Evidence-based laboratory testing algorithms are widely promoted to improve diagnostic accuracy, reduce unnecessary testing, and control laboratory costs. Yet adoption remains inconsistent across healthcare systems. A new review published in Cureus reinforces a familiar reality for lab managers: the barriers to scaling evidence-based laboratory testing algorithms are operational, not scientific.
The review synthesizes existing research showing that structured, stepwise testing pathways—particularly reflex testing—can reduce the utilization of low-value laboratory tests without compromising the quality of care. However, it also highlights why evidence-based laboratory testing algorithms remain unevenly implemented despite long-standing consensus around their benefits.
Operational barriers outweigh clinical debate
For most laboratories, the challenge is no longer convincing clinicians that evidence-based laboratory testing algorithms work. Instead, implementation often breaks down at the system level. The review identifies persistent gaps among laboratory information systems, electronic health records, computerized physician order entry, and clinical decision-support tools.
When evidence-based laboratory testing algorithms are not embedded directly into ordering workflows, they remain optional rather than routine. As a result, laboratory test utilization continues to depend heavily on individual ordering behavior instead of standardized pathways.
Informatics integration shapes laboratory test utilization
The review emphasizes that evidence-based laboratory testing algorithms are most effective when they are automated and consistently applied. Reflex testing, in particular, reduces redundant orders and shortens time to diagnosis, but only when supported by aligned laboratory informatics integration.
For lab managers, this places informatics decisions at the center of utilization strategy. Configuration choices within the LIS and EHR often determine whether laboratory test utilization reflects evidence-based laboratory testing algorithms or historical ordering habits.
Leadership remains a limiting factor
Beyond technology, the review frames laboratory professionals as underutilized contributors to diagnostic strategy. While laboratories generate data that inform most clinical decisions, lab leaders are frequently excluded from discussions about test selection and pathway design.
Without formal authority over utilization management, evidence-based laboratory testing algorithms are difficult to enforce consistently. This reinforces the role of laboratory leadership in translating evidence into operational practice.
What this signals for lab managers
Rather than introducing a new concept, the review highlights the persistent gap between evidence and execution. As healthcare systems face rising cost pressures and staffing constraints, evidence-based laboratory testing algorithms will remain a focal point for improving laboratory test utilization.
For lab managers, success will depend less on proving the value of evidence-based laboratory testing algorithms and more on aligning informatics systems, governance structures, and leadership roles to support sustained adoption.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
