LDS (Laboratory Decision System)

Medical Database LDS is a disease-based system for medical test selection, ranking, ordering and interpretation. LDS encapsulates the intelligent logic of our medical database in an interactive data visualization. It utilizes our proprietary (patent pending) ranking system and enables healthcare providers (physicians, nurses, physician’s assistants, laboratorians) to correctly select the most relevant tests based on diseases, ICD10 codes and other available data. The ranking system scores potential tests for any given disease and assigns an easily interpretable, numerical/color-coded score based on clinical relevance, medical necessity and testing indication.

Benefits to Healthcare Providers and Payers

LDS will decrease healthcare costs by reducing overutilization of unnecessary tests and underutilization of clinically relevant tests, thus saving time and money for providers and payers:

  • Highlights relevant esoteric tests that lead to a shorter time between diagnosis and treatment, and to a reduction of procedures and admissions.
  • Reduces the number of tests sent out to reference laboratories.
  • Uses Medicare-based testing indications such as “initial testing/screening” and “disease management” to provide fine-grained test rankings that are based on the current situation and to give providers a better understanding of how and when to apply various tests.
  • Our special scoring and algorithmic rules are designed for use in automated pre-approval and claim verification systems, which can help ensure that every claim meets medical necessity and clinical relevance.
  • Helps meet Medicare and insurance compliance by serving as an assistant tool to healthcare providers for selecting the right test for each disease.
  • Helps avoid liability, malpractice and lawsuits.
  • Helps in patient satisfaction and makes practice easier, more reliable and efficient.
  • Is easy to use and can be integrated with any electronic medical record system.

How it Works

LDS utilizes our proprietary (patent pending) ranking system to help physicians select and order appropriate tests based on clinical relevance, medical necessity and testing indication.

Our system uses the following testing indications:

  • Screening/Initial testing
  • Diagnostic testing
  • Disease Management testing
  • Confirmatory testing

Tests can be further refined by methodology and specimen type.

Screening/Initial Testing Indication

This testing indication gives physicians a good start by providing the most likely disease-related testing when non-specific symptoms are presented. Therefore, the included tests are usually simple, quick, inexpensive and provide direction toward further diagnostic testing. A good example is TSH followed by FT4 testing.

Diagnostic Testing Indication

In general, diagnostic testing can be viewed as the logical continuation of the screening indication, with the goal of identifying a suspected disease. Selected tests are usually diagnostic, esoteric, sophisticated and expensive, often confirmatory.

Disease Management Testing Indication

The management testing indication, also known as “follow up testing”, applies to tests used to monitor the treatment and management of a disease. Included tests are necessary to monitor disease progression, effects of therapy, disease or therapy-related side effects, development of complications, or disease prognosis and prediction. These test can be specific, follow-up tests or monitoring.

Confirmatory Testing Indication

Confirmatory testing is performed to confirm the results of diagnostic or screening tests. A confirmatory test should never be used until a previous test result suggests it is relevant. A confirmatory test is a second analytical procedure to identify the presence of disease in a specimen, the purpose of which is to ensure the reliability and accuracy of an initial diagnostic or screening test.

Test Scoring System

Numerical ratings appear on a scale from 0 to 10, which is based on specificity of each test to disease, on clinical relevance, medical necessity and testing indication. Scores from 5-10 are considered to be positively relevant and will meet medical necessity for the selected disease. Scores below 5 are considered not to be medically necessary but can still be used as an ancillary or supportive test as circumstances change, or as optional tests. Such tests will, in most cases, be annotated with an explanatory footnote.

Scores are color-coded with these definitions:

  • Scores from 7 - 10 appear green and are considered highly relevant (very specific to disease). Ordering physicians are likely to order such tests with little or no question.
  • Scores from 4 - 6 appear yellow and are possibly relevant. Ordering physicians are likely to hesitate before ordering such tests. Such tests are often optional and will be supplemented with an explanatory footnote. These tests will still meet medical necessity but will have lower specificity for the selected disease.
  • Scores from 0 - 3 appear red and are probably not relevant or are obsolete. Ordering physicians are unlikely to order such tests. These tests most likely will not meet medical necessity and will be labeled with an asterisk and footnote indicating the possibility of not meeting medical necessity.

Search Criteria

The system can be searched by disease, ICD10, test or CPT.

Search by Disease

When searching by disease or ICD10, each disease found will list tests associated with the disease. These tests are rated based on specificity to the disease, based on clinical relevance, medical necessity and testing indication as described above. Diseases can be searched by name, by organ system and by the associated organ tissue. Each disease lists its SNOMED code, synonyms, ICD10 and associated tests.

Search by Test

The test database can be searched by name, by test category or by specimen type. When searching by test, each test found will have a list of diseases associated with the test. These diseases are rated based on specificity to the test, clinical relevance, medical necessity and interpretation. Each test has its content: test overview (description), clinical utility, test interpretation, reference ranges, methodology, specimen collection, additional testing, TAT, CPT codes, specific ICD10 codes, associated disease list, synonyms, LOINC code and list of references used to prepare the content.