The Value Proposition for Pathologists: A Population Health Approach

• Type of Material: Article
• Authors: Barbara S, Ducatman, Oakland University; Alan M. Ducatman, West Virginia University; James M. Crawford, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Michael Laposata, University of Texas Galveston; Alfred Sanfilippo, Emory University
• Language: English
• Date: 2020-01-01
• Publisher: The Association of Pathology Chairs
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by SAGE Publications Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/2374289519898857
• Title of Journal or Parent Work: Academic Pathology
• Volume: 7
• Start Page: 1
• End Page: 12
• Grant/Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
• Keywords: Implementation and decision sciences; Value; Utilization management; Diagnostic error; Precision medicine; Residency training; Healthcare outcomes and costs; Diagnostic management
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Pathology; Health Sciences, Occupational Health and Safety

Abstract

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.