Cost-effective use of laboratory tests: a joint responsibility of clinicians and laboratorians.

The successful attempts to achieve cost savings through improving the effectiveness of test utilization have several things in common. First, if the laboratory is to improve test ordering, it must thoroughly understand the clinical questions behind the test requests. Working with the appropriate clinical experts, the laboratory must establish standards and guidelines for appropriate test use. Then procedures must be developed to review and monitor test utilization to determine compliance with the standards and guidelines. Cost-effective improvements in the use of laboratory tests may require modifying clinicians' test ordering behavior through strategies such as problem-oriented request forms and administrative policy changes, but also the clinical laboratory's testing procedures where appropriate. Because laboratory tests are important elements of medical practice, the cost-effective use of laboratory tests and services is clearly the joint responsibility of clinicians and the clinical laboratory.