Value-based healthcare: the role of laboratory medicine.

The global increase of health demands pushes administrators and policy makers to provide good quality health care at sustainable costs. Many approaches have been developed, among which value-based health care (VBHC) is one of the most promising: value is given by outcomes achieved per dollar spent. Best value is given by shared benefits between all the stakeholders involved in the process: patients, providers, suppliers, payers and citizens. However, VBHC implementation is a current challenge for hospitals and healthcare providers, that may find it difficult to adapt their organization into a patient-centered clinical pathway based on both classical outcomes and innovative patient-evaluation. If any contribution to improve cost-effectiveness over the full cycle of care is welcome, laboratory medicine is achieving increasing importance, by generating useful knowledge to reduce costs and improve patient care, provided by a biunivocal relationship with clinicians. On the one hand, pathologists have to emphasize the importance of laboratory data to improve diagnostic and prognostic traditional thinking. On the other hand, the same data are useful only when supported by strong evidence. Introducing laboratory medicine professionals to VBHC would be useful to achieve better skills on data outline, comparable methodologies, quality control, cost assessment, multidisciplinary coordination and patient-specific procedures.