CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
Editors: Raymond D. Aller, MD, and Hal Weiner
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Desire to stem lab test overuse leads to free software
For Zia Uddin, PhD, enough was enough. After reading time and again about the proliferation of redundant and otherwise medically unnecessary laboratory testing in the U.S. health care system, the clinical chemist and computer scientist decided to take matters into his own hands—quite literally.
So about a year ago, Dr. Uddin, a consultant in clinical chemistry at St. John Macomb-Oakland Hospital, Warren, Mich., formed a volunteer software design team to help him write software with the goal of chipping away at the problem of lab test overutilization. The result is LabLinked: Physician Tool for Laboratory Testing—a free cloud-based system that allows clinicians to search for and select laboratory tests with price considerations in mind. LabLinked, which is based on native computer programming, is available as a website (www.lablinked.com), an app for smartphones and tablets, and a software-as-a-service application (www.physicianlabtests.com). The latter duplicates the function of LabLinked.com and acts as a backup system in the event of downtime on the other offerings.
“I fundamentally believe that education must be free through the Internet,” says Dr. Uddin, when asked why he’s not charging a fee for LabLinked. “It’s better to give than receive,” he adds.
The idea behind LabLinked is “very simple,” explains Dr. Uddin: “Do the test only if you need it; don’t do the test if it’s not helpful to the diagnosis.” By factoring price into the medical decision-making process each time an order is placed, Dr. Uddin hopes the software will get clinicians in the habit of closely assessing the value of every test they order.
The software focuses on clinical need, particularly for expensive tests, by incorporating a price cutoff above which ordering approval is required from a lab director. For example, if an oncologist wants to request a gene test for a patient with cancer, a pop-up in LabLinked appears on the screen showing, among other details, the test’s cost plus the reimbursement rates. If the cost exceeds the predetermined cutoff—say, $200, although a hospital’s medical executive committee can customize this threshold—the test would be listed as “not orderable without authorization and review.” A test with a sticker price below the dollar limit restriction could be ordered immediately.