In 2003, the Institute of Medicine (IOM) identified the utilization of information technology as one of five essential competencies all healthcare practitioners need to deliver quality healthcare.1 With greater than 10 billion laboratory tests being performed each year, our practice and its science are integral components of healthcare. It is critical that Medical Laboratory Science professionals focus their expertise and competency beyond the production of a quality test result. Competent management and utilization of laboratory test information goes beyond the walls of the laboratory. It spans the total testing process (TTP) from test selection, to result distribution, to provider interpretation and appropriate action on results.
Laboratory test information impacts each of the IOM’s Six Aims for Improving Patient Safety and Healthcare Quality with respect to safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.2 Every phase of the Laboratory TTP is key in promoting quality patient outcomes through error prevention and reduction. “When errors occur in the laboratory, they usually occur during test selection (TTP pre-analytical phase) and test result interpretation (TTP post-analytical phase).”3 A study conducted in 2013, discovered that 30% of commonly ordered lab tests were probably unnecessary and, conversely, a similar number should have been ordered and were not.4 Now more than ever, laboratory professionals must focus their efforts and attention on the fact that these errors can be prevented through appropriate changes in laboratory information systems, health care information systems and strong collaboration between physicians, laboratory professionals and all health care professionals who rely on laboratory test information to provide safe patient care.
The 2015 IOM report, “Improving Diagnosis in Health Care” established 8 goals to improve diagnosis and reduce diagnostic errors.5 The third goal is “Ensure that health information technologies support patients and health care professionals in the diagnostic process”.5 The recommendations to achieve this goal relate directly to how we practice our profession through the information we provide.. The IOM recommends that health information used in diagnostic process:
- demonstrates usability
- incorporates human factors knowledge
- integrates measurement capability
- fits well within clinical workflow
- provides clinical decision support
- facilitates the timely flow of information among patients and health care professionals
- assures interoperability to support effective, efficient, and structured flow across care settings
Laboratory professionals have the ability and responsibility to improve health care outcomes by becoming competent, involved and engaged information leaders. Within each Laboratory Professional lies the potential of greatness to improve and manage laboratory information resulting in the delivery high quality, safe health care.
References:
Morris S, Otto CN, Golemboski K. Improving Patient Safety and Healthcare Quality in the 21st Century—Competencies Required of Future Medical Laboratory Science Practitioners. Clinical Laboratory Science. 2013; 26(4): 200-204
Institute for Health Care Improvement. Across the Chasm: Six Aims for Changing the Health Care System; Retrieved from: http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmSixAimsforChangingtheHealthCareSystem.aspx
Arnaaout RA. Medical Tests: Inaccuracies, Risks and the Public’s Health; December 2015 Retrieved from: https://theforum.sph.harvard.edu/events/medical-tests/
Prescott B. Large-Scale Analysis Describes Inappropriate Lab Testing Throughout Medicine; Retrieved from: http://www.bidmc.org/News/In-Research/2013/November/Arnaout.aspx
National Academies of Science, Engineering, and Medicine. 2015. Improving Diagnosis in Health Care. Washington, D.C.: The National Academies Press; Retrieved from: nas.edu/improvingdiagnosis