Laboratory test interpretations and algorithms in utilization management

Appropriate assimilation of laboratory test results into patient care is enhanced when pathologist interpretations of the laboratory tests are provided for clinicians, and when reflex algorithm testing is utilized. Benefits of algorithms and interpretations include avoidance of misdiagnoses, reducing the number of laboratory tests needed, reducing the number of procedures, transfusions and admissions, shortening the amount of time needed to reach a diagnosis, reducing errors in test ordering, and providing additional information about how the laboratory results might affect other aspects of a patient's care. Providing interpretations can be challenging for pathologists, therefore mechanisms to facilitate the successful implementation of an interpretation service are described. These include algorithm-based testing and interpretation, optimizing laboratory requisitions and/or order-entry systems, proficiency testing programs that assess interpretations and provide constructive feedback, utilization of a collection of interpretive sentences or paragraphs that can be building blocks (“coded comments”) for constructing preliminary interpretations, middleware, and pathology resident participation and education. In conclusion, the combination of algorithms and interpretations for laboratory testing has multiple benefits for the medical care for the patient.