068 - Consulting: the tool for the interpretation
Autor(s): R.M. Dorizzi
Issue: RIMeL - IJLaM, Vol. 2, N. 1, 2006 (MAF Servizi srl ed.)
Page(s): 68-84
In the recent years we have seen in the Unites States and all around the world the paradox of continuously rising health costs and patients’ and health workers’ mounting disaffection together to reported risks and damages caused by health systems. In eighties laboratory medicine focussed especially toward a radical technological reorganization induced especially by informatics; this reduced the consulting role of the laboratorians. Therefore, the laboratorian, very often a generalist, encountered more and more difficulties in playing a consulting role for specialists with an ever increasing sector-oriented approach of health care. In the Anglo-Saxon countries some experiences have been reported of systematic consulting activities of laboratorians together to clinicians. In some cases they receive formal requests, they can examine the patients and their documentation and they get reimbursement for this activity. In general the consulting role of the clinical laboratory has been worn away and this contributed to a frequent marginalization of the service. The informatics can help in this regard since the proper information can be obtained in real time and powerful clinical decision support systems allow real consulting of high quality. Handheld devices or personal digital assistants (PDA) amplify this role since they have not only a address book, a to-do list and memo functions but also high quality repositories of medical information and medical calculators and they are linked to several updated papers and documents available in the web. Many interesting models are marketed today; some examples will be provided of the performance yielded by InfopoemTM, DynamedTM and MD First ConsultTM. Therefore, all the laboratorians, equipped with these simple tools, can easily and effectively serve as consultant.