June 3, 2021
According to the U.S. Food and Drug Administration (FDA), “Precision care will only be as good as the tests that guide diagnosis and treatment.” One way to ensure patients are getting the best tests for them is through guidelines-driven, appropriate test utilization.
Approximately 70 percent of medical decisions are based on pathology and laboratory test results. Many pathology and laboratory tests, however, are ordered without sufficient information to be specific to the patient’s needs.
Insights as part of the workflow enables precision care
Thousands of tests are available and the guidelines around how those tests should be used and for whom changes regularly. Our healthcare providers cannot possibly keep up with this massive database of lab testing information and then tailor it to the specific patient’s needs. Like hc1 CEO Brad Bostic said in a recent Precision Medicine Leaders Summit fireside chat, “They are not cyborgs; they cannot remember every single thing or keep up-to-date on every single new thing.”
Lab testing is the single highest-volume medical activity within a health system, yet 21% of diagnostic tests are misused or even overlooked. The challenge health systems face is two-fold: first, they must identify the root cause of inefficient or wasteful practices that include high-cost, low-value, duplicative, and antiquated test ordering, and second, they must identify missed opportunities to deliver the right test to the right patient at the right time to avoid rehospitalizations, ER visits, and other consequences.
If you have been following hc1 for a while now, you’ve likely recognized that we are strong advocates for technology that puts the ability to deliver precision healthcare to all patients at the provider’s fingertips as part of their regular workflow. This means having all of the latest test and prescription information and the patient’s health history, genetics and lifestyle information readily available to be able to choose the optimal tests and treatments based on their unique needs and conditions.
Insights make utilization committees more effective
Many organizations have already established committees focused on improving laboratory stewardship, but often their efforts are slowed by the inability to access the right insights into test ordering practices so that they can take targeted action to effect change.
With over 2.3 trillion gigabytes of data generated every year in healthcare, there is a lot of information to consider when identifying test utilization outside of guidelines. With that data housed in separate and often siloed locations, a method to ingest, organize, and normalize it all is necessary to derive meaningful and actionable insights.
Successful lab stewardship committees have a strong, visible commitment from leadership with sufficient human, financial, and IT resources allocated. With the right knowledge and tools, they can find inefficiencies and eliminate them with policies, education, and technology. The savings that can be realized through implementing an effective program can more than make up for the expense of putting the appropriate resources and team in place to do so.
When structured and supported well, a lab stewardship committee organizes and guides optimal, patient-centric lab testing. Estimates project that health systems can reduce costs up to $5 billion per year just by eliminating redundant tests. Even more savings, and patient satisfaction, can be realized through increasing the use of appropriate tests that diagnose diseases early when treatment can be more effective.
Insights enable health systems to take action
As part of the world’s leading precision health platform, hc1 PrecisionDx Advisor™ (PDx Advisor) is a comprehensive solution that includes both strategic guidance and cloud-based technology to launch an effective utilization program. Formerly known as hc1 Test Utilization, PDx Advisor feeds information about ordered tests to easy-to-use dashboards. From there, you can filter by type of testing, compare ordering trends for different locations, and track progress to your stewardship goals. You can drill down into pre-built reports to see which providers are ordering tests outside of established guidelines and then use this information to tailor programs directed at the changes that will have the most impact on your health system and the patients within it.
The National Committee for Lab Stewardship recommends interventions that educate and guide and direct measures to eliminate waste, such as:
- Provide regular updates on lab capabilities, appropriate use of new diagnostic tests, testing algorithms, and tests approaching obsolescence.
- Deliver information in a variety of ways to suit varied learning styles and habits, such as posters, newsletters, presentations, and videos.
- Use testing cascades, algorithms, and best practice recommendations to implement standardized workflow processes that guide providers toward the most appropriate testing for the patient and reduce the number of inappropriate test orders.
- Use automatic alerts when testing may be unnecessarily duplicative.
- Provide feedback to healthcare providers regarding their ordering patterns.
- Establish a laboratory formulary that provides a concise list of appropriate testing and does not include obsolete or antiquated tests.
- Identify tests requiring a consultation before ordering, such as complex genetic tests.
- Provide applicable collection instructions alongside test orders to ensure specimen integrity.
Precision healthcare requires the right patient to have the right test and the right prescription. By using the hc1 Platform to inject powerful patient-specific insights into the provider’s workflow and the stewardship committee’s efforts, hc1 is breaking down the biggest barriers to delivering precision healthcare for all patients.
What challenges is your health system facing to deliver precision healthcare through appropriate test utilization? Respond to our 1-minute poll.