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Computerized alert reduced D-dimer testing in the elderly.

Ted E Palen¹, David W Price, Aaron J Snyder

¹Institute for Health Research, Kaiser Permanente of Colorado, PO Box 378066, Denver, CO 80237-8066, USA. ted.e.palen@kp.org

The American Journal of Managed Care

|November 20, 2010

Summary

This summary is machine-generated.

A computerized alert effectively reduced D-dimer testing in elderly outpatients. This targeted intervention showed a lasting impact on diagnostic test utilization in older adults.

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Area of Science:

Clinical Informatics
Diagnostic Testing
Geriatric Medicine

Background:

D-dimer testing is frequently overused in elderly patients.
Reducing unnecessary D-dimer tests can improve healthcare efficiency and patient outcomes.

Purpose of the Study:

To evaluate the effectiveness of an age-specific computerized alert system designed to decrease D-dimer testing in elderly outpatients.
To assess the impact of this alert on the utilization of diagnostic imaging.

Main Methods:

A cluster randomized trial was conducted across 8 ambulatory care clinics.
The study utilized a crossover design, implementing computerized alerts during physician order entry.
Key metrics included D-dimer test rates and venous ultrasonography utilization.

Main Results:

Computerized alerts significantly reduced D-dimer testing rates in elderly patients (≥65 years) in both intervention and control clinics.
The reduction in D-dimer testing persisted throughout the study period.
The ratio of venous ultrasonography to D-dimer tests increased, indicating more appropriate test ordering.

Conclusions:

An age-specific electronic alert is an effective tool for reducing D-dimer testing in elderly outpatients.
The alert system demonstrated a sustained positive impact on diagnostic test ordering practices.
This intervention supports more judicious use of D-dimer testing in geriatric populations.