Lab Medicine's Role in Coordinated Care

Laboratory medicine plays a huge role in healthcare — in fact, studies have shown that 70 to 80 percent of all patient management decisions made by primary care providers are based on results from a clinical lab test.

Now, under reform, the landscape of lab medicine is both changing and becoming more important in the grand scheme of healthcare. Here, Doug Beigel, president and CEO of COLA, an independent non-profit accreditor of medical laboratories, explains how lab medicine's role is changing with the rest of healthcare and the important role it plays in popular coordinated care delivery models, such as patient-centered medical homes and accountable care organizations.

Changes ahead

Many forces have come together recently are effecting change in the lab medicine field, including the following:

Increased use of waived labs and lab tests. Waived lab tests are unregulated by the federal government, meaning the tests are produced by a manufacturer and approved by the FDA as being safe for providers to use without oversight. Waived tests include rapid strep cultures, urinalysis and cholesterol checks, and they are performed in hospitals, physician offices, urgent care clinics, surgery centers and other healthcare provider locations. Labs that perform solely waived tests are not subject to federal oversight. "There's no one whose job it is to assure waived tests are being performed correctly," says Mr. Beigel. In other words, there is no formal training for many of the physicians, nurse practitioners and other providers who complete these lab tests. "It's left to the end user to…develop competency in lab testing oversight," he explains.

Since roughly 35 million Americans will gain health insurance in January 2014, the use of waived tests is bound to increase. Additionally, Mr. Beigel says, the increased popularity of retail health clinics will increase the use of waived tests. "They are doing primarily, if not exclusively, waived testing," he explains.

PCMHs and ACOs. These coordinated care models use electronic medical records systems to share data and patient information, which usually leads to better care coordination and patient satisfaction. However, the increased use of EMRs means the accuracy of initial lab test results is of upmost importance. "A lab test result will follow a patient to every provider, and the test result will be available to every provider giving care to that patient," Mr. Beigel explains, because the first test result is more likely to be entered into a medical record and accessed by multiple providers.

"Bad data leads to bad outcomes," Mr. Beigel says, and it is especially important to avoid bad data from tainted lab tests in a coordinated care model.

Lab excellence program

Because of the somewhat behind-the-scenes prevalence of laboratory medicine and its increased importance under healthcare reform, physician practices, hospitals and retail clinics need to examine how they do their lab testing and how lab medicine will fit into their accountable care model.

To help physician practices develop lab testing competency and deliver coordinated, quality lab medicine to their patients, COLA has developed a laboratory recognition program, known as the Patient-Centered Laboratory Excellence program.

The PCLE program helps physician practices integrate lab medicine into their patient-centered medical home model. As part of the program, COLA is creating educational symposia and online training webinars to help providers prepare their facilities and themselves to provide accurate, high-quality lab test results.

For more information on PCLE, click here.

More Articles on Coordinated Care:

Cigna Expands Collaborative Accountable Care Program to 58 Members
A Comprehensive Communication Plan to Streamline Care Coordination Improves Patient & Physician Satisfaction
Growing and Engaging an Accountable Care Patient Base: Q&A with MissionPoint Health Partners' CEO Jason Dinger

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