St John Andrew, O'Kane Maurice, Jülicher Paul, Price Christopher P
Drajon Health, Toodyay, W. Australia, Australia.
Clinical Chemistry Laboratory, Altnagelvin Hospital, Londonderry, N. Ireland, UK.
Clin Chem Lab Med. 2023 Jan 9;61(4):674-678. doi: 10.1515/cclm-2022-1071. Print 2023 Mar 28.
Applying the concept of a value proposition to medical testing is just one of the many ways to identify and monitor the value of tests. A key part of this concept focusses on processes that should take place after a test is introduced into routine local practice, namely test implementation. This process requires identification of the clinical pathway, the stakeholders and the benefits or disbenefits that accrue to those stakeholders. There are various barriers and challenges to test implementation. Implementation requires the process of clinical audit which involves measurement of outcomes external to the laboratory but this is not widely performed in laboratory medicine. A second key challenge is that implementation requires liaison with stakeholders outside of the laboratory including clinicians and other healthcare professional such as finance managers. Many laboratories are remote from clinical care and other stakeholders making such liaison difficult. The implementation process is based on data which again will be primarily on processes outside of the laboratory. However the recent enthusiasm for so-called real world data and new data mining techniques may represent opportunities that will facilitate better test implementation. A final barrier is that a range of new tools not currently in the education curriculum of the laboratory professional is required for implementation such as those of preparing a business case to support the introduction of a test and health economic analysis. The professional bodies in laboratory medicine could assist with education in these areas.
将价值主张的概念应用于医学检测只是识别和监测检测价值的众多方法之一。这一概念的一个关键部分聚焦于在一项检测引入当地常规实践后应发生的过程，即检测实施。这个过程需要确定临床路径、利益相关者以及这些利益相关者所获得的益处或不利之处。检测实施存在各种障碍和挑战。实施需要临床审计过程，这涉及对实验室外部结果的测量，但在检验医学中这一做法并不广泛。第二个关键挑战是，实施需要与实验室外部的利益相关者进行联络，包括临床医生和其他医疗保健专业人员，如财务经理。许多实验室远离临床护理和其他利益相关者，使得这种联络变得困难。实施过程基于数据，而这些数据同样主要来自实验室外部的过程。然而，最近对所谓真实世界数据和新数据挖掘技术的热情可能代表着有助于更好地实施检测的机会。最后一个障碍是，实施需要一系列目前不在实验室专业人员教育课程中的新工具，例如准备商业案例以支持检测的引入和健康经济分析。检验医学专业机构可以在这些领域提供教育帮助。
