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By Lauren VanDenBoom

October 6, 2020

During the 2020 American Society of Clinical Pathology (ASCP) Annual Meeting, Quest Diagnostics was announced as a 2020 ASCP Choosing Wisely Champion for Quest®  Lab Stewardship™ powered by hc1®. The recognition honors the significant impact hc1 and Quest are making together using advanced lab analytics for precision health. 

The Choosing Wisely® Champions program, in collaboration with the American Board of Internal Medicine (ABIM) Foundation, recognizes contributions to the Choosing Wisely campaign, serves to inspire others to drive change in healthcare and helps clinicians learn from the outstanding examples of others. 

Choosing Wisely is an initiative of the ABIM that offers guidelines for testing and therapy with a goal of reducing unnecessary laboratory services while maintaining a high standard of quality in patient care. Choosing Wisely recommendations improve patient care and reduce healthcare costs, and the Choosing Wisely Champions encourage their colleagues to use the right test at the right time for the right cost.  

Nearly 70 percent of all medical decisions are based on laboratory results. An estimated 13 billion laboratory tests are performed in the United States each year. Through this objective evidence, doctors and other healthcare professionals daily make informed diagnostic and therapeutic decisions. 

While the more than 3,500 types of laboratory tests available are a rich source of information, as much as 21 percent of all those ordered are unnecessary or unwarranted based on the patient’s symptoms. To provide high-value care, healthcare organizations must identify and manage this waste. 

The modern laboratory test menu is complex, making it unrealistic for healthcare providers to become experts in laboratory medicine. Nearly 15 percent of healthcare providers say they are uncertain about which tests to order. Laboratory leaders have the knowledge to educate healthcare providers, but are themselves strapped for time and resources. They are focused on producing high-quality test results in a timely manner. Healthcare providers and laboratorians rarely meet to discuss how they could work together to improve laboratory usage and patient care. 

Replacing inefficient practices with a cost-effective utilization strategy requires dedication, resources and the right solutions. With a focused, data-driven program in place, health systems can provide high-value care for patients while increasing internal efficiencies and lowering costs.

The savings that can be realized through implementing an effective utilization program can more than make up for the expense of putting the appropriate resources and team in place to do so. Estimates project that healthcare systems could reduce costs of up to $5 billion per year if they were just to eliminate redundant tests. Even more savings, and patient satisfaction, could be realized through increasing use of appropriate tests that diagnose diseases early, when treatment can be more effective. In addition, insurers are also demanding evidence for the efficacy of a therapy or intervention and denying payment if it is not provided. 

To combat waste in lab test ordering, some health systems and hospitals have implemented test utilization programs to identify patterns in lab ordering trends. However, these programs often require time-consuming manual uploads of data or use platforms that cannot pull from disparate enterprise systems or provide real-time test ordering guidance. Quest, with hc1, created Quest Lab Stewardship to overcome these challenges. 

Quest Lab Stewardship powered by hc1 helps healthcare leaders and lab administrators optimize laboratory utilization, reduce clinical variation, and ensure the right patient gets the right test at the right time. This innovative technology employs machine learning to harmonize laboratory testing across a hospital’s laboratory and other IT systems and matches ordering patterns against guidelines, such as those of Choosing Wisely. The user can quickly filter and analyze this data to identify ordering patterns that may adversely impact care or costs.  

“Lab testing is essential to delivering cost-effective healthcare, but hospital test utilization programs often fail to maximize its value,” said Lee H. Hilborne, MD, MPH, DLM (ASCP), Senior Medical Director, Medical Affairs, Quest Diagnostics, and Chair of the American Society for Clinical Pathology’s Effective Test Utilization Subcommittee (Choosing Wisely). “With Quest Lab Stewardship, health systems have an intuitive solution to identify the right test, for the right patient, at the right time – the same goal embodied in the Choosing Wisely Award.” 

Quest and hc1 are currently working to expand Quest Lab Stewardship to include automated management and alerting to ensure COVID-19 patient continuum of care and risk assessment. Recent studies show that health conditions post-COVID-19 infection may require additional, ongoing monitoring and care for patients as they struggle to return to their usual health pre-infection. Laboratory testing is one critical tool for healthcare providers to develop a baseline understanding of their patients’ health and to manage patient care through a diagnosed or suspected COVID-19 case. Armed with key insights from laboratory testing, Quest Lab Stewardship powered by hc1 helps illuminate a care pathway.

Hospital and health system lab administrators interested in learning more about Quest Lab Stewardship powered by hc1 should click here.

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