Instruction for Use (Guide)

Laboratory Decision System or LDS ™ is a test ordering and utilization management software that allows healthcare providers to select and order the most appropriate laboratory tests using evidence and knowledge-based guidelines and industry best practices.

LDS® utilizes our proprietary ranking system and enables healthcare providers and care managers to correctly select the most relevant tests based on procedures or CPT codes, diseases, and ICD10 codes.

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.

The content can be used as a web based and smart phone application and can be integrated with the LIM, EMR and EHR system.

To download the smartphone app, just go to app store and search for “Laboratory Decision System” and follow directions.

For integration with LIM, EMR and EHR systems call 949-208-0521

Test Scoring System Used by Laboratory Decision System (LDS)

Numerical ratings appear on a scale from 0 to 10. This rating, or score, corresponds to a percentage divided by a factor of 10 for presentation. For example, a score of 6 corresponds to a 60% probability of appropriateness, etc. The score is the likelihood that a given medical test will be relevant to a given indication. It is important to note that the score is a combination of the medical evidence considered not to be medically necessary but can still be used (published guidelines, recommendations), rater’s professional judgment and expertise and any quantitative data that may be available (such as sensitivity, specificity, etc.) to estimate the likelihood that a given test will be appropriate. Hence, while this number may imply a purely quantitative derivation, qualitative factors will often be a significant contribution.

A test with a score of 10 for a given diagnosis will either directly support or rule out the diagnosis. For example, if the result of such a test is abnormal, it will most likely support the diagnosis of the suspected disease. However, if the result of the same test is normal, it will most likely rule out the diagnosis of the suspected disease. Similarly, a test with a score of 9, 8 or 7 will also support or rule out the suspected diagnosis, but in a less specific manner.

In general, tests with scores from 5-10 are considered to be positively relevant and will meet medical necessity for the selected disease. Tests with scores below 5 are considered not meet medical necessity, but still can be used as ancillary or supportive tests as circumstances change or as optional tests, which in most cases will have an explanatory footnote.

In addition to the numerical score, our rating interface also groups scores by color:

  • 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 5 - 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 - 4 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.

Therefore, users should consider scores not only in light of the fine-grained numerical score, but also in terms of the more coarse-grained color group to which the score belongs

How it Works (Instructions for Use)

Test ordering or test search

Test can be ordered or search by disease and/or ICD10 codes or by procedure/test or CPT codes.

Ordering By Diseases or ICD10

When ordering tests by disease or ICD10, each disease will list tests associatedwith the disease ranked and scored from 1-10 based on specificity to the disease,clinical relevance and medical necessity, with the 10 score being most associatedand clinically relevant.

Since each disease has its own ICD10, every submitted order will have its right ICD10 to meet the medical necessity.

Co-morbity (more than one disease)

Many patients might suffer from more than one disease or conditions. In this case, our software can add more diseases to the primary disease order. Tests with the score of the added disease will be added to the primary disease order without doubling or overlapping scored tests for the primary disease. In addition, the system will add ICD10 code to the primary diseases ICD10 code, so any time the order is sent to the lab, it will send IC10 codes for both diseases to meet its medical necessity.

Ordering By Test

When searching by test, the system will list diseases associated with the test. Each disease will have a score ranking from 1-10 based on specificity to the disease, clinical relevance and medical necessity, with the 10 score being most associated and clinically relevant.

Since each disease has its own ICD10, every test order send will have its right ICD10 that meats the medical necessity.

Just click on the disease listed and the system will take you to ICD10, select the right ICD10 to send the order with that ICD10.

Ordering By Testing Indication

Our system follows Medicare and Medical guidelines to minimize orderingof unnecessary tests. Our system uses the following Testing Indications:

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

Screening/Initial Testing Indication

This testing indication will give physicians a good start with most likely disease related testing to get more findings to non-specific presented symptoms.

Therefore, selected tests are usually simple, quick and not expensive, and will provide a good lead to further diagnostic testing.

The system will default to “initial/screening” testing indication, thereforeonly list of tests under this indication will be shown.

Diagnostic Testing Indication

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

To see listed tests under the diagnostic indication, click on the diagnostic indication to expand. The system will show the list of tests under this indication.

Disease Management Testing Indication

The disease management testing indication also known as “follow up testing” applies to tests used to monitor the treatment and management of disease.

To see listed tests under the disease management indication,lick on the disease management indication to expand. The systemwill show the list of tests under this indication.