Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory

Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. •Laboratory test overutilization is 2.9% to 56% of all lab tests ordered.•Guidelines may have a positive publication bias.•Choosing Wisely is 35 medical subspecialty groups targeting overused tests or therapies.•Utilization of disruptive technologies requires time for appropriate use to be established.•Client test utilization by speciality can help predict needs to meet future outreach growth.