Alternate site testing. The old and new paradigm or the past is prologue.

This paper reviews broad themes emerging in the discussion concerning alternate site testing, including the emergence and continuing value of centralized testing, the reasons for alternate site testing, and the relative merits and negative aspects of traditional centralized testing and decentralized models. The paper attempts to identify the expectations of constituencies affected by alternate site testing (patients, physicians, nurses, administrators and managers, and pathologists and other laboratory professionals) and identifies criteria and implementation strategies for decentralized testing.