The Test Utilization Committee at the Cleveland Clinic, led by pathologist Gary Procop, MD, MS, FCAP, is a multidisciplinary team of clinicians, pathologists, administrators, and other caregivers with a commitment to promote best practices for exemplary patient care. Their goals include: working to decrease unnecessary phlebotomy, which in turn improves patient satisfaction and decreases the likelihood of iatrogenic anemia and the sequelae thereof; reduction of unnecessary duplicate orders; the conscientious use of molecular testing; promotion of best practices; development of evidence-based guidelines for optimal testing; and, reduction of health care costs through thoughtful and judicious use of resources. With the laboratory often acting as a central contact point for patient cases, pathologists and their team have a unique opportunity to point out and correct inefficiencies or potential problem areas in care.
Seven ongoing interventions have been integrated into the Cleveland Clinic practice since 2011. These interventions block duplicate or largely unnecessary tests, notify providers of duplicate and expensive tests, and provide guidance for the use of complex molecular genetic testing. One of the most successful components of our program is the engagement of a laboratory-based genetic counselor. Jacquelyn Riley, MS, genetic counselor at the Cleveland Clinic, helps to clarify the need for testing, and if needed, she works with pathologists in guiding clinicians to the best test available for their patients.
In 2015, these interventions stopped 18,982 unnecessary tests for a cost-savings of $717,280. These interventions, in aggregate, have resulted in the cessation of 53,814 unnecessary tests, which has saved $3,442,447.
We will be covering:
â€¢ A brief overview for the need for improved test utilization
â€¢ Describe the role of the laboratory genetic counselor
â€¢ Outline the genetic test review objectives and process
â€¢ Provide case examples of improved patient care and decreased costs associated with lab genetic counselor intervention
â€¢ Describe the interventions used at the Cleveland Clinic and the associated outcomes