Optimize Your Electronic Medical Record to Increase Value: Reducing Laboratory Overutilization.

Area of Science:

• Health Informatics
• Clinical Laboratory Science
• Healthcare Management

Background:

• Overutilization of laboratory testing contributes to increased healthcare costs.
• Electronic ordering systems can facilitate inefficient testing practices, such as daily recurring orders without review.
• Optimizing laboratory test ordering is crucial for efficient patient care and resource allocation.

Purpose of the Study:

• To decrease overutilization of laboratory testing.
• To eliminate a feature in the electronic ordering system that permitted daily laboratory test orders without provider review.

Main Methods:

• A retrospective analysis of laboratory test utilization rates was conducted before and after an intervention.
• The intervention involved removing the capability for daily recurring laboratory test orders from the electronic system.
• Provider surveys were used to assess their experience with the system modification.

Main Results:

• The study analyzed over 1.2 million laboratory tests across nearly 93,000 patients.
• Before the intervention, 33% of target tests were ordered using the daily recurring mechanism.
• Post-intervention, a significant reduction in tests per patient per day was observed, ranging from 8.5% to 20.9% (P <.001), leading to an estimated $300,000 cost saving.

Conclusions:

• A straightforward modification to the electronic order entry system can significantly and immediately change provider ordering practices.
• This strategy is highly replicable in hospitals utilizing similar electronic health record systems.
• Further research should explore the impact of combining this intervention with education and real-time decision support tools.