A referred test formulary can be as simple as a spreadsheet that lists all the tests available to a clinician practice group. The formulary should be made using input from the affected clinicians who order the testing in cooperation with the UM team. The accompanying image is an example of one laboratory's referred test formulary. Notice that the test name (along with any synonyms) is listed, as well as which laboratory the test will be sent to and whether or not the test is restricted. For example, some tests can only be ordered by physicians in the Genetics Department. Also, note that some tests are "Once Per Lifetime." These are tests (almost always genetic tests) that should never be performed more than once on a patient. This column alerts laboratory staff to unneeded duplicate tests that should not be sent out a second time.
In most scenarios, the UM team would own and maintain the referred test formulary. This formulary is an ever-evolving document that needs continual review and updating. When pricing for tests, clinical practice, or the menus of referral labs change, the formulary needs to be updated. Updating the formulary and considering additions to it should be a standing agenda item for any UM team meeting.
