Establishing a Laboratory Formulary Committee to foster better test utilization
By current estimates, 20-40% of U.S. healthcare expenditures do not improve patient management or outcomes. Particularly in academic medical centers, over-ordering of both common and esoteric laboratory tests may be commonplace. The cost of laboratory testing is expected to double in 3-4 years, largely due to expensive molecular and genetic testing. Inappropriate testing may lead to patient harm, through unnecessary phlebotomies, procedures, or treatments.
To begin the process of improving test utilization at YNHH, a Laboratory Formulary Committee was established in January 2014 to help set policies and guidelines, provide a forum for discussion, and develop and promote initiatives to reduce waste and facilitate clinically targeted ordering. Committee membership spans multiple departments and areas of expertise, at both the hospital and medical school.
First steps included implementing a policy of consolidating send-out testing to preferred reference laboratories for better service and lower costs as well as learning about opportunities to support clinical decision making in Epic.
For more information about policies and projects, log on to the Epic physician portal at md.ynhh.org or email Marie Landry, Vice Chair of Laboratory Medicine (marie.landry@yale.edu) or Carol Barsky, Associate Chief of Patient Safety and Quality (carol.barsky@ynhh.org).