CareSelect™ Lab and Mayo Clinic help to mitigate 20-40% of unnecessary lab tests through provider order guidance.
Don Flott
Director of Utilization Management and Integration Services, Mayo Medical Laboratories
Don Flott has 30 years of experience in administrative leadership roles at Mayo Clinic. During the past several years, he has focused on the value of laboratory diagnostics and its impact on a patient’s total cost of care. Flott — together with pathologists, scientists, and clinicians — has developed data-driven methodologies for producing validated diagnostic clinical evidence that can drive out waste and impact the total cost of care for both hospitalized patients and those treated outside of the hospital setting.
“The U.S. spends approximately $3.2 trillion a year on healthcare. For health care providers, reimbursement levels are declining at the same time the cost of care for patients is rising. CareSelect Lab allows providers to introduce appropriateness in order to better align cost to reimbursement and mitigate downstream costs.”
Why is it important for health systems to have Clinical Decision Support within the laboratory?
The transition from volume to value is accelerating. Appropriate lab testing can lead to fewer tests, while delivering the same level of quality patient care. Additionally, the explosion of technology and associated information around the ordering of complex testing – combined with high costs – is leading to the need for additional guidance.
Why is Mayo Clinic’s collaboration with NDSC unique?
Currently, there isn’t a single source of trusted, vetted laboratory guidance on appropriate test ordering. Health care providers are required to reference multiple sources, which can be a very time-consuming task. By partnering with NDSC, Mayo Clinic is able to provide a single source of test guidance, integrated into the electronic health record, available at point-of-order entry. This allows for minimal workflow disruptions, giving health care providers more time to spend with their patients.
Can you elaborate on the process of turning Mayo Clinic best practice guidelines into clinical advisories for CareSelect Lab?
Mayo Clinic sees more than 1 million patients every year, with conditions that range from community patients to high complexity patients. Having the opportunity to see, diagnose and treat these patients allows us to create unique integrated care models. These models represent the highest standard of care delivery with a focus on patient outcomes and efficiency. Mayo Clinic has taken these care models and converted the laboratory testing knowledge into outputs that NDSC then translates for the electronic health record. The end result is CareSelect Lab, which is then available at the provider’s fingertips. Additionally, Mayo Clinic has an internal team that is constantly reviewing and updating the care models to ensure accuracy.
The average 500-bed hospital performs over $750,000 worth of clinically redundant and duplicative tests annually, how does CareSelect Lab help mitigate this?
Literature has identified that 20% to 40% of laboratory orders are unnecessary. When examining a subset of CareSelect Lab guidance against a 5 million life database, it was identified that the average 500-bed hospital has $750,000 of potentially unnecessary laboratory testing.
CareSelect Lab provides healthcare organizations the ability to benchmark their laboratory test ordering against best practices. In doing so, areas for greatest opportunity are highlighted and specific guidelines can be seamlessly activated with minimal intrusion to the provider workflow.
How does CareSelect Lab solve current problems within health care?
The U.S. spends approximately $3.2 trillion a year on healthcare. For health care providers, reimbursement levels are declining at the same time the cost of care for patients is rising. CareSelect Lab allows providers to introduce appropriateness in order to better align cost to reimbursement and mitigate downstream costs.
Why was it important to expand CareSelect Lab to deliver guidance for an expanded range of difficult and uncommon clinical scenarios?
Complex condition management is what Mayo Clinic excels at – we’ve been seeing patients with complex diseases and conditions for over 150 years. Many times, these complex conditions have high-costs associated with them, and can have a large impact on the clinical diagnosis and treatment for the patient. By expanding CareSelect Lab, we’re now able to provide guidance to a variety of patients and healthcare providers – whether you’re a community hospital or a large academic medical center.
What impact does having clinical decision support have for patients?
Clinical Decision Support (CDS) assists healthcare providers in ordering the right test, at the right time, for the right patient. This assistance allows for numerous benefits to the patient, including:
- Fewer lab tests ordered, resulting in less expensive care and fewer blood draws
- Lower total cost of care through appropriate diagnosis and treatment
- Improved quality of life by arriving at a diagnosis quicker and allowing treatment to begin sooner
- Enhanced transparency on care delivery options and costs
Looking forward, what do you hope for the future of CDS with respect to laboratory testing?
CDS enables providers to leverage the full potential of laboratory testing to appropriately diagnose and treat patients. As a result, solutions like CareSelect Lab are critical to bending the unsustainable growth rate of healthcare spending. Mayo Clinic and NDSC are committed to an ongoing partnership to continually deliver existing and emerging best practices to healthcare providers and the patients they serve.