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Managing laboratory test ordering through test frequency filtering.

Pim M W Janssens¹, Gerd Wasser

¹Laboratory of Clinical Chemistry and Haematology, Rijnstate Hospital, Arnhem, The Netherlands. pjanssens@rijnstate.nl

Clinical Chemistry and Laboratory Medicine

|March 5, 2013

Summary

Implementing computerized limits to control frequent laboratory testing is feasible and requires minimal effort. This system, managing repetitive diagnostic tests, offers modest financial savings and improves test requestor accommodation over time.

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Area of Science:

Clinical Chemistry
Health Informatics
Laboratory Medicine

Background:

Modern computer systems enable setting limits on repetitive laboratory testing intervals.
Investigated a computerized system to manage potentially overt laboratory testing frequency.
Aimed to calculate the financial savings achieved through this management system.

Purpose of the Study:

To assess the feasibility of a computerized system for managing laboratory testing frequency.
To determine the financial savings resulting from implementing limits on repetitive testing.
To evaluate the acceptance and operational impact of such a system.

Main Methods:

Collaborated with hospital physicians to select tests for 'spare periods' (barring intervals).
Determined spare periods based on analyte variations, clinical context, and logistical needs.
Implemented frequency filtering for 44 tests with individualized spare periods.

Main Results:

The system was explored with 23 analytes and implemented for 44 tests.
0.56% of tests were barred, most commonly total cholesterol, uric acid, and HDL-cholesterol.
Financial savings were 0.33% of total testing costs, with HbA1c, HDL-cholesterol, and vitamin B12 contributing most.

Conclusions:

Computerized limits effectively manage and prevent overtly frequent laboratory testing.
While financial savings were modest, the system requires little effort to sustain.
Findings provide a basis for system improvement and guidance for similar implementations.