Promoting value-based laboratory medicine: Moving towards an innovative model of clinical laboratory
Mario Plebani, Abdurrahman Coşkun
Abstract
The shift to value-based healthcare, emphasizing quality and clinical outcomes rather than volumes and volume-based payment models presents challenges and opportunities for clinical laboratories. In order to promote value-based laboratory medicine (VBLM), it is imperative to transition from a subjective interpretation of laboratory information by clinicians and/or users to an objective interpretation based on sound and measurable variables. This transition is of the utmost importance to provide evidence of the role of laboratory information and of the fundamental role of laboratory professionals. Therefore, laboratory professionals must promote the adoption of personalized reference intervals (pRIs), personalized decision limits (pDLs) and personalized reference change values (pRCVs), and the remodeling of laboratory information into valuable clinical insights should be achieved through the utilization of longitudinal data. Another essential issue is the role of laboratory medicine in promoting the shift from the prevailing emphasis on "sick care" to that of "well care", as laboratory data play a crucial role in monitoring the health status of both healthy individuals and patients. Finally, clinical laboratories need to move out of the silo and implement integrated practice units rather than focused factories focused on efficiency metrics such as volume, economies of scale and cost per test.