The burden of chronic disease is increasing rapidly in our populations. This in turn drives an increase in pathology testing. Are more tests being ordered because there is not enough information about how test results should best be interpreted? Can clinicians pick a true change in test results, and therefore clinically significant patterns? The answer to these questions indicated information available at the point of test ordering is insufficient and there are gaps in the interpretation of patient lab reports.

Using HBA1C as an example, on average six monthly testing is unnecessary (Aronsen et al, NHS Diabetes). Providing better guidelines on intervals between testing will facilitate a change in the trend of over-ordering of lab tests.

How can labs provide better guidance; i.e. how often are tests needed? Can we guide testing intervals? What is a meaningful change in a test results?

How can value be added for patients, so that the pathology spend is measured in terms of patient care. Current health funding remains focused on treatment, the cost of hospitalisation dominates the health spend and pathology is often referred to as a “cost centre”.

The laboratory service can be utilised as a risk management strategy for health care outcomes by implementing the following initiatives: