The laboratory is a vital part of the continuum of patient care. In fact, there are few programs in the healthcare system that do not rely on ready access and availability of complex diagnostic laboratory services. The existing transactional model of laboratory “medical practice” will not be able to meet the needs of the healthcare system as it rapidly shifts toward value-based care and precision medicine, which demands that practice be based on total system indicators, clinical effectiveness, and patient outcomes. Laboratory “value” will no longer be focused primarily on internal testing quality and efficiencies but rather on the relative cost of diagnostic testing compared to direct improvement in clinical and system outcomes. The medical laboratory as a “business” focused on operational efficiency and cost-controls must transform to become an essential clinical service that is a tightly integrated equal partner in direct patient care. We would argue that this paradigm shift would not be necessary if laboratory services had remained a “patient-centric” medical practice throughout the last few decades. This review is focused on the essential role of laboratory physicians in transforming laboratory practice and management to a value-based patient-centric model. Value-based practice is necessary not only to meet the challenges of the new precision medicine world order but also to bring about sustainable healthcare service delivery.

实验室是患者护理连续性的重要组成部分。实际上，医疗保健系统中很少有程序不依赖现成的访问和复杂的诊断实验室服务的可用性。实验室“医学实践”的现有交易模型将无法满足医疗保健系统的需求，因为它迅速转向基于价值的护理和精准医学，这要求实践应基于总体系统指标，临床有效性和患者预后。与直接改善临床和系统结果相比，实验室的“价值”将不再主要关注内部测试的质量和效率，而是关注诊断测试的相对成本。作为专注于运营效率和成本控制的“业务”的医学实验室，必须转变为必不可少的临床服务，成为直接患者护理中紧密集成的平等合作伙伴。我们认为，如果在过去的几十年中实验室服务一直是“以患者为中心”的医疗实践，则无需进行这种范式转换。这篇综述着重于实验室医师在将实验室实践和管理转变为以价值为基础的以患者为中心的模型中的重要作用。基于价值的实践不仅对迎接新的精密医学世界秩序的挑战，而且对于实现可持续的医疗保健服务都是必要的。我们认为，如果在过去的几十年中实验室服务一直是“以患者为中心”的医疗实践，则无需进行这种范式转换。这篇综述着重于实验室医师在将实验室实践和管理转变为以价值为基础的以患者为中心的模型中的重要作用。基于价值的实践不仅对迎接新的精密医学世界秩序的挑战，而且对于实现可持续的医疗保健服务都是必要的。我们认为，如果在过去的几十年中实验室服务一直是“以患者为中心”的医疗实践，则无需进行这种范式转换。这篇综述着重于实验室医师在将实验室实践和管理转变为以价值为基础的以患者为中心的模型中的重要作用。基于价值的实践不仅对迎接新的精密医学世界秩序的挑战，而且对于实现可持续的医疗保健服务都是必要的。