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A simple, focused, computerized query to detect overutilization of laboratory tests.

Jamie A Weydert1, Newell D Nobbs, Ronald Feld

  • 1Department of Pathology, University of Iowa, Iowa City, IA, USA. jamie-weydert@uiowa.edu

Archives of Pathology & Laboratory Medicine
|August 27, 2005
PubMed
Summary

A computerized query effectively identified overutilization of serum sodium tests in hospitalized patients. This method helps institutions monitor and reduce unnecessary laboratory test ordering.

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Area of Science:

  • Clinical Pathology
  • Health Informatics
  • Healthcare Management

Background:

  • Laboratory test overutilization is a widely acknowledged issue in healthcare.
  • Quantifying and monitoring test overutilization within institutions remains challenging.

Purpose of the Study:

  • To develop and validate a method for detecting repetitive daily ordering of serum sodium tests.
  • To document the extent of overutilization of this common laboratory test.

Main Methods:

  • A retrospective computerized query identified inpatients with 4+ consecutive normal serum sodium results.
  • The query focused on a 1-month period, followed by chart review for validation.
  • Medical necessity documentation for repeat testing was assessed.

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Main Results:

  • 116 patients met the criteria, accounting for 5.1% of monthly serum sodium tests.
  • Chart review showed a lack of documented medical necessity for repeat orders.
  • Repeat serum sodium orders often continued until hospital discharge.

Conclusions:

  • A focused data query from a clinical repository can effectively detect and document laboratory test overutilization.
  • This approach provides a reliable method for institutions to monitor test ordering practices.