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Physician office lab testing: Is it appropriate for your practice?

Published Date
Author Val DuVernet

Should you expand your practice to include in-office lab testing?

Deciding whether to launch physician office lab testing is a complicated question, but comparing the possible pros of in-office testing with the cons can help.

On the plus side, implementing a new laboratory can bring important new avenues for practice improvement. These include:

  • Opportunities for earlier treatment plans and improved patient outcomes, including better patient counseling
  • Control over test results, including faster results and improved patient communication
  • Improved business performance

But implementing a new laboratory also brings its own set of challenges, including:

  • Meeting lab licensing requirements
  • Ensuring that lab personnel have or acquire appropriate qualifications
  • Determining which tests to offer
  • Coping with possible staff reluctance to change

Start by considering quality of care improvements

The first question you should ask yourself when deciding whether physician office lab testing makes sense for your practice comes down to this:

"Can I make meaningful patient care quality improvements by receiving clinical data sooner rather than later?"

In other words, will you create or modify your treatment plan based on seeing point-of-care (POC) test results during the patient visit?

For many primary care practices, urgent care centers, community health centers and specialty practices (such as oncology, pediatrics, internal medicine and family practice) the answer is likely to be "Yes."

How can POC testing in your physician office improve care?

Consider that laboratory tests represent only 2.6% of healthcare spending, yet drive 70% of medical decisions.1,2

Let's look at how this truism plays out in the context of the leading causes of morbidity and mortality in the U.S. — and the potential of POC testing to support improved clinical outcomes in these areas.3

Of the 10 leading causes of American illness and death, at least seven rely on laboratory testing to assist with diagnosis and management:

  • Heart disease
  • Cancer
  • Chronic lower respiratory diseases
  • Stroke
  • Diabetes
  • Kidney disease
  • Influenza and pneumonia

Among the remaining three leading causes of death (accidents, Alzheimer's disease and intentional self-harm), laboratory testing aids in diagnosing Alzheimer's disease by helping to rule out other conditions, even though there is no definitive lab test. Altogether, lab tests play a role in diagnosing and managing 90% of the leading causes of mortality in the U.S.3

Now, consider the patient population you treat every day in your practice and the burden of chronic disease you face. Given that cardiovascular disease, diabetes, kidney disease, lower respiratory ailments and cancer require laboratory testing for both diagnosis and care, implementing a new laboratory in your practice may enable you to improve the care you provide to patients who have these conditions.

In primary care and urgent care settings, there is a high demand for POC testing for common respiratory illnesses as well. This is because a number of these — including influenza, group A streptococcus, RSV and COVID-19 — can present similarly but require different treatments.

Planning ahead

As you review these tests and consider their utility to your practice, consider whether fast access to the information they provide would directly affect your treatment plans.

If the answer is yes, you'll want to learn more about implementing a new laboratory in your practice, including office-based lab requirements and which tests are CLIA-waived laboratory procedures.

For more tips and guidance, continue reading our six-part series, The primary care physician's guide to expanding your practice with point-of-care testing.

1: https://www.cms.gov/files/document/download-clinical-laboratory-services-white-paper.pdf
2: https://www.cdc.gov/csels/dls/strengthening-clinical-labs.html
3: https://www.cdc.gov/nchs/fastats/deaths.htm
4: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/10302020/percent-ili-visits-by-age.html

Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information.

© 2021 McKesson Medical-Surgical Inc.