Clinical laboratories have numerous opportunities to play a role in patient-centered medical homes (PCMH), a new health care model intended to establish a foundation for primary care that achieves the Institute for Healthcare Improvement’s threefold aim of better health, better care, and lower costs. According to a new white paper from COLA, there are numerous opportunities to integrate labs into the PCMH model. Specifically, lab personnel can take the lead in establishing practices that align with PCMH standards in three key areas: Controlling utilization; identifying risks and controls for all phases of laboratory testing, including pre-analytic, analytic, and post-analytic; and coordinating lab results among primary care providers, other providers in the PCMH “neighborhood,” and the patient. Controlling Utilization COLA notes that inappropriate testing can take two forms—overutilization and underutilization. Ramifications of overutilization go far beyond lab costs, unnecessary sample collection, and burden on health care resources. Downstream effects include increased likelihood of false results leading to incorrect diagnoses, unnecessary prescription drugs, longer hospital stays, and additional medical or surgical interventions. Lab utilization controls that could be implemented by physician office labs include physician education on lab test costs and evidence-based medicine, and restricting and auditing test ordering. Identifying Risks and…
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