By Kirell Lakhman

Newly created so-called "integrated healthcare environments" will embolden primary-care physicians to be "more proactive" in diagnosing disease, and "motivate" them to "better utilize" clinical labs, according to recent findings.

They could also increase clinical-lab volumes, both for routine and esoteric tests, because docs practicing in such organizations have a greater incentive to diagnose disease more quickly and monitor it more closely.

Moreover, such groups, which include medical homes and accountable-care organizations, create a "sweet spot" in medical care, especially in clinical labs, by aiming to improve diagnostic accuracy and patient outcomes and to reduce the overall cost of care.

These doctors "understand the importance of ordering the right medical laboratory test at the right time" and "are more open to consultations with pathologists … and the other types" of clinical labs, Dark Daily reported recently.

Medical homes, also called patient-centered medical homes, follow "an approach to providing comprehensive primary care ... that facilitates partnerships between individual patients, their personal providers, and, when appropriate, the patient’s family."

An ACO, meantime, is a form of managed-care organization created by healthcare providers that uses either capitation or fee-for-service payments, though is reimbursed for "reducing costs and meeting quality-improvement markers."

It wasn't immediately clear how many of these types of groups are in practice today in the US, but some research along with a non-scientific poll I conducted recently suggest they are growing in popularity and even have the support of some state governments and large employers.

No wonder, since a goal of both settings is to allow better access to care, increase satisfaction, improve health, and save money.

According to Dark Daily, clinical labs can help PCPs reach these goals by becoming more competitive.

"To better serve an integrated-care environment like a medical home, the clinical laboratory profession needs diagnostic tests which can deliver three primary benefits," it said.

They should give physicians "a more accurate diagnosis, particularly when compared to the existing standard of care," and allow docs to better choose appropriate treatments; they "must be able to produce accurate results in a consistent and economical manner;" and they should "adequately reimburse" clinical labs, "whether by fee-for-service or other payment method."

Cautioning that "such a conjunction of benefits does not happen often," Dark Daily points to two assays that have met these criteria: the generic HIV viral-load and -mutation test, which can inform physicians about the "effectiveness of the expensive multiple-drug regimen" used to treat the disease; and an RNA probe-based automated multiplex assay made by Becton, Dickinson called BD Affirm, which can detect the three bacteria behind vaginitis: the Candida species, Gardnerella vaginalis, and Trichomonas vaginalis.

"The introduction into clinical practice of a rapid, RNA probe-based multiplex assay that can aid the physician in more accurately diagnosing a condition like vaginitis demonstrates how newer molecular diagnostics and genetic testing technologies can advance clinical care — while contributing to an overall reduction" in the cost of healthcare, Dark Daily notes.

For these reasons, "pathologists and clinical laboratory managers are always on the lookout for new assays and new testing technologies, which, when introduced into clinical use, deliver high clinical value …, are economical to run in the medical laboratory, and are reimbursed adequately," it adds.

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