Optimizing the data in direct access testing: information technology to support an emerging care model.

IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Critical reviews in clinical laboratory sciences Pub Date : 2024-03-01 Epub Date: 2023-10-06 DOI:10.1080/10408363.2023.2258973
Michelle Stoffel, Stacy G Beal, Khalda A Ibrahim, Michael Rummel, Dina N Greene
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Abstract

Direct access testing (DAT) is an emerging care model that provides on-demand laboratory services for certain preventative, diagnostic, and monitoring indications. Unlike conventional testing models where health care providers order tests and where sample collection is performed onsite at the clinic or laboratory, most interactions between DAT consumers and the laboratory are virtual. Tests are ordered and results delivered online, and specimens are frequently self-collected at home with virtual support. Thus, DAT depends on high-quality information technology (IT) tools and optimized data utilization to a greater degree than conventional laboratory testing. This review critically discusses the United States DAT landscape in relation to IT to highlight digital challenges and opportunities for consumers, health care systems, providers, and laboratories. DAT offers consumers increased autonomy over the testing experience, cost, and data sharing, but the current capacity to integrate DAT as a care option into the conventional patient-provider model is lacking and will require innovative approaches to accommodate. Likewise, both consumers and health care providers need transparent information about the quality of DAT laboratories and clinical decision support to optimize appropriate use of DAT as a part of comprehensive care. Interoperability barriers will require intentional approaches to integrating DAT-derived data into the electronic health records of health systems nationally. This includes ensuring the laboratory results are appropriately captured for downstream data analytic pipelines that are used to satisfy population health and research needs. Despite the data- and IT-related challenges for widespread incorporation of DAT into routine health care, DAT has the potential to improve health equity by providing versatile, discreet, and affordable testing options for patients who have been marginalized by the current limitations of health care delivery in the United States.

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优化直接访问测试中的数据:支持新兴护理模式的信息技术。
直接访问检测(DAT)是一种新兴的护理模式,为某些预防、诊断和监测指征提供按需实验室服务。与医疗保健提供者订购测试以及在诊所或实验室现场进行样本采集的传统测试模式不同,DAT消费者和实验室之间的大多数互动都是虚拟的。测试是在线订购和结果交付的,样本经常在家里通过虚拟支持自行采集。因此,DAT在很大程度上依赖于高质量的信息技术(IT)工具和优化的数据利用率,而不是传统的实验室测试。这篇综述批判性地讨论了美国DAT与IT的关系,以强调消费者、医疗保健系统、提供者和实验室面临的数字挑战和机遇。DAT为消费者提供了更多的测试体验、成本和数据共享自主权,但目前缺乏将DAT作为一种护理选项集成到传统患者提供者模式中的能力,需要创新的方法来适应。同样,消费者和医疗保健提供者都需要有关DAT实验室质量的透明信息和临床决策支持,以优化DAT作为综合护理的一部分的适当使用。互操作性障碍将需要有意识地将DAT衍生的数据整合到全国卫生系统的电子健康记录中。这包括确保实验室结果被适当地捕获,用于满足人口健康和研究需求的下游数据分析管道。尽管在将DAT广泛纳入常规医疗保健方面面临着与数据和IT相关的挑战,但DAT有潜力通过为因美国目前医疗保健服务的局限性而被边缘化的患者提供多功能、谨慎和负担得起的检测选项来提高健康公平性。
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来源期刊
CiteScore
20.00
自引率
0.00%
发文量
25
审稿时长
>12 weeks
期刊介绍: Critical Reviews in Clinical Laboratory Sciences publishes comprehensive and high quality review articles in all areas of clinical laboratory science, including clinical biochemistry, hematology, microbiology, pathology, transfusion medicine, genetics, immunology and molecular diagnostics. The reviews critically evaluate the status of current issues in the selected areas, with a focus on clinical laboratory diagnostics and latest advances. The adjective “critical” implies a balanced synthesis of results and conclusions that are frequently contradictory and controversial.
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