The Collective Blog of Health IT, a Podcast Episode Companion
Episode 256- Clinical Decision Support at the Point of Care: Advancing Value-Based Care Through Smarter Laboratory Testing
By: Michael McNutt
As healthcare organizations continue their journey toward value-based care, clinicians face a growing challenge: making increasingly complex laboratory and genomic testing decisions while navigating fragmented data, evolving clinical evidence, and mounting administrative requirements. The question is no longer whether technology should support these decisions, but how it can do so in a way that enhances clinical care without disrupting provider workflows.
That was the focus of the latest episode (#256) of WEDI’s Collective Voice of Health IT. Rachael Hulshizer from Mayo Clinic and Elizabeth Zobel from CareSelect® Lab, explored how clinical decision support (CDS) embedded directly within the electronic health record (EHR) can improve laboratory stewardship, reduce unnecessary variation, and promote more informed clinical decision-making. Dr. Sandy Rolfe from Optum and Julie Brown-Georgi from the AMA served as guest hosts. They are the co-chairs for WEDI’s Genomics and Value-Based Care Workgroups respectively.
Bringing Guidance to the Point of Order
Clinical decision support is most effective when it reaches clinicians at the moment a care decision is being made. Rather than relying on retrospective utilization reviews that occur after a test has already been ordered, point-of-order CDS provides real-time, evidence-based recommendations within the existing EHR workflow.
For laboratory testing, this approach can help clinicians identify the most appropriate test for a patient's specific clinical scenario, recognize duplicate or unnecessary orders, and consider alternative testing options before downstream costs and administrative burden are created. Importantly, the goal is not to replace clinical judgment but to provide relevant information that supports more consistent and informed decision-making.
From Utilization Management to Laboratory Stewardship
The discussion highlighted an important distinction between traditional utilization management and modern clinical decision support. Rather than asking whether a laboratory test should be ordered, CDS helps answer a more meaningful question: Which test is the most appropriate for this patient at this point in their care?
By combining evidence-based recommendations with patient-specific clinical context, organizations can improve ordering practices while generating valuable analytics that identify variation across providers, specialties, and facilities. These insights enable laboratory stewardship programs to continuously refine interventions, improve quality, and reduce unnecessary testing over time.
Interoperability Is the Foundation
One of the strongest themes throughout the discussion was that effective clinical decision support depends on high-quality, structured, and interoperable data.
Standards such as HL7 FHIR and CDS Hooks provide a scalable framework for integrating decision support directly into clinical workflows while reducing reliance on highly customized interfaces. As organizations increasingly adopt standards-based data exchange, clinical guidance can become more consistent, portable, and actionable across health systems.
The speakers also emphasized that interoperability extends beyond exchanging clinical information. Future success will require stronger connections between clinical, operational, and administrative workflows so that providers can make informed decisions without navigating multiple disconnected systems.
Preparing for the Future of Precision Medicine
As genetic and genomic testing becomes more prevalent, the complexity of selecting the appropriate test continues to increase. Evidence evolves rapidly, coverage policies vary across payers, and clinicians often need additional support to determine which test best fits an individual patient's clinical presentation.
Clinical decision support offers an opportunity to bring together clinical guidelines, structured patient data, and administrative requirements into a single workflow, helping clinicians make informed decisions while preserving their professional judgment.
Looking Ahead
The conversation concluded with a clear message for healthcare stakeholders: advancing value-based care requires more than new payment models—it requires better information delivered at the right time.
Organizations should focus on high-impact use cases, prioritize data standardization and interoperability, and ensure that clinical decision support reduces friction rather than adding to alert fatigue. Success should ultimately be measured not only by reduced utilization or cost, but also by improved appropriateness, reduced clinical variation, enhanced stewardship, administrative efficiency, and better patient outcomes.
As healthcare continues moving toward a more connected, data-driven future, clinical decision support will play an increasingly important role in helping clinicians deliver the right care at the right time. By combining evidence-based guidance, interoperable data, and thoughtful workflow integration, organizations can improve both the quality and value of care while supporting clinicians in making the best possible decisions for their patients.
Listen to the full WEDI Podcast, episode 256, to hear practical insights from Mayo Clinic and CareSelect® Lab on how point-of-order clinical decision support is shaping the future of laboratory stewardship, interoperability, and value-based care.