Laboratory medicine: over a billion tests, but limited clinical value
The Electronic Health Record 2.0 can make data more measurable, moving from the medical report as a document to the result as structured clinical data
Over 1.13 billion laboratory tests were recorded in 2023, averaging around 19 per inhabitant. This is a huge figure, yet we do not have a unified national overview of the overall costs of diagnostics nor, above all, of its impact on care pathways. It is this gap between volume and value that the National Health Service must learn to bridge.
The Electronic Health Record 2.0 (EHR 2.0) could prove to be a decisive factor. The National Recovery and Resilience Plan (PNRR) has allocated approximately 1.3 billion euros to its development, and the Ministry of Health has stated that, by June 2026, it will have achieved the target of producing at least 90 per cent of the documents covered by the indicator – including laboratory reports – directly in electronic format. However, a digital report does not, in itself, guarantee that individual results are standardised, interpretable and comparable across different laboratories.
Prevention and diagnosis
Laboratory medicine supports individuals throughout their entire lives: it identifies biomarkers for prevention and diagnosis, guides treatment and monitors the response to it. However, its value is not limited to the measurement of individual parameters: it also lies in the ability to correlate different results, track their progression over time and interpret them within a clinical context.
The available figures tell only part of the story. Ministerial surveys do not take into account the work carried out in A&E departments, in the private healthcare sector and in decentralised diagnostic services. Added to this incompleteness is the time lag: we are still using data from 2023 to describe national activity. Furthermore, from an economic perspective, there is no single, consolidated figure that identifies the full cost of laboratory medicine across the various healthcare settings. Fees, recorded expenditure and the actual cost of production measure different phenomena.
For too long, laboratory diagnostics have been assessed primarily in terms of volume, fees and the cost per test: these are necessary indicators, but they are insufficient. Value emerges when timely and reliable information improves diagnosis, prevents inappropriate treatments, guides therapy, reduces complications or hospital admissions, and enhances clinical monitoring. This is the approach of Value-Based Laboratory Medicine: evaluating tests not only on the basis of their cost, but also in terms of the clinical benefits they help to deliver.
