Accelerating Performance With Patho-Pharmacology Support

Reduce Regulatory Risk. Improve Outcomes. Simplify Provider Work.

Physician-owned labs operate in an environment of rising regulatory scrutiny and increasing clinical expectations. Our patho-pharmacology practice integrates board-certified pathologists and clinical pharmacists to ensure every test ordered, resulted, and acted upon is compliant, clinically justified, and easy for providers to use.

1. Assessing Medical Necessity for Molecular Testing

Ensuring every test can withstand audit scrutiny

We review each case against symptoms, documentation, and guidelines to determine when a molecular test is justified—and when a simpler alternative is appropriate.

Examples:

• PCR vs. Culture & Sensitivity (C&S): We identify when PCR is clinically necessary (e.g., nonlocalizing or recurrent infections, need for rapid actionable results, immunocompromised patients) versus when C&S is the correct first-line test.

• Pharmacogenetic Testing (PGx): We evaluate diagnoses, drug classes, adverse events, treatment failures, polypharmacy, and drug–gene risk flags to determine when PGx is warranted under medical-necessity criteria.

• Documentation guidance is provided so your ordering patterns remain audit-proof and defensible.

2. Pathologist-Led Interpretation of Molecular Results

Clear, concise, clinically actionable reporting

Most providers do not have the time—or the training—to interpret molecular diagnostics or understand when a finding should change management. We solve this by providing:

• Structured pathologist interpretations with organism significance, contamination likelihood, resistance markers, and clinical context.

• PGx phenotype translation (e.g., CYP2D6 poor metabolizer → what that means for medication choice or dosing).

• Disease-state–specific commentary so providers understand what matters in seconds.

The result: fewer unnecessary calls, fewer treatment delays, and increased provider confidence in using advanced diagnostics.

3. Antibiotic Streamlining + PGx-Based Pharmacology Recommendations

Eliminating guesswork in complex medication decisions

Our pharmacists and pathologists collaborate to deliver treatment guidance directly tied to the patient’s results, comorbidities, and current medication list.

You receive:

• Recommended first-line vs. alternative agents

• Dose and duration guidance based on age, renal function, and severity

• PGx-aware recommendations (e.g., avoid codeine in CYP2D6 poor metabolizers; adjust antidepressants, antipsychotics, analgesics accordingly)

• Duplicate therapy checks, polypharmacy risk reduction, drug–lab mismatches, and alerts when a selected drug contradicts lab findings

Providers avoid the time, research, and liability of managing complex regimens manually.

4. Closing Gaps in Core Lab Monitoring

Ensuring labs follow national guidelines for chronic disease management

Our reviews continually identify gaps that affect compliance, outcomes, and revenue integrity:

• 53% of chronic-illness patients are missing required monitoring labs(e.g., A1c, TSH, CMP, CBC, lipid panel).

• 38% have outdated abnormal labs, meaning the last disease-related value was abnormal and over 3 months old.

We identify missing tests, outdated tests, and disease-drug mismatches and supply practices with:

• A monitoring plan compliant with national guidelines

• Documentation support for testing frequency

• Alerts when labs indicate the need for medication adjustment or follow-up

• Visibility into risk-adjustment gaps tied to incomplete monitoring

This reduces regulatory exposure, improves CMS/HEDIS compliance, and supports better chronic-disease control.

What This Means for Your Lab

• Higher testing appropriateness

• Defensible ordering patterns under audit

• Greater provider adoption of molecular tests

• Improved outcomes from streamlined therapies

• Better chronic-disease oversight and guideline adherence

• Reduced time burden on physicians

• Increased value of the lab to the practice