• Michael Misialek, MD

Value in Healthcare: The Role of Pathologists

According to Dr. Michael Porter, Bishop William Lawrence University Professor at The Institute for Strategy and Competitiveness, based at the Harvard Business School, the core purpose of health care is value for patient. Value can be defined as:

Value = (Health outcomes that matter to patients) / (Costs of delivering those outcomes)

As health care transitions from volume to value, every link in the care cycle must prove value. Pathology is no exception. Healthcare reform requires implementation of three aims, the so called “Triple Aim”.

  1. Improve the care experience

  2. Improve population health

  3. Reduce cost

There are many examples in the hospital where pathology supported clinical decision support provides real value. Dr. Eleanor Herriman provides examples that are of high strategic interest and high value to hospitals. These include the emergency room, surgery, intensive care unit (ICU), readmissions and hospital-acquired conditions.

Emergency Room

Meningitis: rapid molecular testing to identify viral meningitis:

59% reduction in unnecessary viral meningitis admissions.

Average cost of viral meningitis stay is $8,360.

Pneumonia: biomarkers reduce diagnostic errors:

59% reduction in:

  • ER admissions incorrectly diagnosed pneumonia

  • Pneumonia cases with delays in correct diagnosis and lower profits

  • Misdiagnosed pneumonia patients with adverse events


Blood Product Utilization: utilization management and transfusion consulting services:

15% to 25% reduction in blood product costs.

For 350–450 bed teaching hospitals, this represents ~$450,000–560,000 in savings.

Venous Thromboembolic Embolism: automated laboratory testing tools:

21% reduction in preventable venous thromboembolisms.

For 350–500 bed hospitals, this could represent ~$200,000–$580,000 in annual savings.

Intensive Care Unit

Acute Renal Failure: biomarker for early detection and nephrologist intervention:

~30% reduction in hospital Acute Renal Failure cases.

This represents savings of about $4,400 per AKI case overall.

For 350–500 bed hospitals, this might represent a $1.2 million cost savings.

CMS Readmissions and Hospital-Acquired Conditions

Acute Myocardial Infarction and Congestive Heart Failure Readmissions:

27% readmissions due to avoidable complications and infections

Significant reduction in infections with molecular testing.

Hospital-Acquired Catheter Urinary Tract Infection: Molecular point of care testing to guide antibiotic selection:

17% reduction in hospital Urinary Tract Infection (UTI) costs.

Based on one cost estimate, this might yield ~$1,000 per hospital UTI case in savings

Pathologists are valuable members of the care team. Their contributions help to deliver value based health care and meet the Triple Aim. Follow Path Report to see how patients are healthier because of pathologists.

#value #tripleaim #pathology

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