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The Impact of an Electronic Expensive Test Notification
Jacquelyn D Riley1, Glenn Stanley1, Robert Wyllie1
1Cleveland Clinic, Cleveland, OH.
Objectives:
The impact of clinical decision support tools (CDSTs) that display test cost information has been variable.
Methods:
We retrospectively analyzed the 3-year impact of a passive CDST that notified providers when the test order cost was $1,000 or more. We determined the most common expensive tests ordered, the frequency with which providers abandoned the order after notification, and the costs saved through this intervention.
Results:
The average monthly abandonment rate was 12.5% (2014), 12.9% (2015), and 14.3% (2016). The cost savings from tests not performed for this 3-year period was $696,007. Molecular hematopathology assays were the most frequently ordered tests, with variable abandonment rates.
Conclusions:
Although this CDST was passive (ie, could be overridden at the point of order entry) and was associated with a relatively low abandonment rate, it achieved a considerable cost savings each year since each abandoned test saved the institution $1,000 or more.
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