From the Department of Laboratories (Drs Dickerson, Cole, Jack, Rutledge, and Astion and Mss Conta and Wellner) and the Division of Genetic Medicine (Dr Wallace), Seattle Children's Hospital, Seattle, Washington; the Departments of Laboratory Medicine (Drs Dickerson, Jack, Rutledge, and Astion) and Pathology (Dr Cole), University of Washington, Seattle; and the Department of Pediatrics, University of Washington School of Medicine, Seattle (Dr Wallace).
Arch Pathol Lab Med. 2014 Jan;138(1):110-3. doi: 10.5858/arpa.2012-0726-OA.
Tests that are performed outside of the ordering institution, send-out tests, represent an area of risk to patients because of complexity associated with sending tests out. Risks related to send-out tests include increased number of handoffs, ordering the wrong or unnecessary test, specimen delays, data entry errors, preventable delays in reporting and acknowledging results, and excess financial liability. Many of the most expensive and most misunderstood tests are send-out genetic tests.
To design and develop an active utilization management program to reduce the risk to patients and improve value of genetic send-out tests.
Send-out test requests that met defined criteria were reviewed by a rotating team of doctoral-level consultants and a genetic counselor in a pediatric tertiary care center.
Two hundred fifty-one cases were reviewed during an 8-month period. After review, nearly one-quarter of genetic test requests were modified in the downward direction, saving a total of 2% of the entire send-out bill and 19% of the test requests under management. Ultimately, these savings were passed on to patients.
Implementing an active utilization strategy for expensive send-out tests can be achieved with minimal technical resources and results in improved value of testing to patients.
在医嘱机构之外进行的检测，即外送检测，会给患者带来风险，因为这些检测的复杂性导致外送过程中存在各种风险。外送检测相关的风险包括交接次数增加、开错或不必要的检测、样本延迟、数据录入错误、报告和确认结果的可预防延误以及额外的财务责任。许多最昂贵和最容易被误解的检测都是外送基因检测。
设计和开发积极的利用管理计划，以降低患者的风险并提高外送基因检测的价值。
在儿科三级保健中心，由一组轮流的博士级顾问和遗传咨询师对符合特定标准的外送检测请求进行审查。
在 8 个月的时间里，共审查了 251 例病例。审查后，近四分之一的基因检测请求被向下调整，总共节省了 2%的外送账单和 19%的受管理检测请求。最终，这些节省都转嫁给了患者。
通过最小的技术资源实施昂贵的外送检测积极利用策略，可以提高检测对患者的价值。
