We are now entering an era when sophisticated decision support tools will become commonplace in healthcare based on machine learning algorithms. Certainly, many such tools will be developed in relationship to the laboratory database where numerical results have a close relationship to diagnoses. Mayo Clinic has developed such a tool in conjunction with a company called the National Decision Support (see: Mayo Clinic, National Decision Support Company unveil CareSelect Lab™ to provide real-time medical guidance when ordering laboratory tests). Below is an excerpt from the article describing it:
Mayo Clinic has teamed with National Decision Support Company (NDSC) to develop CareSelect Lab™ — a decision-support tool that aggregates clinical knowledge around a comprehensive menu of conditions and translates that knowledge into best-practice recommendations....Direct interaction with the test guidelines in a health care provider’s normal EHR workflow, receiving feedback as to the most appropriate test(s) to order. Benchmarking and analytics tools that enable organizations to compare health care provider ordering patterns, identify gaps in care and manage overall test utilization.....“Mayo Clinic and NDSC are developing better ways to improve health care for providers and their patients,” says Curt Hanson, M.D., chief medical officer of Mayo Medical Laboratories. “We have all this knowledge at our fingertips — IT capabilities, clinical and laboratory expertise, laboratory test analytics, health care data, etc. Why not put that knowledge at the ordering physician’s fingertips?”
Here is a list of the "Benefits at a Glance" provided by CareSelect Lab copied from the web site of NDSC:
- Flagging obsolete tests.
- Clarifying confusing test names (e.g., creatine vs. creatinine).
- Providing generic cost information.
- Recognizing tests that may produce inaccurate results because of medications or over-the-counter drugs being taken by the patient.
- Identifying test-ordering frequency (repeat tests) and gender rules.
- Offering standardized reports that compare utilization practices among health care providers and across institutions.
Lab professionals have been trying to inform clinicians about duplicate testing and comparing physician test-ordering practices for decades with variable degrees of success in changing test ordering habits. Providing "generic test cost information" is also a noble goal that has the potential to change test ordering habits. When I read the press release shown above, however, I came away with the impression that CareSelect Lab was a novel "decision support tool" in the sense that it would inform clinicians about the most appropriate tests to order for a particular patient. I don't find this goal listed above but Mayo and its partner company may be working toward this goal.
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