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A minimalist electronic health record-based intervention to reduce standing lab utilisation
Kuo-Kai Chin1, Amrita Krishnamurthy2, Talhah Zubair1
1Stanford University School of Medicine, Stanford, California, USA.
Background:
Repetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive.
Objective:
To evaluate the effect of a minimally restrictive EHR-based intervention on utilisation.
Setting:
One year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU).
Intervention:
Providers were required to specify the number of times each test should occur instead of being able to order them indefinitely.
Measurements:
For eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured.
Results:
Utilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU.
Conclusions:
Requiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.
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