The Compelling Need for Optimal Laboratory Utilization

Background: With ever increasing pressure on hospitals to provide quality medicine cost effectively, clinicians and laboratorians must team up to ensure that the most appropriate laboratory investigations are ordered at the most appropriate time and frequency to significantly reduce length of stay, improve patient outcomes, improve hospital and laboratory efficiencies, reduce hospital costs and minimize insurance claim denials. Objective: Ever increasing reliance on laboratory investigations combined with availability of several newer, and usually costlier, testing options have significantly increased treatment costs; and rejection of these insurance claims amounts to hospital losses. In today's atmosphere of managed care, hospitals must revisit test ordering practices to remain competitive. Methods: The current literature was reviewed for prevalent test ordering practices & to suggest the most appropriate laboratory utilization. Results: Laboratory medicine has failed to receive due attention in curricula of most medical schools and in hospital plans. The physician is, therefore, often unaware of the more cost effective investigations, performance indices of various tests and the most effective testing options for the clinical condition of a patient. Collaborative care is still a budding idea in most healthcare facilities. Unnecessary or inappropriate testing delays diagnosis affects patient outcome, patient satisfaction and hospital efficiency; and often results in denial of insurance claims. Discussions: While newer laboratory tests get introduced every day, a clinician is not always aware of its performance indices, hidden lab costs or availability of more cost effective alternatives. Frequency of repeat testing must be regulated to depict a meaningful change in the levels of analyte. Clinicians should consult Laboratorians regarding all these issues. Adoption of Diagnostic Testing algorithms ensures uniformity of care, optimal lab utilization & improvement in efficiency of Clinicians. Insurance claim denials can be minimized by avoiding the traps of unnecessary; or too frequent lab testing. Medical curriculum should lay more emphasis on laboratory medicine. Conclusions: Pathologists can play a more active role in spreading awareness about appropriate lab investigations. It is desirable for hospitals to adopt diagnostic testing algorithms to optimize utilization of laboratory resources and to minimize insurance claim denials.