The American Society of Clinical Pathologists (ASCP) has recently documented the
growing trend of private lab testing or what could be called Direct Access Testing.
The ASCP provided a policy statement in October of 2008 on their position.
Direct Access testing is becoming an increasingly popular option for patients wishing
to monitor their health status and make more decisions about their own health care.
DAT can be a useful tool in enhancing the doctor/patient relationship. ASCP believes
it is critical for patients to use reliable testing sites consult with their physician
and pursue appropriate follow up treatment.
The ASCP has published another paper on Private Lab Testing in July of 2004. Here
is a part of the introduction.
The traditional healthcare model in this country places the physician (or appropriate
ordering provider) in control of determining what diagnostic and therapeutic monitoring
(including laboratory tests) are performed on a patient. In addition, all results
of tests and procedures are reported to the physician who assumes the responsibility
of relaying the information to the patient.
The Consumer
Consumers are now taking charge of their own health and wellness by managing their
laboratory testing with the help of direct access testing. The ability to order
private lab testing without a prescription is precisely what direct access testing
has enabled consumers to do. Physicians are not, however, left out of the loop.
Direct Access Testing (DAT) companies have licensed Physicians on staff to review
results and advise you and if this is not feasible, they strongly advise you to
consult your personal physician to go over your results.
The tremendous upsurge in national media attention on private lab testing online
has prompted companies providing direct-to-consumer laboratory services to form
an organization of DAT?s to establish standards of excellence and assure high quality
screening services along with the low cost. In a few
recent published articles, we see a growing trend of online lab testing without
a prescription.
The Importance of Laboratory Services
Clinical laboratory testing provides objective data about the health of a patient
which enables healthcare providers to screen for risk factors, perform early diagnosis,
evaluate the severity of many disease states and recovery statistics, the monitoring
of treatment and the total evaluation of these outcomes.
Patient safety is another area which laboratory services provide a critical part
of the overall healthcare process. An example of this is the ability to monitor
optimum drug levels in vivo for patients on drug therapies. Personalized prescribing
of medications can also be achieved through laboratory testing. Another example
is how laboratories screen blood supplies for pathogens in donated blood. This safety
mechanism is extremely important for surgery and disease states that require blood
transfusions.
Evidence based medicine is the foundation which laboratory services provide to healthcare.
This evidence based ideology is being incorporated into standard operating procedures
throughout healthcare which assists providers and patients with making decisions
about individual?s health care in specific circumstances. A greater attention is
being given to evidence based medicine by doctors and payers which is paving a new
path to improved care giving practices.
A recent article about Private Lab Testing in the Wall Street Journal?
Aches & Claims: Ordering Up Your Own Medical Tests By Robert
J. Davis
CURIOUS ABOUT your cholesterol but too busy to go to the doctor? A growing number
of people are using direct-to-consumer lab services, which let you order your own
blood and urine tests for everything from allergies to the AIDS virus. The process
is quick and easy, but interpreting the results can be tricky without a doctor's
help
Laboratory Services in the US
The clinical laboratory and the laboratory services which are provided have a major
effect on the clinical decisions that physicians, nurses and various other healthcare
providers make with patient care. These decisions effect disease prevention, diagnosis,
treatment and the management of disease. A surprising number which contrasts the
importance that laboratory services provides is the cost which laboratory testing
accounts for when looking at healthcare spending. The latest healthcare statistics
show that laboratory services accounts for only 2.3 % of US healthcare expenditures
and only 2% of Medicare spending. Consumer directed testing is a key area for market
growth. In 2004, 10-15% of hospital and commercial clinical laboratories offered
some form of direct access testing. Laboratories should be prepared to assume a
greater advisory role and provide other support to promote informed self care by
consumers. Laboratory medicine is an essential element of the health care system.
It is integral to many clinical decisions, providing physicians, nurses, and other
health care providers with often pivotal information for prevention, diagnosis,
treatment, and management of disease. Laboratory tests and services supply clinicians
with information necessary to provide high quality, safe, effective, and appropriate
care to patients. The key role of laboratory testing is reflected in evidence-based
medicine (EBM) and clinical practice guidelines. Health care providers, quality
assurance organizations, and payers are incorporating selected laboratory tests
into indicators to objectively assess quality of care for individual patients and
populations and to support payment policies. Laboratory medicine has an essential
role in risk management. Not only can testing help to prevent certain adverse events,
it can facilitate detection and recovery from adverse health events when they do
occur. Laboratory tests help to prevent infectious agents from getting into the
blood supply and ensure the safety of organs and tissues for transplant. Through
effective and timely surveillance, tests can help to mitigate threats to patient
and population health (e.g., influenza, nosocomial infections, severe acute respiratory
syndrome). The contributions of laboratory tests and services as an essential component
and partner in health systems remain under-recognized. Despite the extensive role
of laboratory medicine in informing medical decision-making, spending on laboratory
services accounts for only 2.3% of national health care spending and 2% of Medicare
expenditures. As overall expenditures on health care continue to rise, appropriate
use of laboratory tests can facilitate cost-effective care via early detection and
improved management of priority health conditions. Recent and emerging technological
advances gained from mapping the human genome, including applications of genetic
testing that enable personalized medicine, call greater attention to the contributions
of laboratory medicine to patient care as well as the scientific and medical knowledge
base. This chapter summarizes the value of laboratory medicine to health care and
patient and population health.