The proliferation of diagnostic tests can make it challenging for clinicians to know which tests are most appropriate to order. Often, tests are ordered that either aren’t needed or aren’t the optimal test based on quality and cost. The downstream effects of inappropriate testing can include unintended consequences such as wasted laboratory resources, increased costs to the system and patients, and even potential harm to patients.
Through the National Pathology Quality Registry (NPQR), the first pathology-specific, institution-based registry, ASCP is providing pathologists and laboratory professionals with the ability to leverage LIS data to measure and improve test utilization. As the only pathology organization participating in the Choosing Wisely campaign, ASCP has capitalized on recommendations developed by our Effective Test Utilization Steering Committee. These recommendations are evidence-based and created by experts who deal with these issues day-to-day. The NPQR provides participants with a way to capture and communicate information on test utilization, translate this information into an action plan, and effectively operationalize these recommendations. Ultimately, NPQR provides data to show ordering patterns that clinicians may not have access to. Once baseline data is examined, ASCP provides educational support and tools to help facilitate downstream changes and improve patient care. These support materials are also able to satisfy CME, MOC and MIPS requirements, providing a practical resource for multiple member needs.
NPQR’s four initial measures are published Choosing Wisely recommendations. These are vetted guidelines to help pathologists aid clinicians in appropriate test ordering. The initial four recommendations were selected because they are broadly applicable to most clinical laboratories. See below for the current appropriate use measures, with more to come in future versions of NPQR.
NPQR provides a platform to aggregate test utilization data in a way that is meaningful to both laboratorians and ordering clinicians. Using NPQR, a pathologist or laboratory professional can analyze test data to pinpoint which ones are being over- or underutilized. Users can then examine the data to detect patterns, bring those patterns to light, and educate ordering providers on how to use tests effectively to benefit their patients.
“The NPQR is about closing the communication loop. We’re providing data that pathologists and lab professionals can take to the rest of the clinical care team to communicate back to them about test utilization,” said Ali Brown, MD, FASCP, ASCP NPQR Medical Director. “It really highlights the laboratory’s role in the healthcare spectrum, and the data provide important practice trends to the clinicians.”
Another added benefit of NPQR is that participants can use a subset of the registry’s measures to fulfill the requirements of the Centers for Medicare and Medicaid Services’ Merit-Based Incentive Payment Systems (MIPS), a quality payment program that rewards or penalizes providers based on their performance. ASCP developed the NPQR to help pathologists come out on top. To learn more about the benefits of participating in NPQR, click here. For more information and descriptions of NPQR's measures click here.