective commissioning ensures appropriate use and optimal patient/economic outcomes.
Conclusions:
- Evidence-based laboratory medicine requires robust commissioning processes.
- Purchasers must ensure diagnostic services align with clinical needs and fiscal responsibilities.
- Properly commissioned diagnostic services improve patient outcomes and health economy efficiency.
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