The medical profession is a key laboratory client. So, it pays to understand the strategic priorities that inform doctors’ testing orders, argues Dirk Heckel.
A recent survey of 408 physicians across primary care, specialty care and acute/emergency care disciplines about test ordering behaviour offers a window into what strategic priorities labs should consider that would add value to those who rely on these services daily [1].
Commissioned by Siemens Healthineers and conducted by YouGov, the data reveals how significant lab testing and the support clinical laboratory professionals provide is to physicians’ clinical decisions. Moreover, it reveals that systemic pressures – such as bureaucracy, testing costs and patient satisfaction – are influencing test orders, underscoring that in the age of automation, human collaboration still counts.
Test results help inform treatment decisions and justify doctors’ next steps. Though lab results are one data point among many, 98% of physicians agree they have modified a diagnosis or treatment plan based on lab test results, and 98% also agree that lab results have helped them justify their clinical course of action.
Lab testing also has a notable impact on the wider health system: 100% of physicians agree lab results help streamline how they use other healthcare resources; for example, more efficient use of imaging and biopsy. This emphasises the importance of laboratory services and underscores the value of clinical lab professionals’ quality control efforts and time spent validating patient results.
The data suggest four main ways physicians rely on laboratory professionals. They trust them to help provide accurate results (98%) and meet their patients’ needs with adequate test menu offerings (97%). They also trust lab professionals to help inform the best test options for their patients and to help them learn. Some 55% of physicians say they heavily rely on the lab’s expertise to confirm which tests are clinically relevant for patients, and 96% agree they are open to receiving constructive feedback to improve or enhance their test ordering practices.
“This 55% stat was the most surprising to me – the glass is half full at 55% but how can we reach the 45% and make it easier to collaborate? We have a big opportunity to show that the expertise of the lab can help and the value that the lab can offer providers,” said Dr Nikola Baumann. The vice chair of quality in the Department of Lab Medicine and Pathology, director of the Central Clinical Laboratory and CLIA director at Mayo Clinic Laboratories was speaking during a press conference that revealed the survey results [2].
As new test options become available, laboratory professionals can expect increased reliance on their expertise for guidance about specific tests.
Systemic pressure is influencing orders
The pathway from test orders to lab results used to be linear: a patient visits their physician, the physician orders tests, the lab produces results and sends them to the physician, who then discusses the results with the patient.
Now, system-wide pressure to reduce costs, inadequate insurance coverage and the rise of patient agency are influencing doctors’ testing orders. Nearly a third of physicians (32%) have experienced bureaucratic pressure to reduce lab test utilisation. Many doctors (67%) order tests without knowing whether they’re covered by patients’ insurance. Of those with visibility, 60% have postponed tests because of cost.
While experience and evidence-based guidelines remain foundational, doctors are navigating patients’ open access to health information (and misinformation), creating tension between clinical judgment and patient expectations.
When patients raise concerns, lab testing is often an initial option. It turns out that 76% of physicians agree patient requests have forced them to weigh satisfaction against judgment, 90% agree patients feel entitled to diagnostic testing upon request, and 84% agree they have ordered testing to satisfy a patient’s request.
In a parallel survey of 1,000 Americans who have had bloodwork in the past two years, 93% expect their doctor to order testing upon request, and 13% would not trust their doctor’s recommendation if advised against a requested test. This may flag an erosion of trust – or a growth in patient confidence.
Plus 37% have asked for a test based on outside information; 17% based on social media.
If these trends continue, laboratory professionals could see rising test orders aligned with on-demand patient interest – potentially correlating with ‘influencer’ attention.
What doctors really want
Physicians are concerned about healthcare staffing shortages (94%), but they feel lab shortages more acutely – 96% say it has a downstream effect on their patient care, 99% that delayed results affect care, 98% say lab results help provide meaningful patient interactions and 98% agree visits are more effective when results are discussed.
Physicians’ test ordering behaviours offer a window into four strategic priorities labs should consider. The doctors indicated in their open-ended responses that they want laboratory colleagues to communicate earlier and be more transparent about steps of the testing process that affect them (e.g. delays/ downtime, anticipated turnaround times). This helps manage expectations and enables them to make more informed decisions for their patients.
Second, they want increased access to the expertise laboratory professionals provide, to answer questions or help clarify vague or unexpected findings. Third, they view clinical laboratory professionals as collaborative partners in their continuing education. They rely on laboratory professionals to help educate them and inform them about tests better suited for their patients.
And finally, they recognise that innovation in the lab helps improve care for patients. Innovation in the laboratory is a conduit to improve patient care and new technology and tests can help improve the lab’s profitability. Physicians want improved turnaround time, new tests and risk assessment that is easy for patients to understand. They foresee incorporating AI tools for trendspotting or to suggest follow-up tests.
Automation preserves collaboration
Lab services account for only 4% of hospital costs but are frequent targets of cost-cutting. Consolidation and outsourcing are rising, but outsourcing can create communication challenges – of the 19% of physicians who do not typically communicate with lab colleagues, nearly half (49%) said orders are primarily outsourced.
98% of physicians agree they have modified a diagnosis or treatment plan based on lab test results, and 98% also agree that lab results have helped them justify their clinical course of action
Meanwhile, as staff numbers shrink and patient test volumes rise, many labs are investing in automation to preserve collaboration. In fact, 95% of lab professionals agree automation will help improve patient care, and 89% believe their lab needs it to keep up with demand [3].
From built-in automation on individual analysers to ‘dark labs’ designed to harness the power of robotics, artificial intelligence and advanced data analytics, automation is supporting staff in redirecting time spent on manual tasks to other activities such as clinical consultations and quality control that physicians have affirmed are of value.
Strengthening labs with technology that reduces repetitive tasks safeguards the clinical support physicians rely on. Maintaining patient satisfaction benchmarks – key to reimbursement, retention and referrals – may hinge on these investments.
Dirk Heckel is chief technology officer, diagnostics for Siemens Healthineers
References:
1 Decoding Doctors’ Decisions: How System Friction and Patient Agency Affect Physicians— And What This Means for Lab Testing. Siemens Healthineers
2 Dr. Nikola Baumann was not involved in the commissioning, design, execution, or analysis of this survey and did not contribute to the development of its findings
3 Clinical Labs in Critical Condition. Siemens Healthineers
