College of American Pathologists Conference XXVIII on alternate site testing. What must we now do?

Implementation of the conference consensus that alternative site testing should be under the direction of the laboratory director supported by an institutional structure of users, laboratorians, and possibly administrators will optimize success. Information is needed if, when, and where alternative site testing improves the care of patients, and if faster results are associated with better and less expensive patient care. Costs and the timeliness of both central clinical laboratory and alternative site testing must be estimated in an identical fashion, then both must be compared with the costs and timeliness attributed to all steps of the total testing process included. As has been done with glucose, accuracy and precision goals must be developed for analytes measured at alternative test sites, then agreement reached on what these goals are and whether speed of measurement can influence these goals. Consideration of successful models is essential by those implementing or reevaluating alternative site testing programs. Required scientific information cannot be obtained in a timely manner unless improved funding occurs.