Defining Best Practices for Urinalysis Diagnostics in a Value-Based Healthcare System

Urinalysis is one the oldest, most established, and most frequently ordered laboratory tests.  However, there is wide variation in the methods, processes, quality checks, specifications, and diagnostic scope in clinical use today.  Dr. Skelton will describe his experience with a focused systematic effort to identify and implement best practices in all aspects of urinalysis testing at Lahey Health.  Decisions on best practice were made with the goal of optimizing clinical benefit to Lahey Health’s patient population and reducing the total healthcare cost attributable to the burden of diseases evaluated by urinalysis.  Changes to institutional policies combined with novel application of information technology were applied to overcome perceived regulatory obstacles to optimal evidence-based clinical practice.  Best practices for order design, result reporting, and data architecture and their impact on workflow efficiencies will be discussed.  Recent technical advances in instrumentation allow improved diagnostic abilities that enable a redesign of the laboratory process and clinical scope of urinalysis.  Data will demonstrate the impact that this type of redesign has had at Lahey Health. 
 
Learning Objectives:
After attending this session, participants will be able to:

• 1 Understand the variables that impact the clinical diagnostic performance of urinalysis testing
• 2 Identify key developments in instrumentation, information technology, and healthcare delivery that improve the value of urinalysis diagnostics