Dear Mike

Robert Michel (The Dark Report) provided the following information in relation to EHR. It is not recent (2007) but it does cite some data:
http://www.darkdaily.com/mayo-medical-lab-executive-highlights-market-opportunities-for-hospital-laboratories-091610

Leslie Burnett (Sydney, AU)

Excerpt of above link is:

> This Dark Daily briefing will concentrate on several comments made by Rodney W. Forsman. He is the Administrative Director of Outcomes at Mayo Medical Laboratories(MML) and Associate Professor of Laboratory Medicine at the Mayo Clinic School of Medicine. 
> 
> The event was the sixth annual Spring Fling conference, produced by the Golden Gate Chapter of the CLMA (Clinical Laboratory Management Association). The keynote speaker was our own Dark Daily Editor, Robert L. Michel. In attendance was an enthusiastic crowd of laboratory professionals from across Northern California, along with a large number of lab industry exhibitors.
> 
> Forsman was speaking on the subject of how community laboratories—particularly hospital laboratories with outreach programs—could play an important role in supporting integration of clinical services within a region. Forsman discussed the leverage that laboratory testing offers clinicians. After mentioning the oft-discussed fact that lab testing costs are about 5¢ on the healthcare dollar and play a role in as much as 70% of all clinical decisions, he provided two insights about the use of laboratory test data at Mayo Clinic which should be of interest to Dark Daily readers.
> 
> First, he provided a statistic about the role of laboratory testing inside the Mayo Clinic. Forsman explained that the Mayo Clinic’s EMR (electronic medical record) system has operated since 1995. Laboratory test data comprises 94% of the “objective data” within Mayo’s EMR system. This is a proportion which exceeds the widely-noted statement that laboratory test data makes up 70% to 80% of the typical patient’s permanent health record. 
> 
> Second, Forsman provided another fact about Mayo to reinforce his point about the essential role that laboratory test data plays within the clinical continuum. At the Mayo Clinic each day, 60,000 laboratory test results are added to the Mayo EMR. This lab test data is in high demand, as Mayo tracks, on average, 200,000 daily retrievals of lab test data from the system by caregivers within the Mayo Clinic.
> 
> Forsman's major point in his remarks was to emphasize how clinical laboratories could improve the value they offer their parent hospitals, referring physicians, and the patients they serve in their local community. He stressed the importance of using financial tools and close management of laboratory resources to accomplish these goals.

On 08/07/2011, at 9:01 AM, ACB-CLIN-CHEM-GEN automatic digest system wrote:

> Date:    Thu, 7 Jul 2011 10:49:06 +0100
> From:    "Hallworth Mike (RLZ)" <[log in to unmask]>
> Subject: The 70% thing...
> 
> Hi all
> 
> I know this has come up before, but I have recently been looking for evidence underpinning the widespread claim that lab tests underpin 70% of [whatever]. I thought I would summarise my (limited) understanding of this, and see if the collective brain has anything to add. Happy to post a summary of whatever I receive.
> 
> I have seen the assertion in three main forms:
> 
> "60-70% of NHS patients' diagnoses depend on laboratory tests" 
> (stated - unreferenced - in DH Modernising Pathology Services document, 2004)
> I can find no evidence for this, and common sense suggests that if you consider all NHS diagnoses (including primary care, mental health etc) it must be wrong. I have previously offered the trainees £100 for anyone who can provide the evidence to support this statement, and am happy to repeat the offer here!
> 
> "60-70% of all critical medical decisions depend on laboratory data"
> This much more circumspect claim is made in a 1996 paper from the Mayo Clinic (Forsman RW, Clin Chem 1996: 42: 813-816, p813). The paper actually says
> "We know that, although the laboratory represents a small percentage of medical center costs, it leverages 60-70% of all critical decisions, e.g. admission, discharge and therapy". - although it does not say how we know that! - presumably internal Mayo studies. But it is at least believable and referenced! (I think the first quote above derives from misquotation of this statement)
> A variant occurs in Carter 1: "It is estimated that 70-80% of all health care decisions affecting diagnosis or treatment involve a pathology investigation" (para 1) - but NB the loss of the word 'critical' and the increased percentage!
> 
> "70-80% of the EMR consists of laboratory data"
> This also sounds feasible, but I cannot trace a reference to it.
> 
> Can anyone add to this with published references or primary sources? The statement has become a very familiar one, quoted and requoted in its various guises. I am fully convinced of the importance of lab medicine, but just think that as scientists we should be able to support the statements we make! Or is it just a lab 'urban myth'?
> 
> Many thanks
> 
> Mike

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