La prescription en biologie clinique : rationaliser sans altérer la qualité

Nowadays, clinical pathology has becoming a central medical discipline in the health care ecosystem and blood sampling is an unavoidable step. Lab testing results influence about 70% of medical decisions. In response to the economic pressure on health care accentuating the need for rationalization in many countries, clinical pathology laboratories must act and implement measures to reduce costs while ensuring that they maintain and respect highest quality standards. Therefore, to target the effective actions to be implemented, it is necessary to identify and define the reasons explaining the observed increase in the budgets devoted to laboratory tests. A whole literature appealing to the notion of "Right order" is available and is a source of inspiration for many authors. What are the concepts behind these words? What does it mean to “What does right order mean”? As part of an analytical approach to review the literature, a search for tools to optimize the prescription of clinical biology will make it possible to establish recommendations for implementing, developing and perpetuating a strategy of “prescribing correctly” with prescribers. An in-depth analysis of the context of use of these tools is thus in order to understand their adaptation and the essential conditions for their implementation in an academic context. Eventually, it will be necessary to define the elements to be introduced into an information management tool (EMR – Electronic Medical Record) to support the learning of “right order” and, through this, achieve the defined objective. Throughout the process, the emphasis is placed on respecting the freedom of the prescriber, who remains the sole judge of the relevance of his ordering act in relation to the particular context of each patient.
(SP - Sciences de la santé publique) -- UCL, 2022