Utilization management and information technology: adapting to the new era.
Overuse of clinical laboratory services has been written about for many years (1), but remedies that easily could be implemented and effective over the long term have been in short supply. This issue has been acute for CLS, Inc., which is wholly owned by a managed care organization (HIP Health Plan of New York). Because CLS is assessing the possibility of acquiring a new laboratory information system, we reviewed past reports on approaches to utilization management (UM) and considered how developments in information technology (IT) may affect the latter. We feel there is a distinct possibility for implementation of UM in real time, and we propose this as a new paradigm whose realization has implications for choice of IT and for how clinical laboratories operate in the future.
Pearlman
E S
ES
Wolfert
M S
MS
Miele
R
R
Bilello
L
L
Stauffer
J
J
D002984:Clinical Laboratory Information Systems; D006300:Health Services Misuse; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007753:Laboratories / Q000458:organization & administration / Q000706:statistics & numerical data*; D009518:New York; D009936:Organizational Innovation; D014600:Utilization Review / Q000458:organization & administration*