Utilization management in the core laboratory

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Diagnostic Testing

Background:

• Effective utilization management of diagnostic testing is vital.
• Core laboratories handle the majority of tests, emphasizing high throughput and cost-efficiency.
• Current practices necessitate better strategies for test ordering and frequency.

Purpose of the Study:

• To establish a framework for appropriate utilization management of diagnostic tests.
• To categorize laboratory tests based on necessity and reasonable ordering frequency.
• To enable electronic rule-based systems for clinical indication-based test selection.

Main Methods:

• Categorization of core laboratory tests.
• Classification based on whether tests should be ordered at all.
• Defining appropriate ordering frequency (e.g., daily, weekly, yearly).

Main Results:

• A classification system for diagnostic tests was developed.
• Tests were categorized by their necessity and appropriate ordering frequency.
• This classification supports the development of electronic decision support tools.

Conclusions:

• Classifying diagnostic tests by ordering appropriateness and frequency is key for utilization management.
• This approach facilitates the implementation of electronic rules for appropriate test ordering.
• Optimizing diagnostic test utilization improves healthcare efficiency and patient care.