The Value Proposition for Pathologists: A Population Health Approach
The Value Proposition for Pathologists: A Population Health Approach
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DOI：
10.1177/2374289519898857
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发表时间：
2020-01-13
影响因子：
1
通讯作者：
Sanfilippo, Fred
中科院分区：
文献类型：
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作者：
Ducatman, Barbara S.;Ducatman, Alan M.;Sanfilippo, Fred
向基于价值的支付系统的过渡为病理学家提供了机会，通过改善结果和安全性以及降低成本，在人口健康方面发挥更大的作用。尽管实验室检测本身只占医疗保健支出的一小部分，但实验室数据在患者管理和诊断方面具有重大的下游影响。病理学家目前致力于精准医学，利用实验室和病理测试结果(包括尸检数据)来减少诊断错误，并在诊断管理团队中发挥主导作用。此外，病理学家可以使用汇总的实验室数据来监测人群的健康状况，并改善个别患者和人群的卫生保健结果。为了使这一职业蓬勃发展，病理学家需要专注于将他们的角色扩展到实验室之外，超越传统的检测分析阶段的角色。这应该包括在确保实验室检测的正确顺序和解释方面发挥领导作用，以及在人口健康计划方面发挥领导作用。在培训中的病理学家将需要学习信息学和数据分析、卫生保健经济学、公共卫生、实施科学和卫生系统科学中的关键概念。虽然这些变化可能会减少病理学家传统活动的报销，但新的价值创造和新的补偿模式出现了机会。这份报告回顾了病理学家在利用管理、精确医学、减少诊断错误和改善卫生保健结果方面发挥领导作用的机会。
The transition to a value-based payment system offers pathologists the opportunity to play an increased role in population health by improving outcomes and safety as well as reducing costs. Although laboratory testing itself accounts for a small portion of health-care spending, laboratory data have significant downstream effects in patient management as well as diagnosis. Pathologists currently are heavily engaged in precision medicine, use of laboratory and pathology test results (including autopsy data) to reduce diagnostic errors, and play leading roles in diagnostic management teams. Additionally, pathologists can use aggregate laboratory data to monitor the health of populations and improve health-care outcomes for both individual patients and populations. For the profession to thrive, pathologists will need to focus on extending their roles outside the laboratory beyond the traditional role in the analytic phase of testing. This should include leadership in ensuring correct ordering and interpretation of laboratory testing and leadership in population health programs. Pathologists in training will need to learn key concepts in informatics and data analytics, health-care economics, public health, implementation science, and health systems science. While these changes may reduce reimbursement for the traditional activities of pathologists, new opportunities arise for value creation and new compensation models. This report reviews these opportunities for pathologist leadership in utilization management, precision medicine, reducing diagnostic errors, and improving health-care outcomes.