Ann Lab Med 2019; 39(2): 121-124  https://doi.org/10.3343/alm.2019.39.2.121
Reducing Diagnostic Errors Worldwide Through Diagnostic Management Teams
Roberto Verna, M.D., Ph.D.1,2, Adriana Berumen Velazquez, Ph.D.3, and Michael Laposata, M.D., Ph.D.4
1World Association of Societies of Pathology and Laboratory Medicine, 2Department of Experimental Medicine, Sapienza – University of Rome, Italy; 3Innovation Access and Use, Medicines and Health Products Department, World Health Organization, Geneva, Switzerland; 4Department of Pathology, University of Texas Medical Branch, Galveston, USA
Corresponding author: Roberto Verna, M.D. https://orcid.org/0000-0002-1869-3912
Department of Experimental Medicine, Sapienza – University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
Tel: +3939 2468 1165
E-mail: roberto.verna@uniroma1.it
Received: June 28, 2018; Revised: July 26, 2018; Accepted: September 27, 2018; Published online: March 1, 2019.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
A major challenge facing most countries is the growing cost of healthcare. Laboratory testing costs constitute approximately 3% of all clinical costs, while waste of funds due to inappropriate admissions to clinical departments is reported to be as high as 15%. A frequently used approach to save money in healthcare is random reduction of laboratory budgets, focusing on decreasing the number of unnecessary laboratory tests. The World Health Assembly has approached this problem by publishing a list of essential in vitro diagnostic tests, to achieve a global rationalization of the problem. A much more thoughtful strategy to reducing healthcare expenditure is to improve the efficiency of the diagnostic process. Decreasing the time to a correct diagnosis provides considerable financial and clinical benefits. Additionally, reducing both overutilization and underutilization of laboratory tests while achieving the correct diagnosis is of great benefit to challenged healthcare budgets. Examining the situation in the United States and Italy, this review presents an opportunity for reducing diagnostic error and increasing the efficiency of diagnostic testing worldwide. One approach taken to achieve major savings in healthcare in the United States, which can be applied in Italy and other countries, is the creation of “diagnostic management teams,” comprising experts in specialty areas of medicine, primarily based in the clinical laboratory, who can advise physicians on the selection of necessary tests and the interpretation of complex test results.
Keywords: Diagnosis, Diagnostic error, Clinical laboratory, Diagnostic management team



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