Developing a value proposition for high-sensitivity troponin testing

Laboratories are looking for ways that they can identify and deliver value through their service rather than just provide high quality test results. One way to demonstrate value has been described in the form of a value proposition where the application of a laboratory test is described explicitly in terms of the process of care and the patient outcomes. We have applied this concept to the use of high sensitivity troponin assays for the assessment of patients with suspected acute coronary syndrome. From a previously described framework we use a checklist to describe the various steps in the complete intervention or clinical pathway, demonstrating how the test should be used, highlighting key evidence in the literature that supports the intervention and list some of the measures which can be used to assess how well the intervention is being adopted and implemented. While the value proposition concept is based on the foundations of evidence based medicine it also requires collaboration between the laboratory and other stakeholders including clinicians to ensure that appropriate resources are applied across the complete clinical pathway in order to ensure its effectiveness.