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Enhanced cosyntropin stimulation test performance enabled by electronic medical record.
Anat Ben-Shlomo1, Joseph Guzman2, James Mirocha3
1Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Davis Building, Room 3021, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA. anat.benshlomo@cshs.org.
Implementing an electronic medical record (EMR) system protocol significantly improved the accuracy of the cosyntropin stimulation test (CST) for diagnosing adrenal-cortisol insufficiency, reducing errors and saving costs.
Area of Science:
- Endocrinology
- Clinical Diagnostics
- Health Informatics
Background:
- Adrenal-cortisol insufficiency diagnosis relies on the cosyntropin stimulation test (CST).
- Accurate CST performance is crucial for reliable diagnosis.
- Previous CST protocols faced challenges in consistent medical staff adherence.
Purpose of the Study:
- To enhance the performance of the cosyntropin stimulation test (CST) for diagnosing adrenal-cortisol insufficiency.
- To implement an electronic medical record (EMR) system protocol to standardize CST procedures.
Main Methods:
- A SmartForm protocol for the validated CST was integrated into an EMR system (CS-Link™, EPIC).
- Medical staff performance of the CST was compared before and after the EMR protocol implementation.
Main Results:
- Correct CST performance significantly increased from 16.1% to 53.5% post-EMR implementation (p < 0.0001).
- Incorrect or uninterpretable CSTs decreased from 36.2% to 7.1% (p < 0.0001).
- This improvement yielded an estimated cost saving of $50,414 per 100 tests.
Conclusions:
- EMR systems effectively guide medical staff in accurate CST performance.
- Implementation reduces test wastage and optimizes staff time and resources.
- EMR protocols enhance diagnostic accuracy and cost-efficiency for the CST.
