Laboratory Medicine: Challenges and Opportunities (Opinion‪)‬

During the last decade, business has undergone fundamental changes (1) as the world economy has become more global and competition has grown. Reliance on information technology has increased along with exponential growth of internet-driven processes. The knowledge economy, described by Cooke as "knowledge working on knowledge to create value" (2), has become a key economic driver (3) and is critical for global competitiveness. Laboratory medicine, the medical specialty that deals with testing of specimens from patients and consulting with physicians who order the tests, has undergone major transformations during the last decade (4). Ongoing technological developments have considerably improved the productivity of clinical laboratories. Information on laboratory services is globally available, and clinical laboratories worldwide face international competition and a huge pressure to reduce costs. Clinical laboratory services have been increasingly commoditized. Moreover, there is a gap between what is technically possible on the one hand and the available financial resources on the other. In this report we reflect on how current and anticipated developments may affect the future of laboratory medicine and how one can deal with these changes. We propose that the clinical laboratory industry should imitate the trend in other industries toward networks, consolidation, integration, outsourcing, and emphasis on core competencies and, more importantly, create additional value by providing knowledge services related to in vitro diagnostic services.