Demand management and approaches to the rationalisation of test requesting

Abstract

The literature is peppered with studies on demand management in laboratory medicine, though probably with considerable positive reporting bias. Demand management interventions range from simple changes in the profile content contained on a written request form, the internal content of the various profiles offered, to initiatives requiring more sophisticated computing including avoidance of primary/secondary care test repetitions, diagnosis-based requesting profiles and minimum retesting intervals. These have been reviewed 1 and a suggested toolkit is offered. 2 These initiatives appear to work best when they are combined with educational support for users. Advances in informatics, particularly electronic test requesting, offer great potential to advance these interventions. Laboratories must design solutions which achieve the desired outcome without overly complicating the test requesting process. ‘Logic rules' are straightforward to insert into requesting software, but risk introducing many keyboard/mouse steps for already rushed practitioners. This may alienate rather than engage users of the service. Much remains to be done in this field.