A single controlled pathway from physician request to go-live and beyond. Covers request submission and departmental endorsement, three-class triage, the in-house versus standing referral decision with the factors that determine it, a ten-domain feasibility assessment, published timelines and an appeal route, full implementation requirements including verification acceptance criteria, reference intervals, critical values and the information system build, a twenty-item go-live authorization checklist, six and twelve month post-implementation review against predicted volume, and a decommissioning pathway