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Format change of a laboratory test order form affects physician behavior
Varda Shalev1, Gabriel Chodick, Anthony D Heymann
1Medical Division, Maccabi Healthcare Services, 27 HaMered Street, Tel Aviv, Israel.
International Journal of Medical Informatics
|June 27, 2009
Summary
Altering computerized laboratory order forms significantly impacts physician test ordering. Modifying the form layout can guide physicians toward more appropriate laboratory test selection, enhancing clinical guideline adherence.
Area of Science:
- Health Informatics
- Clinical Pathology
- Healthcare Management
Background:
- Computerized medical records are widely used in healthcare.
- Physician ordering of laboratory tests can be influenced by system design.
- Optimizing laboratory test utilization is crucial for healthcare efficiency.
Purpose of the Study:
- To determine if modifying the electronic laboratory order form impacts physician test ordering practices.
- To assess the effect of a simplified check-box laboratory order form on physician behavior.
Main Methods:
- A prospective intervention study was conducted with 865 primary healthcare physicians over three years.
- The computerized laboratory order form was redesigned, reducing check-box options from 51 to 26.
- Data on laboratory test orders were analyzed before and after the form modification.
Main Results:
- Tests added to the form saw significant increases in ordering (+60.7% and +90% in consecutive years).
- Unchanged tests showed variable changes (+18.4% and -22.4%), while deleted tests decreased (-27% and -19.2%).
Conclusions:
- The format of laboratory test order forms can effectively alter physician ordering habits.
- Thoughtfully designed order forms can support clinical guidelines for preventive and follow-up testing.
- Form modifications represent a valuable tool for improving the appropriateness of laboratory testing.
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