The Impact of an Electronic Expensive Test Notification

Area of Science:

• Health Informatics
• Health Economics
• Clinical Decision Support

Background:

• Clinical decision support tools (CDSTs) integrating cost information have shown variable impacts on healthcare spending.
• Effective strategies are needed to manage the cost of diagnostic testing in clinical practice.

Purpose of the Study:

• To evaluate the 3-year impact of a passive CDST designed to alert providers about high-cost laboratory tests (≥$1,000).
• To assess the effectiveness of cost-awareness interventions in reducing unnecessary diagnostic test utilization.

Main Methods:

• Retrospective analysis of a passive CDST implemented over three years.
• Tracking provider order abandonment rates following cost notifications.
• Identifying the most common expensive tests and calculating overall cost savings.

Main Results:

• The average monthly test order abandonment rate increased from 12.5% in 2014 to 14.3% in 2016.
• Total cost savings reached $696,007 over the 3-year study period.
• Molecular hematopathology assays were frequently ordered, with varied provider responses to cost alerts.

Conclusions:

• A passive CDST, even with a low abandonment rate, can achieve substantial cost savings by increasing provider awareness of test expenses.
• The intervention demonstrated a positive return on investment, saving over $1,000 per abandoned test order.
• Passive cost-displaying CDSTs represent a viable strategy for healthcare cost containment in diagnostic testing.